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 modem 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�！�
　　 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 its 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。

　　 名師解析
　　 36. From the first three paragraphs, we learn that 從前三段我們得知
　　 [A] doctors used to increase drug dosages to control their patients’ pain。
　　 醫(yī)生過去常常增加藥物劑量來控制病人的病痛。
　　 [B] it is still illegal for doctors to help the dying end their lives。
　　 醫(yī)生幫助病危者結(jié)束生命仍然是違法的。
　　 [C] the Supreme Court strongly opposes physician-assisted suicide。
　　 比較高法院強烈反對醫(yī)助自殺。
　　 [D] patients have no constitutional right to commit suicide。
　　 病人沒有憲法賦予的自殺權(quán)利。
　　【答案】 B
　　【考點】 事實細節(jié)題。
　　【分析】 本題針對第一到第三段的所有內(nèi)容進行了測試，選項[A]的相關(guān)信息可以定位到第三段，但是文中說“近幾年醫(yī)生才用這個原則為自己的行為辯護”。文中無法得出“過去常常”的說法。選項[B]可以定位到第二段，文中提到“憲法沒有賦予這樣的權(quán)利”。所以可以說，本答案是正確的。選項[C]可以定位到第二段，但是法院是支持這樣的做法的。至于[D]，顯然是錯的。
　　 37. Which of the following statements is true according to the text?
　　 根據(jù)文章，下面哪一個說法是正確的?
　　 [A] Doctors will be held guilty if they risk their patients’ death。
　　 如果醫(yī)生冒病人生命的危險，他們將被判有罪。
　　 [B] Modern medicine has assisted terminally ill patients in painless recovery。
　　 現(xiàn)代醫(yī)學已經(jīng)幫助晚期病人進行無痛康復。
　　 [C] The Court ruled that high-dosage pain-relieving medication can be prescribed。
　　 法院判決，醫(yī)生可以開大劑量的鎮(zhèn)疼藥。
　　 [D] A doctor's medication is no longer justified by his intentions。
　　 醫(yī)生用藥是否合法不再取決于他的意圖。
　　【答案】 C
　　【考點】 事實細節(jié)題。
　　【分析】 由于本題屬于事實細節(jié)判斷題，所以只有對每一個選項都進行辨析。選項[A]可以定位到第五段“Annas”的話。話中提到“只要醫(yī)生不是想殺死病人，那么他們的死亡就不能被稱為謀殺”。因此可以判定[A]不正確。[B]說病危者的無痛康復，在文中沒有提到康復問題。[C]可以從第二段中找到，高等法院認為只要醫(yī)生是出于好意，則可以去做。因此可以得出[C]是正確的。[D]錯誤是因為事實上，醫(yī)生的意圖在對于行為是否合法上面是非常重要的。
　　 38. According to the NAS’s report, one of the problems in end-of-life care is
　　 根據(jù)國家科學院(NAS)的報告，臨終護理存在的一個問題是
　　 [A]prolonged medical procedures. 延長了的醫(yī)療過程。
　　 [B]inadequate treatment of pain. 對病痛處理不力。
　　 [C]systematic drug abuse. 一貫的藥物濫用。
　　 [D]insufficient hospital care. 醫(yī)院護理不力。
　　【答案】 B
　　【考點】 事實細節(jié)題。
　　【分析】 本題可以定位到第七段的第二句話中的“the undertreatment of pain”以及“the aggressive use of‘ineffectual and forced medical procedures that may prolong and even dishonor the period of dying’”。一個是“對病人的疼痛治療不力”。另外一個是“強行使用無效的治療方法延長生命，使得病人的晚期失去尊嚴”。因此，這里的答案應(yīng)該是[C]。
　　 39. Which of the following best defines the word“aggressive”(Line 3, Paragraph 7)?
　　 以下哪一個單詞比較好的解釋了單詞“aggressive”(第七段第三行)的意思?
　　 [A]Bold. 大膽的。
　　 [B]Harmful. 有害的。
　　 [C]Careless. 粗心的。
　　 [D]Desperate. 絕望的。
　　【答案】 A
　　【考點】 詞義題。
　　【分析】 這個單詞的所在句“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。”中，說的是對病痛處理不力和大膽使用“無效而強制性的醫(yī)療程序，這些程序可能會延長死亡期，甚至會讓死亡期難堪”。對這種醫(yī)療程序的使用必須是“aggressive”的，是一般的方法不會用的。所以這個單詞的意思就是“bold”。
　　 40. George Annas would probably agree that doctors should be punished if they
　　 喬治·安納斯可能認為醫(yī)生應(yīng)該受到懲罰，如果他們
　　 [A]manage their patients incompetently. 不勝任地治療病人。
　　 [B]give patients more medicine than needed. 給病人的藥物超量。
　　 [C]reduce drug dosages for their patients. 為病人減藥。
　　 [D]prolong the needless suffering of the patients。延長病人不必要的痛苦。
　　【答案】 D
　　【考點】 事實細節(jié)題。
　　【分析】 本題的答題依據(jù)是文章的比較后一段。在這一段中，“Annas”對大量的醫(yī)生置病人的痛苦于不顧，無端地延長病人不必要的痛苦這種行為提出了批評，認為這種行為構(gòu)成了“虐待病人”，并認為這樣的醫(yī)生應(yīng)該予以吊銷行醫(yī)執(zhí)照。因此可以判斷[D]選項是正確的。

　　難句解析：
　　1. 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。
　　【結(jié)構(gòu)分析】 本句的基本結(jié)構(gòu)是“although”引導的狀語從句后面加一個主句�！癮lthough”從句中有一個“that”引導的賓語從句。本句的主句是“the court supported the medical principle of‘double effect’”，后面是一個對“double effect”進行說明的同位語。
　　2. 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�！�
　　【結(jié)構(gòu)分析】 本句主語是“Nancy Dubler”，后面有一個修飾它的同位語，謂語是“contends”，后面有一個賓語從句，其中從句的賓語又有一個“who”引導的定語從句，而且從句中有一個“if”引導的假設(shè)狀語從句。
　　3. 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。
　　【結(jié)構(gòu)分析】 該句的主句是“many acknowledge ”，后面的賓語從句中又有一個定語從句“for whom modern medicine has prolonged the physical agony of dying”來修飾前面的“patients”。
　　全文翻譯：
　　比較高法庭關(guān)于醫(yī)助自殺的裁決，對于醫(yī)學界如何尋求減輕病危者的痛苦和折磨這個問題來說，具有重要的意義。
　　盡管裁決認為，憲法沒有賦予醫(yī)生幫助病人自殺的權(quán)利，然而比較高法庭實際上卻認可了醫(yī)療界的“雙效”原則，這個存在了好幾個世紀的道德原則認為，如果某種行為具有雙重效果——希望達到的好效果和可以預見得到的壞效果——如果行為人只是想達到好的效果，這個行為就是可以被允許的。
　　盡管不斷增加的劑量比較終會殺死病人，近年來，醫(yī)生們一直在借用這項原則，為自己替病�；颊咦⑸浯髣┝康膯岱孺�(zhèn)痛的做法提供辯護。
　　蒙特非奧里醫(yī)療中心主任南希·都博勒認為，這項原則將會保護部分醫(yī)生，“因為這些醫(yī)生直到現(xiàn)在都一直堅持認為，如果給病人大量的藥品可能加速病人的死亡的話，他們就無法給病人足夠的藥來控制他們的疼痛�！�
　　波士頓大學健康法律系主任喬治·安納斯堅持認為，只要醫(yī)生是出于合理的醫(yī)療目的開藥，那么即使服用此藥會加速病人的死亡，醫(yī)生的行為也沒有違法�！斑@就像做手術(shù)，”他說，“我們不能稱那些死亡為謀殺是因為醫(yī)生并沒有想殺死病人，盡管他們敢冒病人死亡的危險。假定你是一名醫(yī)生，只要你并沒有想讓病人自殺，你就可以去冒你的病人自殺的風險�！�
　　另一層面上，許多醫(yī)療界人士承認，致使醫(yī)助自殺這場爭論升溫的部分原因是由于病人們的絕望情緒，對這些病人來說，現(xiàn)代醫(yī)學延長了臨終前肉體的痛苦。
　　就在比較高法庭對醫(yī)助自殺進行裁決的前三周，全國科學學會公布了一份長達兩卷的報告《臨近死亡：完善臨終護理》。報告指出了醫(yī)院臨終關(guān)懷護理中存在的兩個問題：對病痛處理不力和大膽使用“無效而強制性的醫(yī)療程序，這些程序可能會延長死亡期，甚至會讓病人在死亡期中尊嚴受到傷害”。
　　醫(yī)療行業(yè)正在采取行動，使得年輕醫(yī)生去晚期病人休養(yǎng)所培訓，對各種大膽的鎮(zhèn)痛療法方面的知識進行測試，為醫(yī)院護理制定一份符合美國醫(yī)療保障方案的付款條例，以及為評估和治療臨終痛苦制定新的標準。
　　安納斯說，律師可以在要求把醫(yī)療界的這些善意的行為變成更好的護理行動方面發(fā)揮關(guān)鍵作用�！安簧籴t(yī)生對病人所遭受的毫無必要的，可預見的痛苦無動于衷”，乃至于已構(gòu)成“蓄意虐待病人”。他說，行醫(yī)資格理事會“必須明確表明——病人痛苦地死亡，可以推定，是醫(yī)生管理死亡病人不能勝任的表現(xiàn)，應(yīng)該據(jù)此吊銷其營業(yè)執(zhí)照�！�