Answers:
Dan is very close. I believe this is something the Rev. Dimsdale is saying to Roger Collingsworth who is a physician taking care of him (among other plot twists). The Rev. is troubled by the secret he has been hiding for years and is ready to unburden himself from the eartly part of his torments and face the spritual, eternal consequences for his transgressions he knows he will have to endure. He is now, finally, more willing to let his ailing body die and be rid of all the earthly messes he has created and go to his eternal fate than have the doctor prove how skillful he is by continuing to prolong his life.
It sounds like the speech of a sick and dying person to a physician, with the more brief meaning of "Rather than work your physician's skills on me, let me die now, so that all of my problems will remain here on earth while my spirit goes on to Heaven."
It's been a while since I read the Scarlet Letter. Is this Hester speaking? To whom is she speaking? Was her husband a doctor? I think the first answer on here is on the right track. If it's her husband she's speaking to then I think she doesn't want him to try to help her. If it's Rev. Dimsdale, then the same answer since it's his fault she's had all of her trouble.
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