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The Supreme Court’s decisions on physician-assisted suicide carry important implications for how medicine seeks to relieve dying

admin2013-07-02  76
问题     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(吗啡)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 good 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(杀人者)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 hospitals, 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. "
We learn from the passage that______.
选项 A、doctors never 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
答案B
解析 推理判断题。文中第二段第一句话提到尽管最高法院裁定，没有宪法权利支持医生帮助病人自杀的行为，但实质上，法院支持了医学界的“双效”原则。也就是说事实上，医生帮助病人自杀这种行为是不合法的。由此推断出[B]项正确，[C]项错误。第三段说医生曾用大剂量吗啡来控制的是晚期病人的病痛，而非所有病人，选项[A]错误；[D]项在文中找不到依据。
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