死亡质量排名:英国位居全世界第一

Britain may not be the best place to live, but it is the best place to die.

英国可能不是最适宜居住的地方，但却是最适合死的地方。

The Economist Intelligence Unit (EIU) ranked the country first in its latest quality-of-death index, which uses 20 quantitative and qualitative indicators to measure the effectiveness of end-of-life care in 80 countries. The measures include the the quality of palliative care, affordability, the health care environment, and community engagement.

《经济学人》信息部在其最新的"死亡质量指数"排名上将英国排在第一位，这一指数运用20个定量和定性指标，对80个国家的临终关怀效率进行分析。这些指标包括临终关怀质量、经济负担能力、医疗环境和社会参与度。

How we die is becoming a critical topic as populations live longer, often with multiple diseases requiring complex (and costly) management. Developing countries in particular grapple with how to deliver basic pain relief to the dying. Some have seen notable improvements in recent years: Uganda has dramatically increased the availability of morphine through a public-private partnership between the health ministry and Hospice Africa, a British charity.

随着人类寿命的延长，各种疾病要求很复杂（且昂贵）的护理，如何度过生命的最后时光正逐渐成为一个重要问题。发展中国家更是苦于如何为病危的人提供缓解痛苦的服务。有些国家近几年取得了一些显著的进步：在乌干达，当地卫生部与英国慈善机构非洲临终关怀中心建立了公私合作关系，极大地推广了吗啡在非洲的使用。

Not surprisingly, rich countries generally did better than poor ones in the rankings. But there are noteworthy variations: the US came in ninth place with a score of 80.8 (out of 100), far below the 93.9 score achieved by Britain, where complaining about health care is as popular as grumbling about the weather.

不出所料，富裕的国家通常都比贫穷的国家排名靠前，但也有些值得注意的变化：美国以80.8分（100分制）排名第九，远低于英国的93.9分，主要原因是美国的医疗卫生系统饱受诟病。

Costa Rica ranks top among middle-income countries, thanks in part to extensive volunteer networks that support public services, according to the EIU.

哥斯达黎加在中等收入国家中排名第一，据EIU分析，这一结果部分得益于该国广泛的志愿者系统为公共服务提供了很多支持。

The most striking finding in the report is that Mongolia, a poor country with few provisions for end-of-life care in 2000, now leads the low-income countries with a score of 57.7, which puts it 28th overall, above a host of more advanced economies. It "overachieves by some margin given its resources," according to the EIU.

报告中最令人惊讶的是蒙古，它在2000年时还是一个对临终关怀投入很少的贫穷国家，现在却得分57.7，在低收入国家中位居第一，总排名28，超过了许多更先进的国家。EIU的报告称，"鉴于蒙古的资源状况，该国真是超额完成了任务。"

Remarkably, Mongolia's performance is largely attributed to the work of a single doctor, Odontuya Davaasuren, a pediatrician who learned about the latest advancements in end-of-life care at a conference in Sweden and brought some of the ideas back to her home country. When Davaasuren set up the Mongolian Palliative Care Society (MPCS) in 2000, the country had no hospices or palliative care teaching programs. "We did not even have the terminology for palliative care," she says.

值得一提的是，蒙古取得如此骄人的成绩，很大程度上要归功于一位医生的努力。她叫Odontuya Davaasuren，是一名儿科医生，她在瑞典的一次医学会议上了解到了临终关怀的最新进展，并把一些观念带回了祖国。2000年，Davaasuren医生创立了蒙古临终关怀中心，当时整个国家都没有临终关怀的教育体系。"我们当时甚至都没有临终关怀的专业术语，"Davaasuren医生说道。

According to the EIU, her work helped establish 10 palliative-care facilities in Ulaanbaatar, with provincial hospitals also now able to accommodate patients in need of such care. Palliative care is now included in health and welfare legislation, and taught at medical schools. Affordable morphine is now available and prescribed more widely. The country is also now expanding non-cancer and pediatric palliative-care services, in addition to "outpatient consultation and nursing, home care, and spiritual and social services," Davaasuren says.

EIU的报告称，在Davaasuren医生的努力下，乌兰巴托成立了10家临终关怀中心，各省级医院也能够为病人提供此类服务。临终关怀现已被纳入健康和福利立法当中，各医学院校也开设了相关课程。价格亲民的麻醉剂应用越来越广泛，规定也更加宽泛。蒙古还推行非癌症和儿童疗养服务，除此之外，"门诊会诊、普通护理、家庭护理、精神和社会服务也在进行。"Davaasuren医生说道。

In spite of recent progress around the world, the EIU notes that experts estimate that globally less than 10 percent of people who require end-of-life care actually receive it.

尽管近年来全球在临终关怀方面取得了进步，但是EIU指出，专家估计，全球只有不到10%的人真正得到了所需的临终关怀。