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共用题干 Physician-assisted Suicide1.The Supreme Court's decisions on physician...

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问题 共用题干
Physician-assisted Suicide

1.The Supreme Court's decisions on physician-assisted suicide carry important implications forhow medicine seeks to relieve dying patients of pain and suffering.
2.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一a good one that is intended and a harmful one that is foreseen一is permissible if the actor intends only the good effect.
3.Doctors have used that principle in recent years to justify using high dose of morphine to control terminally ill patients' pain,even though increasing dosages will eventually kill the patient.
4.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 medication to control their pain if that might hasten death.
5.George Annas,chair of the health law department at Boston University,maintains that, as long as a doctor prescribes a drug for a legitimate medical purpose,the doctor has done nothingillegal even if the patient uses the drug to hasten death."It's like surgery,"he says."We don't callthose 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 theirsuicide."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.
6.Just three weeks before the Court's ruling on physician-assisted suicide,the National Academy of Science(NAS)released a two-volume report,Approaching Death:Improving Care atthe 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.
7. The profession is taking steps to require young doctors to train in hospices（临终关怀医院）, 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 trans-late into better care.
选项 According to the NAS,one of the problems in end-of-life care is________.
A:help the dying end their lives
B:can be prescribed
C:the needless suffering of the patients
D:the helplessness of the patients
E:inadequate treatment of pain
F: prescribe a drug
答案E
解析本段的第一句decisions on physician-assisted suicide即是主题句，法庭对医生辅助自杀所做的决定。答案为C。
第二段中间讲到the medical principle of " double effect"，医助自杀的双重效应：有益的和有害的两个方面，这也是本段的主要内容，所以选F。
第三段提到了一个实例，借此说明医助自杀带来的双重效果，医生使用高剂量的吗啡控制在帮助晚期病人减轻痛苦的同时，过高的剂量又会导致病人丧命。所以选项 A正确。
本段谈到了该原则对医生的保护，这些医生认为既然药物会加速病人的死亡，他们就不能给病人开足量的药物来减轻他们的痛苦，故选D。
法庭裁定，医生开出的高剂量的镇痛药只要是出于正当的医疗目的就是合法的（for a legitimate medical purpose)，可以推断医生能够开处方。所以选择B。
第六段提到了NAS的两卷报告，提到Improving Care at the End of Life（改进临终关怀服务），即under-treatment of pain，可以看出临终服务的问题之一是对病痛医治的不足，故选E。
第六段中间的另外一个问题是the aggressive use of "ineffectual and forced medical procedures that may prolong and even dishonor the period of dying"。对于这个l'q题，医生应该受到惩罚，故应选选择C。
第二段第一句指出there is no constitutional right to physician-assisted suicide，即医生帮助病人自杀是违法的，故选A。
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