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  3. 共用题干 Double EffectThe Supreme Court's decisions on physician-assisted suici...

共用题干 Double EffectThe Supreme Court's decisions on physician-assisted suici...

admin2020-12-24  42
问题 共用题干
Double Effect
The Supreme Court's decisions on physician-assisted suicide carry important implications for how medicine seeks to relieve dying patients of pain and suffering.
Although it ruled that there is no constitutional right to physician-assisted suicide,the Court in effect supported the medical principle of"double effect",a centuries-old moral principle holding that an action having two effects-a good one that is intended and a harmful one that is foreseen-is permissible if the actor intends only the good effect.
Doctors have used that principle in recent years to justify using high doses of morphine to control terminally ill patients'pain,even though increasing dosages will eventually kill the patient.
Nancy Dubler,director of Montefiore Medical Center,contends that the principle will shield doctors who"until now have very,very strongly insisted that they could not give patients sufficient mediation to control their pain if that might hasten death."
George Annas,chair of the health law department at Boston Univeisity,maintains that,as long as a doctor prescribes a drug for a legitimale medical purpose,the doctor has done nothing illegal even if the patient uses the drug to hasten death."It's like surgery,"he says."We don't call those deaths homicides because the doctors didn't intend to kill their patients,although they risked their death.if you're a physician,you can risk your patient's suicide as long as you don't intend their suicide."
On another level,many in the medical community acknowledge that the assisted-suicide debate has been fueled in part by the despair of patients for whom modern medicine has prolonged the physical agony of dying.
Just three weeks before the Court's ruling on physician一assisted suicide,the National Academy of Science(NAS)released a two-volume report,Approaching Death:Improving Care at the End of Life.It identifies the under-treatment of pain and the aggressive use of"ineffectual and forced medical procedures that may prolong and even dishonor the period of dying" as the twin problems of end-of-life care.The profession is taking steps to require young doctors to train in hospices,to test knowledge of aggressive pain management therapies,to develop a Medicare billing code for hospital-based care,and to develop new standards for assessing and treating pain at the end of life.
Annas says lawyers can play a key role in insisting that these well-meaning medical initiatives translate into better care."Large numbers of physicians seem unconcerned with the pain their patients are needlessly and predictably suffering,"to the extent that it constitutes"systematic patient abuse." He says medical licensing boards"must make it clear that painful deaths are presumptively ones that are incompetently managed and should result in license suspension."
选项 George Annas would probably agree that doctors should be punished if they______.
A:manage their patients incompetently
B:give patients more medicine than needed
C:reduce drug dosages for their patients
D:prolong the needless suffering of the patients
答案D
解析文章第一段说：最高法院对于医生协助病人自杀的裁决对如何使用药物来减轻晚期病人的痛苦有着重大的意义。第二段说：尽管宪法没有赋予医生帮助病人自杀的权力，法院实际上支持率医疗界的“双效”原则。第三段说：医生们正是借用这个原则，为大剂量地给晚期( terminally ill）病人注射吗啡提供正当的理由，尽管增加剂量将最终致使病人死亡。由此从第二段可推断出，B项“医生们帮助病人自杀仍是非法的”为正确答案。其他三项均与文意不符。
文章第二段说：法院实际上支持医疗界的“双效”原则。第三段又说：医疗界正是借用这个原则，为大剂量地给晚期病人注射吗啡提供正当的理由，尽管增加剂量将最终导致病人死亡。由此可知，法庭实际上同意给病人开大剂量的止痛药。这与C项意思相符。其他三项均与文意不符。
第七段中提到“NAS的报告指出了对临终病人的护理存在着两个问题：一是治疗病痛不力（under-treatment of pain)，二是对无效且有强制性的医疗程序的大胆使用（the aggressive use of ineffectual and forced medical procedures)"。据此可知，B项内容正确。
aggressive的意思有“咄咄逼人的，好斗的；攻击性的，侵略的；有闯劲的，大胆的”，根据上下文，aggressive在这里应为“大胆的”，所以选A0
在文章最后一段中，Annas指出：许多医生对病人所受的不必要的痛苦漠不关心，甚至到了“系统地虐待病人”的程度，并指出病人痛苦地死亡如果被认为是医生护理不力的后果，那就应该吊销他们的行医执照。D项“延长病人不必要的痛苦”为正确答案，因为Annas认为吊销医生执照的前提是导致病人痛苦地死亡。
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