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

admin2013-04-17  29
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 mediation 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 under-treatment 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 推断题。文章第一段说：最高法院对于医生协助病人自杀的裁决，对如何使用药物来减轻病人的痛苦有着重大的意义。第二段说：尽管宪法没有赋予医生去帮助病人自杀的权力，法院实际支持了医疗界的“双效原则”。第三段说：医生们正是借用这个原则，为大剂量地给晚期(terminally ill)病人注射吗啡提供正当的理由，尽管增加剂量将最终致病人于死地。由此从第二段可推断，[B]项：医生们帮助病人自杀仍是非法的，为正确答案。[A]项：医生过去常用增加剂量的方法来控制病人的痛苦与第三段的增加吗啡剂量不符合。[C]项：最高法院强烈反对医生帮助病人自杀，与[D]项：宪法没有赋予病人自杀的权力，都与文章内容不符。
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