Shortening them will save more than personal misery. In Britain a kidney transplant, which lasts for 10 to 13 years on average, starts saving the National Health Service (nhs) money compared with the cost of dialysis in the third year. In America a transplant saves $60,000 per year compared with remaining on dialysis. (In poor countries few people can a?ord dialysis, and so cannot wait for a deceased donor, meaning no waiting lists.)

將腎捐獻(xiàn)等待名單縮短會(huì)比個(gè)人痛苦節(jié)省更多資金。在英國(guó)，一次可作用平均10-13年的腎移植移植手術(shù)費(fèi)用與透析治療費(fèi)用相比，從第三年便開(kāi)始為國(guó)民健康服務(wù)(nhs)省筆錢(qián)。在美國(guó)，與繼續(xù)透析相比，腎移植每年可節(jié)省6萬(wàn)美元。(但是在貧窮國(guó)家，很少有人能負(fù)擔(dān)得起透析，所以不能等待一位已故的捐贈(zèng)者，這意味著沒(méi)有等待名單)。

Roughly two-thirds of kidney transplants in rich countries are from deceased donors (see chart on next page). The rest are from living donors who part with a kidney to help someone. One kidney can perfectly well manage the job of the two that most people are born with.

在富裕國(guó)家，大約三分之二的腎臟移植來(lái)自已故的捐贈(zèng)者（看表格）。其余的來(lái)自活體捐贈(zèng)者，他們捐出一個(gè)腎來(lái)幫助別人。一個(gè)腎可以很好地實(shí)現(xiàn)大多數(shù)人與生俱來(lái)的兩個(gè)腎所帶來(lái)的功能。

Historically, northern European countries have promoted kidney donations from living donors. Southern Europeans have had reservations about the unnecessary surgery involved. Instead they have sought ways to increase donations from the dead. In Spain just 15% of families refuse to donate the organs of relatives who die; in Britain a third say no. Some are unsure what the deceased person wanted; others think that doctors might not do all they can to save their loved one if they can take the organs. Cultural differences play a role, too. Most Japanese, for example, feel uneasy about the idea of taking organs out of a dead body.

從歷史上看，北歐國(guó)家一直提倡活體捐贈(zèng)者捐獻(xiàn)腎臟。南歐國(guó)家對(duì)這項(xiàng)不必要的手術(shù)持保留意見(jiàn)。相反，他們?cè)O(shè)法增加死者的捐款。在西班牙，只有15%的家庭拒絕捐贈(zèng)死亡親屬的器官;在英國(guó)，三分之一的人拒絕捐獻(xiàn)。有些人不確定死者的想法;另一些人認(rèn)為，如果醫(yī)生能夠摘取這些器官，他們可能不會(huì)盡其所能來(lái)拯救他們所愛(ài)的人（個(gè)人認(rèn)為是擔(dān)心醫(yī)生不能很好的做手術(shù)而造成死亡，再把亡者器官捐獻(xiàn)出去）。文化差異也是一個(gè)原因。例如，大多數(shù)日本人對(duì)于從尸體中取出器官的想法感到不安。

By and large more people say they want to donate than actually volunteer to add their names to a donor registry. This has encouraged more countries to follow Spain, which has the world’s highest organ-donor rate and in 1979 became the first country to introduce a law making organ donation upon death the presumed choice of anyone who has not registered to opt out. England, France and the Netherlands recently changed their laws to that effect; Australia and several other countries are debating the idea.

總的來(lái)說(shuō)，表示愿意（有意向）捐出自己的器官的人比自愿將自己的名字加入捐贈(zèng)登記的人要多。這鼓勵(lì)了更多的國(guó)家效仿西班牙。西班牙擁有世界上最高的器官捐獻(xiàn)率，并在1979年成為第一個(gè)引入專(zhuān)門(mén)的器官移植法律的國(guó)家，該法律規(guī)定，沒(méi)有登記的人可以選擇在死后捐獻(xiàn)器官。英國(guó)、法國(guó)和荷蘭最近為此修改了法律;澳大利亞和其他幾個(gè)國(guó)家正在討論這個(gè)想法。

詞匯

Registry/ ?注冊(cè)；登記處；掛號(hào)處；

opt out/決定退出；插播；請(qǐng)求免除

But in practice these new laws may not make much difference. In Spain, for a decade after 1979, donations did not increase. They did so only after other measures were introduced: a new transplant co-ordination hub; intensive-care doctors and nurses were trained in organ donation; and looking out for potential donors became the norm. Croatia copied the Spanish model (rebranding it “the Croatian model”) and saw organ transplants more than double between 2007 and 2011.

但在實(shí)際中，這些新法律可能不會(huì)產(chǎn)生多大改變。在西班牙，1979年后的10年里，捐款沒(méi)有增加。只有在其他措施出臺(tái)之后，他們才會(huì)這么做:建立一個(gè)新的移植協(xié)調(diào)中心;加強(qiáng)護(hù)理醫(yī)生和護(hù)士接受器官捐贈(zèng)方面的培訓(xùn);尋找潛在的捐贈(zèng)者成為了一種常態(tài)?？肆_地亞復(fù)制了西班牙的模式(將其重新命名為“克羅地亞模式”)，在2007年至2011年間，該國(guó)的器官移植數(shù)量增加了一倍多。

詞匯

intensive-care/重病特別護(hù)理

All but a few presumed-consent countries still give next-of-kin a final say, as an extra safeguard (and to avoid an outcry from critics of organ donation). Mark Murphy, the outgoing head of the European Kidney Patients Federation, sees the fuss around presumed consent as a distraction. Politicians, he says, prefer to blame the organ shortage on bereaved people than to invest in the logistics and incentives proven to increase transplants.

除了少數(shù)幾個(gè)假定捐獻(xiàn)人同意同意的國(guó)家，其他所有國(guó)家仍然給予近親最后發(fā)言權(quán)，作為額外的保障(同時(shí)也避免了器官捐贈(zèng)批評(píng)者的強(qiáng)烈抗議)。即將離任的歐洲腎病患者聯(lián)合會(huì)(European Kidney Patients Federation)主席馬克?墨菲看到圍繞“假定捐獻(xiàn)人同意”一說(shuō)的紛爭(zhēng)。他說(shuō)，政客們更愿意將器官短缺歸咎于失去親人的人（不愿意捐獻(xiàn)），而非注重建設(shè)腎臟儲(chǔ)備和腎臟捐獻(xiàn)鼓勵(lì)政策，但是這些政策已被證實(shí)能夠增加腎移植的數(shù)目。

詞匯

Safeguard/保護(hù)；保衛(wèi)

Fuss/ 大驚小怪

Outcry/強(qiáng)烈抗議；

Consent/同意；贊成；答應(yīng)

Bereaved/喪失的；死了…的

Logistics/后勤；物流