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The Supreme Court's decisions on physicianassisted 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 physicianassisted suicide, the Court in effect supported the medical principle of“double effect,”a centuriesold moral principle holding that an actionshavingstwo effects—a good one that is intended and a harmful one that is foreseen—is permissible if the actor intends only the good effect. )(OGo`4Qz
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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. HVdB*QEH
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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.” z6Fl$FFP
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George Annas, chair of the health law department at Boston University, maintainsthat, 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.” Scug
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On another level, many in the medical community acknowledge that the assistedsuicide debate has been fueled in part by the despair of patients for whom modernmedicine has prolonged the physical agony of dying. SQ*%d.1
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Just three weeks before the Court's ruling on physicianassisted suicide, the National Academy of Science (NAS) released a twovolume report, Approaching Death: Improving Care at the End of Life. It identifies the undertreatment of painand the aggressive use of“ineffectual and forced medical procedures that may prolong and even dishonor the period of dying”as the twin problems of endoflife care. 1g,Ofr
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The profession is taking steps to require young doctors to train in hospitals, to test knowledge of aggressive pain management therapies, to develop a Medicare billing code for hospitalbased care, and to develop new standards for assessing and treating pain at the end of life. \x<,Ma=D
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Annas says lawyers can play a key role in insisting that these wellmeaning medical initiatives translatesintosbetter care.“Large numbers of physicians seem unconcerned with the pain their patients are needlessly and predictably suffering,”to the extent that it constitudes“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.” p(-EtxP
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56.From the first three paragraphs, we learn that. mN
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Adoctors used to increase drug dosages to control their patients pain r"
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Bit is still illegal for doctors to help the dying end their lives m^zD']
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Cthe Supreme Court strongly opposes physician-assisted suicide P9R-41!
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Dpatients have no constitutional right to commit suicide }8ESp3~e_
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57.Which of the following statements is true according to the text? R6`mmJ+'
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ADoctors will be held guilty if they risk their patients death. T24$lhM
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BModern medicine has assisted terminally ill patients in painless recovery. J*zQ8\f=}
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CThe Court ruled that high-dosage pain-relieving medication can be prescribed. s0CDp"uJY
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DA doctor's medication is no longer justified by his intentions. &4%78K\
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58.According to the NAS's report, one of the problems in endoflife care is. zGc]*
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Aprolonged medical procedures
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Binadequate treatment of pain 5Vdy:l
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Csystematic drug abuse Q
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Dinsufficient hospital care Y4lN xvY
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59.Which of the following best defines the word“aggressive”(line 3, paragraph 7)? 32y 9r z
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ABold. Q.'2v%i
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BHarmful. )T&r770
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60.George Annas would probably agree that doctors should be punished if they. ^>eV}I5ak
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Amanage their patients incompetently -D1A
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Bgive patients more medicine than needed !kH 1|
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Creduce drug dosages for their patients V^><
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Dprolong the needless suffering of the patients dYlVJ_0Zr
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Passage 2(1993年考研阅读第1篇) # $'H?lO
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Is language,like food,a basic human need without which a child at a critical period of life can be starved and damaged? Judging from the drastic experiment of FrederickⅡin the thirteenth century,it may be.Hoping to discover what languagea child would speak if he heard no mother tongue,he told the nurses to keep silent. o!c~"
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All the infants died before the first year.But clearly there was more than lack of language here.What was missing was good mothering.Without good mothering,in the first year of life especially,the capacity to survive is seriously affected. vWL|vR
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Today no such severe lack exists as that ordered by Frederick.Nevertheless,some children are still backward in speaking.Most often the reason for this is that the mother is insensitive to the signals of the infant,whose brain is programmed to learn language rapidly.If these sensitive periods are neglected,the ideal time for acquiring skills passes and they might never be learned so easily again.A bird learns to sing and to fly rapidly at the right time,but the process is slowand hard once the critical stage has passed. GNHW bC6_m
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Experts suggest that speech stages are reached in a fixed sequence and at a constant age,but there are casesswheresspeech has started late in a child who eventually turns out to be of high IQ. At twelve weeks a baby smiles and makes vowellike sounds;at twelve months he can speak simple words and understand simple commands;at eighteen months he has a vocabulary of three to fifty words.At three heknows about 1,000 words which he can putsintossentences,and at four his language differs from that of his parents in style rather than grammar. C<w&mFozL
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Recent evidence suggests that an infant is born with the capacity to speak.What is special about man's brain,compared with that of the monkey,is the complex system which enables a child to connect the sight and feel of,say,a toybear with the sound pattern `toybear. And even more incredibleis the young brain's ability to pick out ansgroupsin language from the mixture ofsound around him,to analyse,to combine and recombine the parts of a language innew ways. k/BlkjlNE
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But speech has to be induced,and this depends on interaction between the mother and the child,where the mother recognize the signals in the child's babbling (咿哑学语),grasping and smiling,and responds to them.Insensitivity of the mother to these signals dulls the interaction because the child gets discouraged and sends out only the obvious signals.Sensitivity to the child's nonverbal signalsis essential to the growth and development of language. CT'#~~QB
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13.The purpose of FrederickⅡ's experiment was. IlB*JJnl
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A.to prove that children are born with the ability to speak +wI<w|!
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B.to discover what language a child would speak without hearing any human speech ;krIuk-
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C.to find out what role careful nursing would play in teaching a child to speak HuQdQ*Q
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D.to prove that a child could be damaged without learning a language OG
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14.The reason some children are backward in speaking is most probably that. Qd>\{$N
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A.The faculty of speech is inborn in man. d`=LZio
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B.Encouragement is anything but essential to a child in language learning. `#vbV/sM
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D.Most children learn their language in definite stages. 1:>F{g
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17.If a child starts to speak later than others,he willin future. n?;rWq"
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American no longer expect public figures, whether in speech or in writing, to command the English language with skill and gift. Nor do they aspire to such command themselves. In his latest book, Doing Our Own Thing:The Degradation of language and Music and why we should like, care, John McWhorter, a linguist and controversialist of mixed liberal and conservative views, sees the triumph of 1960s counter-culture as responsible for the decline of formal English.
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Blaming the permissive 1960s is nothing new, but this is not yet another criticism against the decline in education. Mr.McWhorter’s academic speciality is language history and change, and he sees gradual disappearance of “whom” ,for example, to be natural and no more regrettable than the loss of the case-endings of Old English F_jHi0A
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But the cult of the authentic and the personal, “doing our own thing”, has spelt the death of formal speech, writing, poetry and music. While even the modestly educated sought an elevated tone when they put pen to paper before the 1960s, even the most well regarded writing since then has sought to capture spoken English on the page. Equally, in poetry, the highly personal, performative genre is the only form that could claim real liveliness. In both oral and written English, talking is triumphing over speaking, spontaneity over craft. 9;?u%
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Illustrated with an entertaining array of examples from both high and low culture, the trend that Mr. McWhorter documents is unmistakable. But it is less clear to take the question of his subtitle, why we should, like care. As a linguist, he acknowledges that all varieties of human language, including non-standard ones like Black English, can be powerfully expressive-there exists no language or dialect in the world that cannot convey complex ideas .He is not arguing, as many do, that we can no longer think straight because we do not talk proper. @qq"X'3t
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Russians have a deep love for their own language and carry large chunks of memorized poetry in their heads, while Italian politicians tend to elaborate speech that would seem old-fashioned to most English-speakers. Mr. McWhorter acknowledges that formal language is not strictly necessary, and proposes no radical education reforms-he is really grieving over the loss of something beautiful more than useful. We now take our English “on paper plates instead of china”. A shame, perhaps, but probably an inevitable one. #c>GjUJ.w
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[D]. brought about changes in public attitudes in the 1960s. $`E?=L`$
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[A]. modesty. ]?tRO
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. personality. tDX&