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  3. Disease is a fluid concept influenced by societal and cultural attitudes that change diachronically in response to new scien

Disease is a fluid concept influenced by societal and cultural attitudes that change diachronically in response to new scien

admin2009-05-19  71
问题         Disease is a fluid concept influenced by societal and cultural attitudes that
    change diachronically in response to new scientific and medical discoveries.
    Historically, doctors defined a disease according to a cluster of symptoms, and
    as their clinical descriptions became more sophisticated, they started to classify
(5)  diseases into separate groups, so that from this medical taxonomy came new
    insights into disease etiology. Before the 20th century, schizophrenia and
    syphilitic insanity were treated as the same disease, but by early 1900 it became
    evident that psychoses without associated dementia represented a separate
    disease for which the term schizophrenia was then coined. The definition of
(10) schizophrenia continues to evolve from the psychiatric disease of the 1960s to an
    illness with a suspected genetic etiology, though the existence of such an
    etiology remains uncertain. While an optimistic hunt is still on for the genes
    involved, we must continue to define schizophrenia in terms of the presence or
    absence of "positive" and "negative" symptoms.
(15)     Labeling someone as diseased, however, has enormous individual, social,
    financial, and physical implications, for irrespective of disease symptoms, the
    label itself may lead to significant distress.  Individuals with asymptomatic
    conditions, including genetic variations, may be perceived by themselves or
    others as having a disease. It is not that labeling someone as diseased is always
(20) positive—it does have severe ramifications, affecting decisions to have children
    or resulting in unjust treatment by life, medical, and disability insurers--but it
    can be beneficial,  legitimizing symptoms,  clarifying issues of personal
    responsibility,  and improving accessibility to health care.  Nevertheless,
    deviations from normal that are not associated with risk should not be
(25) considered synonymous with disease. Two schools—nominalist and essentialist
    or reductionist—have debated the clinical criteria used to label a patient as
    diseased. Nominalists label symptoms with a disease name, such as
    schizophrenia, and do not offer an explanation of the underlying etiology, while
    essentialists contend that for every disease there is an underlying pathological
(30) etiology, and now argue that the essential lesion defining the disease state is a
    genetic abnormality.
        It has been suggested that diseases defined according to the essentialist
    tradition may be precisely wrong, whereas those defined in the nominalist
    traditional may be roughly accurate. But in labeling a disease state, we must
(35) consider both the phenotype (symptoms) or the genotype (genetic
    abnormality), for the former describes a state that places individuals at some
    definable risk of adverse consequences, while the latter helps suggest specific
    genetic or pharmacologic therapies. Thus, both clinical criteria and genetic
    abnormalities should be used to define a disease state, and the choice of a
(40) disease definition will vary according to what one wishes to achieve, the genetic
    counseling of family members or the effective treatment of the patient.
选项 A、revealing a commonly ignored distinction
B、proposing a return to a traditional taxonomical system
C、describing an way to resolve a taxonomical dilemma
D、assessing the success of a new taxonomical method
E、predicting a change in future taxonomy
答案C
解析
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