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C
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 effects" , 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. holds that the principle will shielddoctors who "until now have very, very strongly insisted that they could not give patients sufficientmediation to control their pain if that might hasten death."
George Annas, chair of the health law department at Boston University, maintains that, as longas a doctor prescribes a drug for a legitimate medical purpose, the doctor has done nothing illegaleven if the patient uses the drug to hasten death. "It's like surgery," he says, "We don't call thosedeaths homicides (杀人 ) because the doctors didn't intend to kill their patients, although they riskedtheir death. If you're a physician, you can risk your patient's suicide as long as you don't intendtheir suicide."
On another level, many in the medical community acknowledge that the assisted-suicide debatehas been fueled in part by the despair of patients for whom modem medicine has prolonged thephysical agony of dying.
Just three weeks before the Court's ruling on physician-assisted suicide, the National Academyof Science (NAS) released a two-volume report, Approaching Death: Improving Care at the Endof Life. It identifies the undertreatment of pain and the aggrcssjve use of "ineffectual and forcedmedical procedures that may prolong and even dishonor the period of dying" as the twin problemsof end-of-life care.
The profession is taking steps to require young doctors to train in hospices, to test knowledgeof aggressive pain management therapies, to develop a Medicare billing code for hospital-basedcare, 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 initiativestranslate into better care. "Large numbers of physicians seem unconcemed with the pain theirpatients are needlessly and predictably suffering.” to the extent that it constitutes "systematicpatient abuse" . He says medical licensing boards “must make it clear ... that painful deaths arepresumptively ones that are incompetently managed and should result in license suspension. "
61 . 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
62. Which of the following statements is true according to the text?
A. Doctors will be held guilty if they risk their patients' death.
B. Modem 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.
63. Which of the following best defines the word "aggressive" (Paragraph 7)?
A. Bold. B. Harmful.
C. Careless. D. Desperate.
64. 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 suffbering of the patients
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