单选题 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 medication to control their pain if that might hasten death."
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 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-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 undertreatment 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./

单选题 From the first three paragraphs, we learn that ______.
A. doctors used to increase drug dosages to control their patients' pain
B. it is still illegal for doctors to help the dying end their lives
C. the Supreme Court strongly opposes physician-assisted suicide
D. patients have no constitutional right to commit suicide

【正确答案】 B

【答案解析】这是一道归纳题。题干中的信号词为the first three paragraphs，也就是文章的前面三段。文章前面三段指出：最高法院就医生协助的自杀所作的裁决对医学界如何寻求解除垂死病人的痛苦与苦难具有重要的意义；尽管最高法院裁定宪法没有赋予医生有协助病人自杀的权力，但是，最高法院实际上支持一条流传了几个世纪道德准则。这说明，最高法院认为，医生没有协助病人自杀的权力。B说“医生帮助垂死病人结束生命仍然是违法的”，这与文章的意思相符。文中是说“近几年来，医生已经利用这一原则来为自己使用大剂量的吗啡控制晚期病人的痛苦而辩护”，并没有说医生过去常利用增加药量的方法来减轻病人的痛苦，所以A不对。文中是说“最高法院实际上支持双重效应的医疗准则——如果行动者只想要良好的效果，那么一种具有双重效果的行为就是可以容许的”，这说明C不对。文中是说“最高法院裁定宪法没有赋予医生有协助病人自杀的权力”，并没有说宪法没有赋子病人自杀的权力，所以D不对。

单选题 Which of the following statements is TRUE according to the passage?
A. Doctors will be held guilty if they risk their patients' death.
B. Modern medicine has assisted terminally ill patients in painless recovery.
C. The Court ruled that high-dosage pain-relieving medication can be prescribed.
D. A doctor's medication is no longer justified by his intentions.

【正确答案】 C

【答案解析】这是一道细节题。文章第二、三段指出：尽管最高法院裁定宪法没有赋予医生有协助病人自杀的权力，但是，最高法院实际上支持“双重效应”的医疗准则——如果行动者只想要良好的效果，那么一种具有双重效果的行为就是可以容许的；近几年来，医生已经利用这一原则来为自己使用大剂量的吗啡控制晚期病人的痛苦而辩护，尽管加大剂量最终会导致病人死亡。这说明，最高法院认为，医生可以使用大剂量药物来减轻晚期病人的痛苦。C说“法院裁定，医生可以开大剂量减轻病痛的药物”，这与文章的意思相符。A与文章第五段的意思不符。文章第六段指出；医学界许多人都承认，有关协助病人自杀的争论一部分是由病人的绝望而引起的，因为现代医学延长了这些病人垂死时肉体所承受的极大痛苦；这说明B不对。D明显与文章第二段的意思不符。

单选题 According to the NAS's report, one of the problems in end-of-life care is ______.
A. prolonged medical procedures B. inadequate treatment of pain
C. systematic drug abuse D. insufficient hospital care

【正确答案】 B

【答案解析】这是一道细节题。题于中的信号词为report，出自于文章第七段中。文章第七段指出：就在最高法院对医生协助病人自杀作出裁决的三个星期之前，国家科学院发表了一份两册的报告；该报告认为，对病人的痛苦处理不足和大胆使用“可能延长甚至不尊重死亡时期的无效的强制性医疗手段”是临终护理存在的两个问题。这说明，国家科学院的报告认为，对病人的痛苦处理不足是临终护理存在的问题之一。B说“缺乏对痛苦的医治”，这与文章的意思相符。文中提到prolonged时是说“大胆使用‘可能延长甚至不尊重死亡时期的无效的强制性医疗手段’是临终护理存在的问题之一”，这说明A不是临终护理存在的问题之一。文章最后一段指出：许多医生似乎对病人遭受的不必要的、可以预见的痛苦漠不关心，甚至到了有计划地虐待病人的程度；但这并不是临终护理存在的问题，所以C不对。文中是说“临终护理对病人的痛苦处理不足是存在的问题”，并没有说医院的护理不适当是存在的问题，所以D不对。

单选题 Which of the following best defines the word "aggressive" (Paragraph 7)?
A. Bold. B. Harmful. C. Careless. D. Desperate.

单选题 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

【正确答案】 D

【答案解析】这是一道细节题。题干中的信号词为George Annas，出自于文章最后一段第一句话中。文章最后一段指出：安纳斯说，许多医生似乎对病人遭受的不必要的、可以预见的痛苦漠不关心，甚至到了有计划地虐待病人的程度；他还说，医师执照颁发委员会必须明确，如果痛苦的死亡被推测是因为治疗不得力而造成的，那么这样的死亡应当造成吊销执照的后果。这说明，安纳斯认为，如果医生造成病人痛苦的死亡，那么应当吊销他们的执照。D说“延长病人不必要的痛苦”，这与文章的意思相符。A和B不是乔治·安纳斯的观点；文中没有提到C。