填空题Mike and Adam Hurewitz grew up together on Long Island, in the
suburbs of New York City. They were very close, even for brothers. So when
Adam's liver started failing, Mike offered to give him half of his. The
operation saved Adam's life. But Mike, who went into the hospital in seemingly
excellent health, developed a complication—perhaps a blood colt—and died last
week. He was 57. Mike Hurewitz's death has prompted a lot of soul searching in
the transplant community. Was it a tragic fluke or a sign that transplant
surgery has reached some kind of ethical limit? The Mount Sinai Medical Center,
the New York City hospital where the complex double operation was performed, has
put on hold its adult living donor liver transplant program, pending a review of
Hurewitz's death. Mount Sinai has performed about 100 such operations in the
past three years. A 1-in-100 risk of dying may not seem like
bad odds, but there's more to this ethical dilemma than a simple ratio. The
first and most sacred rule of medicine is to do no harm. "For a normal healthy
person a mortality rate 1% is hard to justify," says Dr. John Fung, chief of
transplantation at the University of Pittsburgh Medical Center. "If the rate
stays at 1%, it's just not going to be accepted." On the other hand, there's an
acute shortage of traditional donor organs from people who have died in
accidents or suffered fatal heart attacks. If family members fully understand
the risks and are willing to proceed, is there any reason to stand in their way?
Indeed, a recent survey showed that most people will accept a mortality rate for
living organ donors as high as 20%. The odds, thankfully, aren't nearly that
bad. For kidney donors, for example, the risk ranges from 1 in 2,500 to 1 in
4,000 for a healthy volunteer. That helps explain why nearly 40% of kidney
transplants in the U.S. come from living donors The operation to
transplant a liver, however, is a lot trickier than one to transplant a kidney.
Not only is the liver packed with blood vessels, but it also makes lots of
proteins that need to be produced in the right ratios for the body to survive.
When organs from the recently deceased are used, the surgeon gets to pick which
part of the donated liver looks the best and to take as much of it as needed.
Assuming all goes well, a healthy liver can grow back whatever portion of the
organ is missing, sometimes within a month. A living-donor
transplant works particularly well when an adult donates a modest portion of the
liver to a child. Usually only the left lobe of the organ is required, leading
to a mortality rate for living-donors in the neighborhood of 1 in 500 to 1 in 1,
000. But when the recipient is another adult, as much as 60% of the donor's
liver has to be removed. "There really is very little margin for error," says
Dr. Fung. By way of analogy, he suggests, think of a tree. "An adult-to-child
living-donor transplant is like cutting off a limb. With an adult-to-adult
transplant, you're splitting the trunk in half and trying to keep both halves
alive." Even if a potential donor understand and accepts these
risks, that doesn't necessarily mean the operation should proceed. All sorts of
subtle pressures can be brought to bear on such a decision, says Dr. Mark
Siegler, director of the MacLean for Clinical Medical Ethics at the University
of Chicago. "Sometimes the sicker the patient, the greater the pressure and the
more willing the donor will be to accept risks." If you feel you can't say no,
is your decision truly voluntary? And if not, is it the medical community's
responsibility to save you from your own best intentions?
Transplant centers have developed screening programs to ensure that living
donors fully understand the nature of their decision. But unexamined, for the
most part, is the larger issue of just how much a volunteer should be allowed to
sacrifice to save another human being. So far, we seem to be saying some risk is
acceptable, although we're still vaguer about where the cutoff should be. There
will always be family members like Mike Hurewitz who are heroically prepared to
make the ultimate sacrifice for a loved one. What the medical profession and
society must decide is if it's appropriate to let them do so.
填空题Word order refers to the ________arrangement of words in a language
填空题You think I"m joking? No! I"m in dead______.(earn)
填空题________ established himself as the spokesman for the school of Art for arts sake, which affirmed that art was valuable as art, that artistic pursuits were their own justification and that art did not need moral justification
阅读理解Текст 6
В космосе (宇宙) люди живут теперь неделями, месяцами
阅读理解В России традиционно рабочий день начинается не так рано, как во многих европейских странах, обычно - в интервале с 8
阅读理解Текст 2
Сейчас много говорят об отдыхе
阅读理解Текст 1
Одни люди собирают марки, другие значки, а у Николая Тагрина коллекция открыток
阅读理解Текст 5
Площадь Москвы около 900 кв
翻译题我们每个人都明白这项工作的重要意义
翻译题Стоит ли иметь дело с русскими? Этот почти шекспировский вопрос задают себе тысячи предпринимателейкак на Западе, так и на Востоке
翻译题她从前是一名教师, 而现在成了作家
翻译题就读于历史系
翻译题Зимний дворец и Летний сад в Санкт-Петербурге
翻译题弹钢琴弹得不错
翻译题Желаю вам больших успехов в работе!
翻译题酷爱现代音乐
翻译题учиться на первом курсе в университете
翻译题весь день заниматься домашними делами
翻译题ехать на выставку на автобусе