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

admin2014-02-27  40
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 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 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 license suspension."  
From the first three paragraphs, we learn that______.
选项 A、doctors used to 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 这是一道归纳题。题干中的信号词为the first three paragraphs，也就是文章的前面三段。文章前面三段指出：最高法院就医生协助的自杀所作的裁决对医学界如何寻求解除垂死病人的痛苦与苦难具有重要的意义：尽管最高法院裁定宪法没有赋予医生有协助病人自杀的权力，但是，最高法院实际上支持一条流传了几个世纪道德准则。这说明，最高法院认为，医生没有协助病人自杀的权力。B说“医生帮助垂死病人结束生命仍然是违法的”，这与文章的意思相符。文中是说“近几年来，医生已经利用这一原则来为自己使用大剂量的吗啡控制晚期病人的痛苦而辩护”，并没有说医生过去常利用增加药量的方法来减轻病人的痛苦，所以A不对。文中是说“最高法院实际上支持双重效应的医疗准则——如果行动者只想要良好的效果，那么一种具有双重效果的行为就是可以容许的”，这说明C不对。文中是说“最高法院裁定宪法没有赋予医生有协助病人自杀的权力”，并没有说宪法没有赋予病人自杀的权力，所以D不对。
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