2002 Text 4??

　　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 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."

56. 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

57. 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.

58. 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

59. Which of the following best defines the word "aggressive" (line 4, paragraph 7)?
　　[A] Bold.
　　[B] Harmful.
　　[C] Careless.
　　[D] Desperate.

60. 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


重點詞匯：

suicide /5sjuisaid/ （v.n.自殺）即sui+cide，sui詞根=self，cide詞根“切”=cut，于是“拿刀切自己”→自殺。Every suicide is a solution to a problem.每件自殺都是對一個問題的解決。suicide — the only perfect crime that remains unpunished 自殺——唯一不受懲罰的完美罪行。

constitutional /7kCnsti5tju:FEnEl/ （構(gòu)成的；體質(zhì)的；憲法的）即con+stitut(e)+ion+al，con-前綴“一起”，stitute詞根“建立”，-ion名詞后綴，-al形容詞后綴；名詞形式為constitution（構(gòu)成；體質(zhì)；憲法）←con+stitut(e)+ion；動詞為constitute（構(gòu)成）←con+stitute。Why is woman persistently regarded as a mystery? It is not that she has labored to conceal the organic and psychological facts of her constitution, but that men have showed no interest in exploring them.為什么女人總是被視為神秘的事物？原因并不是她極力隱瞞了關(guān)于自身生理與心理的事實，而是男人從來就沒有對探索這些事實表現(xiàn)過興趣。The two powers which in my opinion constitute a wise man are those of bearing and forbearing.在我看來，造就智者的兩種力量是忍受和克制。

principle /5prinsEpl/ （原理；信念）可把princi看作print（印刷），ple看作“倍數(shù)”（如quadruple、triple，參2002年Text 3），于是“反反復(fù)復(fù)印刷的東西”→原理（聯(lián)想：地下黨反復(fù)印刷革命刊物宣傳馬克思主義原理）。When a fellow says, "It isn't the money but the principle of the thing," it's the money.當(dāng)一個人說“這不是錢的問題而是原則問題”時，那就是錢的問題。Important principles may and must be flexible.重要的原則可以有伸縮性，也必須有伸縮性。

foresee /fC:5si:/ （v.預(yù)知）即fore+see，fore前綴“在前”（如forehead額←fore+head），see看，“在事情發(fā)生前就能看到”→預(yù)知。He who foresees calamities suffers them twice over.預(yù)見災(zāi)難的人承受了它們兩次。

sufficient /sE5fiFEnt/ （足夠的）即suf+fici+ent；suf-前綴“在下”（=sub-，f前b變形為f），fici看作face面（元音字母替換），-ent形容詞后綴，低于(suf)平均水平(fici)的(ent)消費使本來不多的收入變得“足夠的”；insufficient /7insE5fiFEnt/ （不足的）←in否定前綴+sufficient。Life is the art of drawing sufficient conclusions from insufficient premises.生活是從不足的前提得出足夠的結(jié)論的藝術(shù)。

mediation /7mi:di5eiFEn/ （仲裁，媒介作用）即medi+ation，medi(=middle)詞根“中間的”，-ation名詞后綴，文中指代“鎮(zhèn)痛劑”。同根詞：medium（中等的；媒介；手段）←medi+um后綴。

maintain /mein5tein/ （v.維修；維持；支持）即main+tain，main詞根=hand，tain詞根=hold（參unsustainable，2003年Text 4）。He who tells a lie is not sensible how great a task he undertakes; for he must invent twenty more to maintain that one.說謊者沒有意識到自己要承擔(dān)多么艱巨的任務(wù)，因為他必須再說二十個謊言來維持這個謊言。

prescribe /pris5kraib/ （v.指示；開處方）←pre在前+scribe寫，“在拿藥之前寫”→開處方。If I were a medical man, I should prescribe a holiday to any patient who considered his work important.我如果是醫(yī)生，就會開處方給所有認為自己的工作非同小可的病人放一天假。

legitimate /li5dVitimit/ （合法的；v.合法）即legitim+ate，legitim詞根“合法”（leg即詞根“法律”），-ate后綴。

homicide /5hCmisaid/ （n.殺人，殺人者）即homi+cide，homi詞根“人”=human，cide詞根“切”=cut。

debate /di5beit/ （v.n.爭論，辯論）即de+bate，de-向下，bate詞根“打”=beat，“通過語言把對手打倒”→“辯論”。同根詞：combat（v.n.戰(zhàn)斗，格斗）←com一起+bat。Debate is the best catalyst of thought.爭論是思想最好的催化劑。

ineffectual /7ini5fektjuEl/ （無效的）←in否定前綴+effect效果+ual形容詞后綴，與ineffective意思相近但有區(qū)別，ineffectual強調(diào)“不起作用的”，ineffective強調(diào)“效率低的”。To be prepared for war is one of the most effectual means of preserving peace.備戰(zhàn)是維持和平的最有效途徑之一。

hospice /5hCspis/ （收容所）可看作hosp(ital)+ice，醫(yī)院里什么都沒有，只有冰，于是就不能再叫醫(yī)院了，叫“收容所”。

predictably /pri5diktEbli/ （可預(yù)言地）←pre+dict+abl(e)+(l)y，參prediction（2003年Text 1）。

systematic /7sisti5mAtik/ （系統(tǒng)的；有計劃的）←system系統(tǒng)+-atic形容詞后綴。systematic liar 故意說謊者。

incompetently /in5kCmpitEntli/ （無能力地）即in+competent+ly，in-否定前綴，competnet（有能力的），-ly副詞后綴。

define /di5fain/ （下定義；限定）即de+fine，de-向下，fine詞根“界限”。Man is made in such a way that he continually has to define himself and continually escape his own definitions.人注定要不斷地給自己下定義，又不斷地逃避他自己的定義。Bigotry may be roughly defined as the anger of men who have no opinions.可以給偏執(zhí)下一個粗略的定義：沒有觀點的人的憤怒。

desperate /5despErit/ （絕望的；不顧一切的）←desper+ate，desper同despair（v.n.絕望），-ate形容詞后綴。If the failures of this world could realize how desperate half the present-day geniuses once felt, they would take heart and try again.世上的失敗者若能了解到當(dāng)今的天才有半數(shù)一度感到過多么絕望，他們就會振作精神再次努力。It is a characteristic of wisdom not to do desperate things.不做孤注一擲之事是智者的特征。Never despair. But if you do, work on in despair.永遠都不要絕望。但如果已經(jīng)絕望，就在絕望中繼續(xù)工作?！诮^望中復(fù)習(xí)考研！

morphine /5mC:fi:n/ 嗎啡（音譯）；well-meaning 善意的。

難句解析：

①The Supreme Court's decisions on physician-assisted suicide carry important implications for how medicine seeks to relieve dying patients of pain and suffering.
▲要理解本句，一定要抓住它的核心成分，主語是The Supreme Court's decisions，謂語是carry，賓語是important implications，后面有一個how引導(dǎo)的從句作介詞for的賓語。
△該句是本文的第一段，也是第一句，因此理解本句對全文的理解很有幫助。

②Although 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.
▲該句是一個復(fù)雜句，其基本結(jié)構(gòu)是although引導(dǎo)的狀語從句后面加一個主句，其主干是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，里面又有一個holding引導(dǎo)的賓語從句。
△本句閱讀的重點在于搞清基本句子結(jié)構(gòu)。在最開始閱讀時可以先不看對double effect進行修飾的成分。

③Nancy 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."
▲該句的主語是Nancy Dubler，后面有一個修飾它的同位語，句子的謂語是contends，后面有一個賓語從句，其中從句的賓語又有一個who引導(dǎo)的很長的定語從句。
△本句閱讀的重點在于理清句子主干結(jié)構(gòu)，另外對于一些詞的理解也很關(guān)鍵。Mediation本意是“調(diào)停，調(diào)和”，此處結(jié)合上下文，它更傾向于指代醫(yī)生用來緩解病人疼痛的藥物，因此最好把它理解為“鎮(zhèn)痛劑”。

④On 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.
▲該句的主語是many，謂語是acknowledge承認，后面有一個賓語從句，用的是被動語態(tài)，而其中由by引導(dǎo)的短語后面又有一個定語從句for whom modern medicine has prolonged the physical agony of dying來修飾前面的patients。
△本句閱讀的重點在于理清句子主干結(jié)構(gòu)。

⑤It 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.
▲該句的主語it，指代的是上文提到的NAS，謂語的主干結(jié)構(gòu)是identifies something as something，賓語有兩個并列成分the undertreatment of pain和the aggressive use of "ineffectual and forced medical procedures"，后面的一個還有個定語從句來修飾。
△本句閱讀的重點在于理清句子主干結(jié)構(gòu)，并且要抓住復(fù)雜賓語中的核心部分。

試題解析：

56. [B]

　　此題的難度合適，區(qū)分度好。
　　本題的答題依據(jù)是第二段中的“there is no constitutional right to physician-assisted suicide”，即從法規(guī)上講，在醫(yī)生幫助下的自殺是不合法的。

57. [C]
　　此題的難度合適，區(qū)分度好。
　　這是一道總括性的題，需要以文章中的多處信息為線索。這些信息較多地集中在文章的前三段：盡管在醫(yī)生幫助下的自殺是不合法的，但是最高法院認為只要醫(yī)生的本意是為了減輕病人的痛苦，那么他們使用大劑量的鎮(zhèn)痛藥就是允許的。

58. [B]
　　此題的難度合適，區(qū)分度很好。
　　本題的答題依據(jù)是第七段的第二句話中的“the undertreatment of pain”，理解了該短語的意思，這道題也就迎刃而解了。

59. [A]
　　此題稍難，但區(qū)分度好。
　　選擇四個選項的考生人數(shù)比較平均。這道題考查考生根據(jù)上下文判斷詞義的能力。一方面考生對“aggressive”這個詞的基本意思要有所了解，同時要運用上下文的信息。

60. [D]
　　此題的難度合適，區(qū)分度不大理想。
　　有29.6％的考生選擇A項。本題的答題依據(jù)是文章的最后一段。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。有29.4％（guangxian注：本段開頭認為是29.6％，孰是孰非只有天知道。）的考生選擇A的主要原因是受到了最后一句話中的“that are incompetently managed”的影響。

全文翻譯：

　　最高法庭關(guān)于醫(yī)生協(xié)助病人結(jié)束生命問題的裁決，對于如何用藥物減輕病危者的痛苦這個問題來說，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，然而最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(jì)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(yù)見得到的壞效果），那么，只要行為實施只是想達到好的效果，這個行為就是可以允許的。
　　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)痛的做法提供正當(dāng)?shù)睦碛?，盡管他們知道，不斷增加的劑量最終會殺死病人。蒙特非奧里醫(yī)療中心主任南?！ざ疾├照J為，這項原則將消除部分醫(yī)生的疑慮，這些醫(yī)生在此之前一直強烈地認為，如果給病人充分的藥品來止痛會加速他們的死亡的話工那就不能這樣做。
　　波士頓大學(xué)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殺人是因為醫(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(fēng)險?！?/span>
　　另一方面，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(xué)延長了臨終前肉體的痛苦。
　　就在最高法庭對醫(yī)助自殺進行裁決的前三周，全國科學(xué)學(xué)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?xí)屗劳銎陔y堪”。
　　“醫(yī)療行業(yè)采取步驟，讓年輕醫(yī)生去晚期病人休養(yǎng)所培訓(xùn)，對各種大膽的鎮(zhèn)痛療法方面的知識進行評估，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(biāo)準(zhǔn)。
　　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(yù)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，是由于醫(yī)生處理不力造成的，應(yīng)該因此吊銷其從醫(yī)資格”。