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

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

admin2014-02-27  43
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."  
Which of the following statements is TRUE according to the passage?
选项 A、Doctors will be held guilty if they risk their patients’ death.
B、Modern medicine has assisted terminally ill patients in painless recovery.
C、The Court ruled that high-dosage pain-relieving medication can be prescribed.
D、A doctor’s medication is no longer justified by his intentions.
答案C
解析 这是一道细节题。文章第二、三段指出：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“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；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，尽管加大剂量最终会导致病人死亡。这说明，最高法院认为，医生可以使用大剂量药物来减轻晚期病人的痛苦。C说“法院裁定，医生可以开大剂量减轻病痛的药物”，这与文章的意思相符。A与文章第五段的意思不符。文章第六段指出：医学界许多人都承认，有关协助病人自杀的争论一部分是由病人的绝望而引起的，因为现代医学延长了这些病人垂死时肉体所承受的极大痛苦：这说明B不对。D明显与文章第二段的意思不符。
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