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【阅读理解】该不该拔输食管之争  

2011-10-01 08:54:13|  分类: 阅读理解 |  标签: |举报 |字号 订阅

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【阅读理解】该不该拔输食管之争 - 佳中 - 佳中Blog

           

【阅读理解】             该不该拔输食管之争                      

                                                                         命题:佳中

                                  

      If it doesn’t break, don’t fix it. When it comes to the current laws regarding the withdrawal of

feeding tubes in the terminally ill and permanently comatose, this sound bit of practical advice

needs to be heeled.

      But recently the Pope proclaimed that feeding tubes should never be withdrawn from any 

patient and that health-care providers are normally obligated to provide nutrition and hydration 

regardless of a patient’s wishes. The Pope’s order spells trouble for your health care — not only

because it threatens to undermine a powerful social consensus in the United States about your 

right to refuse medical treatment, but also because it means you can no longer be sure whether 

a hospital will respect your request or that of your loved ones making a decision for you.

     The Pope’s position is directly at odds with current clinical practice in U.S. hospitals. In the 

1990 case of Missouri’s Nancy Cruzan, the U.S. Supreme Court answered the question of 

whether food and water are medical treatments that can be declined. Cruzan was in a car crash 

that left her in a persistent vegetative state. But, at the insistence of U.S. Attorney General John 

Ashcroft, Cruzan was kept alive by a feeding tube despite the wishes on her family. Cruzan’ 

patients fought for the better part of decade to have her feeding tube withdrawn. Finally, in a 

landmark decision, the Supreme Court ruled that receiving food and water through tubes 

administered by nurses and doctors constitutes medical treatment and that if there is clear and 

convincing evidence about what a patient would have want, then the feeding tubes can be 

withdrawn.

      Ever since then, America has maintained an ethical consensus on the issue. Medial 

rganizations, critical care specialists, hospice workers, numerous state and appellate courts, and 

legal experts have all affirmed the soundness of the Cruzan decision. The Pope’s aim in reminding 

us that all people, even those in permanent comas or vegetative states, are human beings

deserving of compassion and care is important. But he is wrong about what confers dignity on the 

sick and the dying. It is not about artificially feeding them against their will, but about finding ways 

to let their will be respected.

    The right to control your medical care is one of the most fundamental rights you have. Respect 

for you liberty means that even if you are unable to assert your autonomy, others should be able to 

do so for you or you should be able to write your wishes down so that others must respect them. 

No one should be forced to endure medical treatment that they do not want. Nothing could be more 

cruel or disrespectful of human dignity.              

 

 (447 words)

 

01.The author implies in the first paragraph that the current laws regarding the withdrawal of 

      feeding tubes in the terminally ill are

     [A] amendable.

     [B] justifiable.

     [C] defective.

     [D] controversial.

02. On the question whether the feeding tubes should be withdrawn, U.S. hospitals

     [A] look up to the patient’s own decision.

     [B] go against the social consensus.

     [C] stand in line with the Pope’ position.

     [D] perform the practice only in vegetative patients.

03. From the case of Cruzan we learn that

     [A] the Supreme Court was caught in a dilemma.

     [B] the Pope’s position misled people in making wrong decision.

     [C] Cruzan’s patients are eager to get rid of their daughter.

     [D] the withdrawal of feeding tubes is more a legal than ethical issue.

04. The strong argument against Pole’s order is that it

     [A] ignores the great pressure exerted on the patient’s family.

     [B] places the moral obligation on the family rather than on the society.

     [C] violates the autonomy of the patient for independent decision.

     [D] shows no consideration and compassion for the terminally ill.

05. It is evident the author is

     [A] a proponent of the Pope’s position.

     [B] an opponent of the current hospital practice.

     [C] an advocate of the patient’s rights.

     [D] a critic of doctor-assisted suicide.

 

 

篇章分析

 

       美国有法规规定准许按病人的愿意或家人的要求拔掉绝症病人输食管,但最近有人提出从道

义上医务人员有责任给病人提供食物与水,不应该拔掉绝症病人的输食管。本文作者认为现行法

规没有问题无需更改,他在文中批驳Pope的观点,强调病人的自主权利应该得到尊重。

 

      第一段:  作者认为现行准许拔掉绝症病人输食管的法规没有问题。

      第二段:  Pope对法规提出异议,主张不能拔掉绝症绝症病人的输食管。

      第三段:  美国最高法院的裁决:尊重病人意愿,可以拔掉输食管。

      第四段:  作者批驳Pope不尊重病人的自主权利的主张。

      第五段:  作者强调接受不接受医疗是病人的基本权利。

 

答案解析 

01.【答案】   B

       【解析】   这是一道推理题,针对第一段命题。解本题的关键是对“If it doesn’t break, don’t 

        fix it” 理解。这句话的含意是“如果它没有坏,就不必修理”。 从下文可以看出作者认为现有的

        关于赞同给绝症绝症病人拔输食管法规没有问题,因此不必修理。换言之,作者认为现有的

        关于赞同给绝症绝症病人拔输食管法规是合理的,由此可以确定B项是本题的正确答案。

 

02.【答案】  A

       【解析】  这是一道推理题。Pope主张不能给绝症病人拔输食管,理由是不管病人的愿意是

        什么,医务人员在道义上有责任给病人提供食物与水。Pope的主张与社会上一种强势观点相

        悖,这种观点认为医院应该尊重病人的愿意。就Cruzan的案例美国最高法院作出裁决,认为

        医生和护士通过输食管给病人食物与水是医疗的延续。如果有病人明确的愿意,可以拔掉输

        食管。美国最高法院的裁决认为是划时代意义的事件,受到医疗结构、临床医学专家和临

         终护理人员的支持。由此可以得出 “美国医院尊重病人自己决定”的推断,A项是本题的正确

         答案。

 

03.【答案】  C

       【解析】  这是一道细节题,针对第三段命题。Cruzan因车祸成为了植物人,在律师Ashcroft

        的坚持下,Cruzan在医院靠输食管维持生命,但是Cruzan的家人要求拔掉输食管,他们为此

        奋斗多年,最终促使美国最高法院作出具有划时代意义的裁决。可见Cruzan的家人一直在要

        求对Cruzan实行安乐死,C项的意思是Cruzan的父母想放弃他们的女儿,与段中所述相符。

         A、B和C项的意思分别为 “美国最高法院陷入困境”、“Pope的观点误道人们作出错误决定”和

         “拔掉输食管是法律问题而不是伦理问题”,有一定的干扰性,但文中没有信息能支持这些说

         法。

 

39.【答案】  D

        【解析】  这是一道观点题,针对第四段命题。Pope认为所有人,即使在长期昏迷和植物人

         状态,都是值得同情的,治疗对他们是十分重要的(第四段第二句)。作者认为在对待临死

         病人的尊严问题上Pope的观点是错误的,不是人工喂食违反临死病人的愿意,而是要找到

         方法让他们的愿意得到尊重(It is not about artificially feeding them against their will, but 

         about find ways to let their will be respected)。D项的意思是“违反病人有自主决定的权利”,

         这正是作者批驳Pope观点的理由。

 

05.【答案】  D

       【解析】  这是一道推测题。从上面四题的解析中可以清楚地看出作者观点的基本出发点是

        尊重病人地权利。作者在文章的最后二段特别强调接受不接受医疗是病人的权利,病人的自

        主权利必须得到尊重,因此不难推断作者是“病人权利的提倡者”, D是本题的正确答案。

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