第一段
①The Supreme Court’s decisions on physician-assisted suicide carry important implications for how medicine seeks to relieve dying patients of pain and suffering.
单词&翻译
physician-assited 由医生协助的
suicide n. 自杀
implication n. ［一般用复数］（行为，事件，或决定等）可能的影响；可能的后果
relieve v. 减轻或解除（痛苦、困苦、忧虑等）
dying a. 临终的，垂死的
seek to 力图、争取
本段翻译
最高法院就医助自杀问题的裁决对“医学如何致力于减轻临终病人的痛苦与折磨”具有重大影响。
第二段
①Although 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.
单词&翻译
constitutional a. 宪法的，符合宪法的，立宪的
hold v. 认为，相信
permissible a. 可允许的
morphine n. 吗啡
in effect 实际上
the medical principle of "double effect" 双效医疗原则
本段翻译
尽管法庭认定宪法并未赋予医生协助病人自杀的权利，实际上却认可了“双效”医疗原则。这个存在了几个世纪的道德原则认为，如果某种行为具有双重效果——希望达到的好效果和可以预见的坏效果，那么，只要行为实施者仅仅意在好的效果，其行为就是允许的。
第三段
①Doctors 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.
单词&翻译
terminally ad. 致命地，晚期地
dosage n. ［一般用单数］（一次用药的）剂量，服用量
本段翻译
近年来，医生们一直在借用这项原则为“使用大剂量吗啡抑制晚期病人痛苦”的行为辩护，尽管不断增加的剂量最终将导致病人死亡。
第四段
①Nancy 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”.
单词&翻译
contend v. 主张，争辩
shield v. 保护，庇护
sufficient a. 足够的，充分的
hasten v. 加快；匆忙做
本段翻译
蒙特非奥里医疗中心主任南希·道布勒断言，这项原则将保护那些直到现在还非常、非常强烈坚称“如果大剂量药物可能加速病人死亡，他们不可能给病人开足够的药以帮助他们止痛”的医生。
第五段
①George 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.②“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.③If you’re a physician, you can risk your patient’s suicide as long as you don’t intend their suicide.”
单词&翻译
maintain v. 断言（某事）属实，坚持说……
prescribe v. 给……开（药/处方）
legitimate a. （按照公认的行为准则）合理的，公正的
homicide n. 杀人（者）（hom词根“人”＋cide词根“切”）
本段翻译
波士顿大学健康法系主任乔治·安纳斯坚持认为，只要医生开药是出于正当的医疗目的，那么即使病人使用该药物加速死亡，医生的行为也没有违法。“这就像做手术，”他说，“尽管存在导致病人死亡的风险，我们也不能称那些死亡为谋杀，因为医生并没有意在杀死病人。假定你是一名医生，只要你的目的不是想让你的病人自杀，你就可以去冒病人自杀的风险。”
第六段
①On 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.
单词&翻译
fuel v. 给……加燃料，供给……燃料，文中实比喻的用法
prolong v. 延长
agony n. （精神或身体的）巨大痛苦
本段翻译
另一方面，许多医学界人士承认，致使医助自杀这场争论升温的部分原因是病人们的绝望情绪，对这些病人来说，现代医学延长了他们临终时肉体的痛苦。
第七段
①Just 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.②It 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.
单词&翻译
release v. 发布，发行
ineffectual a. 无效的
twin problems 双重问题
本段翻译
就在最高法院对医助自杀做出裁决的前三周，国家科学院公布了一份两卷的报告《临近死亡：改善临终护理》。报告指明了临终护理中并存的两大问题：对病痛处理不力和极端大胆采用“无效而强制性的医疗手术”，这些手术可能会延长死亡期，甚至会让病人死得不体面。
第八段
①The 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.
单词&翻译
hospice n. （晚期病人）护理所
code n. 道德准则，行为规范
aggressive pain management therapy 大胆镇痛疗法
本段翻译
医疗行业正在采取措施，要求年轻医生到临终安养院接受培训，对其大胆的镇痛疗法知识进行测试，制定基于医院护理的医疗报账法规，以及设定新的标准来评估和治疗病人临终的痛苦。
第九段
①Annas says lawyers can play a key role in insisting that these well-meaning medical initiatives translate into better care.②“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”.
③He says medical licensing boards “must make it clear...that painful deaths are presumptively ones that are incompetently managed and should result in license suspension”.
单词&翻译
well-meaning 意图良好的
initiative n. （为解决某个问题的）计划
be unconcerned with 对……不关心
translate into 转化为，用另外的形式表现
constitute v. 被视为，是……
systematic a. 系统化的，细致彻底的
presumptively ad. 据推测，据推定
incompetently ad. 不胜任，无能力
suspension n. 暂停，中止；暂时停职或停学
本段翻译
安纳斯说，在坚持要求上述善意的医疗动机转化成更好的护理方面，律师可以发挥关键作用。“许多医生对病人所遭受的非必要、可预见性痛苦似乎无动于衷”，甚至构成“蓄意虐待病人”。他说，美国各州行医执照委员会“必须明确——病人的痛苦死亡如果可以推定是由于医生治疗不当所致，应当吊销医生行医执照”。
五道题
36. From the first three paragraphs, we learn that .
[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
37. Which of the following statements is true according to the text?
[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.
38. According to the NAS’s report, one of the problems in end-of-life care is .
[A] prolonged medical procedures
[B] inadequate treatment of pain
[C] systematic drug abuse
[D] insufficient hospital care
39. Which of the following best defines the word “aggressive” (line 3, paragraph 7)?
[A] Bold. [B] Harmful. [C] Careless. [D] Desperate
40. George Annas would probably agree that doctors should be punished if they .
[A] manage their patients incompetently
[B] give patients more medicine than needed
[C] reduce drug dosages for their patients
[D] prolong the needless suffering of the patients
选项单词
hold sb. guilty 认为某人有罪
参考答案
BCBAD
答案解析
36、第二段首句指出，法院认定医生协助病人结束生命不是宪法赋予的权利，[B]正确。
37、由第二、三段可知：法院支持“双重效果”，即肯定医生为临终病人开大剂量止痛药物的行为，[C]正确。
38、根据关键词NAS's report和the problems in end-of-lifecare定位到第七段②句。该句提到，国家科学院发布的报告指出了临终护理中存在两大问题：①对病痛不进行足够的处理；②大胆使用“无效而强制性的医疗过程”来延长死亡期，甚至让病人死得没有尊严。因此[B]是问题之一。
39、第七段②句指出临终护理中两个紧密相关的问题“对病痛处理不力和对无效而强制性医疗手术的……使用”及其负面作用“延长死亡期， 甚至让病人死得不体面”， 可知， aggressive应为贬义且与under treatment“不足、不力”相对；第八段指出“年轻医生需接受培训， 考查其对……的了解”， 暗示问题源于医生对此认识不足而冒然求进， 故aggressive取“大胆冒进的”之意， [A] 用于贬义时意为“大胆的、冒失的、失慎的”，含义最接近。
40、末段中安纳斯指出，许多医生对病人遭受不必要的、可预见的痛苦无动于衷。如果病人痛苦的死亡可以推定是由于医生治疗不当造成的，应当吊销其行医执照，[D]正确。
