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  3. Death is a difficult subject for anyone, but Americans want to talk about it less than most. They have a cultural expectation th

Death is a difficult subject for anyone, but Americans want to talk about it less than most. They have a cultural expectation th

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问题     Death is a difficult subject for anyone, but Americans want to talk about it less than most. They have a cultural expectation that whatever may be wrong with them, it can be fixed with the right treatment, and if the first doctor does not offer it they may seek a second, third or fourth opinion. Legal action is a constant threat, so even if a patient is very ill and likely to die, doctors and hospitals will still persist with aggressive treatment, paid for by the insurer or, for the elderly, by Medicare. That is one reason why America spends 18% of its GDP on health care, the highest proportion in the world.
    That does not mean that Americans are getting the world’s best health care. For the past 20 years doctors at the Dartmouth Institute for Health Policy and Clinical Practice have been compiling the "Dartmouth Atlas of Health Care" , using Medicare data to compare health-spending patterns in different regions and institutions. They find that average costs per patient during the last two years of life in some regions can be almost twice as high as in others, yet patients in the high-spending areas do not survive any longer or enjoy better health as a result.
    Ira Byock is the director of palliative medicine at Dartmouth-Hitchcock Medical Centre. His book is a plea for those near the end of their life to be treated more like individuals and less like medical cases on which all available technology must be let loose. With two decades’ experience in the field, he makes a good case for sometimes leaving well alone and helping people to die gently if that is what they want.
    That does not include assisted suicide, which he opposes. But it does include providing enough pain relief to make patients comfortable, co-coordinating their treatment among the different specialists, keeping them informed, having enough staff on hand to see to their needs, making arrangements for them to be cared for at home where possible—and not officiously keeping them alive when there is no hope.
    But it is not easy to decide when to stop making every effort to save someone’s life and allow them to die gently. The book quotes the case of one HIV-positive young man who was acutely ill with multiple infections. He spent over four months in hospital, much of the time on a ventilator, and had countless tests, scans and other interventions. The total bill came to over $ lm. He came close to death many times, but eventually pulled through and has now returned to a normal life. It is an uplifting story, but such an outcome is very rare.
    Dr Byock’s writing style is not everybody’s cup of tea, but he is surely right to suggest better management of a problem that can only get worse. As life expectancy keeps on rising, so will the proportion of old people in the population. And with 75m American baby-boomers now on the threshold of retirement, there is a limit to what the country can afford to spend to keep them going on and on.
The author cited the findings of Dartmouth Institute for Health Policy and Clinical Practice to illustrate that______.
选项 A、the medical care quality differs widely from region to region
B、there is little that hospitals can do in saving people’s lives
C、a lot of medical resources are wasted
D、the American medical system is notorious for its low cost-effectiveness
答案C
解析 本题考查对第二段中作者举例意图的理解。接着第一段提到的美国医疗费用居高不下的现实，第二段第一句话就指出高昂的医疗费用并不意味着美国人享受了世界上最好的医疗。接着作者就以达特茅斯卫生政策与临床实践学院的研究为例说明了这个问题。该学院使用医保数据对不同地区和医疗机构的卫生保健支出模式进行了对比。研究结果发现，在生命的最后两年中，虽然有些地区病人的平均支出可达其他地区的两倍，但是他们的寿命并没有延长，健康状况也不比其他地方好。使用这项研究结果想要说明的问题是医疗费用和人的寿命以及健康之间并不一定呈正相关关系。[A]选项错误，这项研究只比较了各个地区的医疗投入和人们寿命之间的关系，并没有对每个地区的医疗质量进行比较。[B]选项夸大其辞，虽然医疗投入加大并没有能够延长人们的平均寿命或者提高人们的平均健康水平，但是也不能因此就说医院在拯救人类生命方面没有什么作为。[C]选项正确。[D]选项错误，这项研究是为了说明这样一个道理，高昂的医疗并不能换来延长的寿命，并无意对美国医疗系统提出批判。
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