研究生公共英语教材阅读B第34101114课文原文及翻译文档格式.docx
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研究生公共英语教材阅读B第34101114课文原文及翻译文档格式.docx
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3.ManyAmericansarecaughtinmedicallimbo,aswastheSouthKoreanboxerDukKooKim,whowaskeptalivebyartificialmeansafterhehadbeenknockedunconsciousinafightandhisbrainceasedtofunction.Withthepermissionofhisfamily,doctorsinLasVegasdisconnectedthelife-supportmachinesanddeathquicklyfollowed.
4.Inthewakeoftechnology’sadvancesinmedicine,aheateddebateistakingplaceinhospitalsandnursinghomesacrossthecountry---overwhethersurvivalorqualityoflifeistheparamountgoalofmedicine.
5.“Itgetsdowntowhatmedicineisallabout,”saysDanielCallahan,directoroftheInstituteofSociety,Ethics,andtheLifeSciencesinHastings-on-Hudson,NewYork.“Isitreallytosavealife?
Oristhelargergoalthewelfareofthepatient?
”
6.Doctors,patients,relatives,andoftenthecourtsarebeingforcedtomakehardchoicesinmedicine.Mostoftenitisatthetwoextremesoflifethatthesedifficultyethicalquestionsarise---atthebeginningfortheverysicknewbornandattheendforthedyingpatient.
7.Thedilemmaposedbymodernmedicaltechnologyhascreatedthegrowingnewdisciplineorbioethics.Manyofthecountry’s127medicalschoolsnowoffercoursesinmedicalethics,afieldvirtuallyignoredonlyadecadeago.Manyhospitalshavechaplains,philosophers,psychiatrists,andsocialworkersonthestafftohelppatientsmakecrucialdecisions,andoneintwentyinstitutionshasaspecialethicscommitteetoresolvedifficultcases.
DeathandDying
8.Ofallthepatientsinintensive-careunitswhoareatriskofdying,some20percentpresentdifficultethicalchoices---whethertokeeptryingtosavethelifeortopullbackandletthepatientdie.Inmanyunits,decisionsregardinglife-sustainingcarearemadeaboutthreetimesaweek.
9.Eventhedefinitionofdeathhasbeenchanged.Nowthattheheart-lungmachinecantakeoverthefunctionsofbreathingandpumpingblood,deathnolongeralwayscomeswiththepatient’s“lastgasp”orwhentheheartstopsbeating.Thirty-onestatesandtheDistrictofColumbiahavepassedbrain-deathstatutesthatidentifydeathaswhenthewholebrainceasestofunction.
10.Morethanadozenstatesrecognize“livingwills”inwhichthepatientsleaveinstructionstodoctorsnottoprolonglifebyfeedingthemintravenouslyorbyothermethodsiftheirillnessbecomeshopeless.AsurveyofCaliforniadoctorsshowedthat20to30percentwerefollowinginstructionsofsuchwills.Meanwhile,thehospicemovement,whichitsemphasisonprovidingcomfort---notcure---tothedyingpatient,hasgainedmomentuminmanyareas.
11.Despiteprogressinsociety’sunderstandingofdeathanddying,theoryissuesremain.Example:
Awoman,87,afflictedbythenervous-systemdisorderofParkinson’sdisease,hasamassivestrokeandisfoundunconsciousbyherfamily.Theirchoicesaretoputherinanursinghomeuntilshediesortosendhertoamedicalcenterfordiagnosisandpossibletreatment.ThefamilyoptsforateachinghospitalinNewYorkcity.Testsshowthewoman’sstrokeresultedfromabloodclotthatiscurablewithsurgery.Aftertheoperation,shesaystoherfamily:
“Whydidyoubringmebacktothisagony?
”Herhealthcontinuestoworsen,andtwoyearslatershedies.
12.Ontheotherhand,doctorssayprognosisisoftenuncertainandthatpatients,justbecausetheyareoldanddisabled,shouldnotbedeniedlife-savingtherapy.Ethicistsalsofearthatundertheguiseofmedicaldecisionnottotreatcertainpatients,deathmaybecometooeasy,pushingthecountrytowardtheacceptanceofeuthanasia.
13.Forsomepeople,theagonyofwatchinghigh-technologydyingistoogreat.Earlierthisyear,WoodrowWilsonCollums,aretireddairymanfromPoteet,Texas,wasputonprobationforthemercykillingofhisolderbrotherJim,wholayhopelessinhisbedatanursinghome,avictimofseveresenilityresultingfromAlzheimer’sdisease.Afterthekilling,thevictim’swidowsaid:
“IthinkGod,Jim’soutofhismisery.Ihatetothinkithadtobedonethewayitwasdone,butIunderstandit.”
CrisisinNewbornCare
14.Attheotherendofthelifespan,technologyhassorevolutionizednewborncarethatitisnolongerclearwhenhumanlifeisviableoutsidethewomb.Newborncarehasgothugeprogress,soitisabsolutelyclearthathumanbeingcansurviveindependentlyoutsidethewomb.Twenty-fiveyearsago,infantsweightinglessthanthreeandone-halfpoundsrarelysurvived.Thecurrentsurvivalrateis70percent,anddoctorsare“salvaging”somebabiesthatweighonlyoneandone-halfpounds.Tremendousprogresshasbeenmadeintreatingbirthdeformitiessuchasspinabifida.Justtenyearsago,only5percentofinfantswithtranspositionofthegreatarteries---thecongenitalheartdefectmostcommonlyfoundinnewborns---survived.Today,50percentlive.
15.Yet,formanyinfantswhoowetheirlivestonewmedicaladvances,survivalhascomeataprice.Asignificantnumberemergewithpermanentphysicalandmentalhandicaps.
16.“Thequestionoftreatmentandnontreatmentofseriouslyillnewbornsisnotasingleone,”saysThomasMurrayoftheHastingsCenter.“ButIfeelstronglythatretardationorthefactthatsomeoneisgoingtobelessthanperfectisnotgoodgroundsforallowinganinfanttodie.”
17.Formanyparents,however,theexperienceofhavingasicknewbornbecomesalingeringnightmare.Twoyearsago,anAtlantamothergavebirthtoababysufferingfromDown’sSyndrome,aformofmentalretardation;
thechildalsohadblockedintestines.Thedoctorsrejectedtheparents’pleanottooperate,andtodaythechild,severelyretarded,stillsuffersintestinalproblems.
18.“EverytimeMelaniehasabowelmovement,shecries,”explainshermother.“She’snotabletotakecareofherself,andwewon’tliveforever.Iwantedtosaveherfromsorrow,pain,andsuffering.Idon’tunderstandtheemphasisonlifeatallcosts,andI’mveryangryatthedoctorsandthehospital.WhowilltakecareofMelanieafterwe’regone?
Wherewillyoudoctorsbethen?
ChangingStandards
19.Thechoicesposedbymoderntechnologyhaveprofoundlychangedthepracticeofmedicine.Untilnow,mostdoctorshavebeenactivists,trainedtouseallthetoolsintheirmedicalarsenalstotreatdisease.Thecurrenttrendistowardnontreatmentasdoctorsgrapplewithquestionsnotjustofwhoshouldgetcarebutwhentotaketherapyaway.
20.Alwaysinthebackgroundisthethreatoflegalaction.InAugust,twoCaliforniadoctorswerechargedwithmurderingacomatosepatientbyallegedlydisconnectingtherespiratorandcuttingofffoodandwater.In1981,aMassachusettsnursewaschargedwithmurderingacancerpatientwithmassivedosesofmorphinebutwassubsequentlyacquitted.
21.Betweenlawsuits,governmentregulations,andpatients’rights,manydoctorsfeeltheyareundersiege.Moderntechnologyactuallyhaslimitedtheirabilitytomakechoices.Morerecently,theseactionsareresolvedbycommittees.
PublicPolicy
22.Inrecentyears,thedebateonmedicalethicshasmovedtothelevelofnationalpolicy.“It’sjustbeginningtohitusthatwedon’thaveunlimitedresources,”saysWashingtonHospitalCenter’sDr.Lynch.“Youcan’ttalkaboutethicswithouttalkingethicswithouttalkingaboutmoney.”
23.Since1972.Americanshaveenjoyedunlimitedaccesstoataxpayer-supported,kidneydialysisprogramthatofferslife-prolongingtherapytoallpatientswithkidneyfailure.Toanumberofpoliceanalysts,theprogramhasgrownoutofcontrol---toa$1.4billionoperationsupporting61,000patients.Themajorityareover50,andaboutaquarterhaveotherillness,suchascancerorheartdisease,conditionsthatcouldexcludethemfromdialysisinothercountries.
24.Somehospitalsarepullingbackfromcertainlifesavingtreatment.MassachusettsGeneralHospital,forexample,hasdecidednotperformhearttransplantsonthegroundthatthehighcostsofprovidingsuchsurgeryhelptoofewpatients.Burnunits---throughextremelyeffective---alsoprovideveryexpensivetherapyforveryfewpatients.
25.Asmedicalscientistspushbackthefrontiersoftherapy,themoraldilemmawillcontinuetogrowfordoctorsandpatientsalike,makingthechoiceoftotreatthebasicquestioninmodernmedicine.
1.在特效药、风险性手术进程、放疗法以及特护病房方面的医学进展已为数千人带来新生。
然而,对于他们中不少人而言,现代医学已成为一把双刃剑。
2.医生采用一系列航空时代技术进行治疗的能力已超过人体本身的治愈能力。
从医学的角度来说,有更多的疾病能够得以诊治,可对于许多病人而言,复原的希望却微乎其微。
甚至生死之间的基本差别也难以界定清楚。
3.不少美国人身陷医学囹圄,形同南韩拳击手金得九(DukKooKim)的境遇。
金得九在一次打斗中受到重击,人事不省,大脑停止运转,只能依靠人为方法赖以存活。
经其家人允许,拉斯维加斯的医生切断了维持其生命的器械,死神便接踵而来。
4.医疗技术进步了,是力求生存还是注重生命质量,哪个目标更为重要,这一问题在全美的医院和疗养院里引发了激烈的争论。
5.“归根结底,问题在于,医疗的宗旨是什么?
”位于纽约哈德逊河上黑斯廷斯的社会、伦理及生命科学学会主席丹尼尔·
卡拉汉说,“是真的要挽救生命还是要为病人谋取更大的利益?
”
6.医生、病患、家属,通常还有法庭都不得不在医疗方面作出艰难的抉择。
而这些道德难题往往最容易产生于生命的两个极端——生命开初的重病新生儿和生命终端的垂死病患。
7.这些因现代医学技术而产生的两难问题已不断催生出生物伦理学的新准则。
如今,全美127家医学院中已有不少机构开设了医学伦理学课程,要在十年前,根本没人会去注意这个领域。
不少医院的员工队伍都包含了牧师、哲学家、精神病医师以及社会工作者,以求帮助病人作出关键性抉择,而有二十分之一的机构专门成立了伦理委员会解决这些难题。
8.在所有特护病房的垂死病人当中,有约莫20%的病例,其当事人面临艰难的道德抉择——是继续尽力挽救生命还是改变初衷、听凭病患死去。
对于是否要维持生命的治疗,不少病房每周大约要作三次决定。
9.现在就连死亡的定义也已经改变。
既然人工心肺机能够代替心肺维持人的呼吸和血液循环,死神往往不会随着病患的“最后一丝喘息”或是心
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