复合题

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 mediation 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 1icense suspension.”

单选题 From the first three paragraphs, we learn that _____.
【正确答案】 B
【答案解析】参考文章第二段首句“there is no constitutional right to physician-assisted suicide”， 由此可知， 法院在判决中承认医生协助病人自杀不是宪法赋予的权利， 对应题目中的B选项。 而文章第三段提到， 近年来， 医生一直使用这一原则为他们大剂量使用吗啡来控制临死病人的疼痛进行辩护， 可见， 这一做法一直存在着， 故A选项错误。 文章二段提到“the Court in effect supported the medical principle of ‘double effect’”， 由此可推断C选项表述有误。 D选项未在文中提及， 可排除。
单选题 Which of the following statements is true according to the text?
【正确答案】 C
【答案解析】根据文章第二段首句“the Court in effect supported the medical principle of “double effect””可知， 其实法院对“双重效果”的原则表示了支持， 而第三段又提到， 近年来许多医生以此为由为他们在临危病人身上大量使用吗啡这一行为作辩护， 从而可推断， 法院是支持医生大量使用镇痛药物的， 所以正确答案为C选项。
单选题 According to the NAS’s report, one of the problems in end-of-life care is _____.
【正确答案】 B
【答案解析】根据题干关键词“NAS’s report”和“end-of-life care”定位第七段。 全国科学院发布的报告中明确提到了临终关怀的两个问题分别是 “the undertreatment of pain”和“the aggressive use of ‘ineffectual and forced medical procedures that may prolong and even dishonor the period of dying’”。 因此B选项“inadequate treatment of pain”（对病痛的处理不力） 是提到的问题之一。
单选题 （对病痛的处理不力） 是提到的问题之一。Which of the following best defines the word “aggressive” (Line 1, Paragraph 8)?
【正确答案】 A
【答案解析】根据题干关键词“aggressive”可定位至文章第七段， 联系其修饰的名词use后的“ineffectual and forced medical procedures that may prolong and even dishonor the period of dying”， 由此可推断， aggressive意为“大胆的， 鲁莽的”与A选项中的bold相对应， 表示“大胆的， 冒失的”。
单选题 George Annas would probably agree that doctors should be punished if they _____.
【正确答案】 D
【答案解析】根据文章最后一段可知， Annas所关注的是病人的疼痛能否得到有效的处理， 为了解决这一问题， 他认为医生可以采取任何必要的措施和手段， 但是， 面对诸如“the pain their patients are needlessly and predictably suffering”这一类的情况， 医生应当受到处罚， 所以D选项为正确答案。