学术英语-医学教学课件：Unit 7 Physician-Patient Relationship

1、TABLE 1 Prefixes for DegreePREFIXMEANINGEXAMPLEDEFINITION OF EXAMPLEolig/ofew, scantyoligomenorrheaa scanty menstrual flow (men/o)经量异常pan-allpanaceapnsi:remedy that cures all ills; a cure-all治百病的药super-*above, excesssupernumeraryin excess numberTABLE2 Prefixes for Size and ComparisonPREFIXMEANINGEXA

2、MPLEDEFINITION OF EXAMPLEequi-equal, sameequilateralhaving equal sides等边的，等面的hetero-other, different, unequalheterosexualpertaining to the opposite sex异性恋的；异性的homo-,homeo-same, unchanginghomothermicmaintaining a constant body temperature(root therm/o); warm blooded恒温的iso-equal, sameisograftaisr:ftgr

3、aft between two genetically identical individuals同基因移植物macro-large, abnormally largemacrocytemkrsaitextremely large red blood cell大红细胞TABLE3 Prefixes for Size and Comparison, continuedPREFIXMEANINGEXAMPLEDEFINITION OF EXAMPLEmega-,*megalolarge; abnormally largemegabladderenlargement of the bladder膀胱

4、扩张micro-smallmicroscopicextremely small; visible only through a microscope显微镜的neo-newNeonateni:neta newborn infant新生儿哺乳动物normonormalnormovolemian:mvli:minormal blood volume血量正常orthostraight, correct, uprightorthotic:tikCorrecting or prevcnting deformities矫正的*Mega- also means “one million” as in mega

5、hertz.Micro- also means “one millionth” as in microsecond.TABLE4 Prefixes for Size and Comparison, continuedPREFIXMEANINGEXAMPLEDEFINITION OF EXAMPLEpoikilo-varied; irregularpoikilodermapikilud:m皮肤异色病pseudo-falsepseudoplegiafalse paralysis (suffix -plegia)假麻痹，假瘫re-again; backregurgitationbackward or

6、 return flow, as of blood orstomach contents回流；反刍TABLE5 Prefixes for Time and/or PositionPREFIXMEANINGEXAMPLEDEFINITION OF EXAMPLEante-beforeantenatalntineitlbefore birth产前pre-before, in front ofpredisposingleading toward a condition, such as disease使易于患（病）pro-before, in front ofprodromeprudrumsympt

7、om that precedes a disease前驱症状post-after, behindpostmenopausalpustmenup:zlafter menopauseadj.（妇女）绝经后的TABLE6 Prefixes for PositionPREFIXMEANINGEXAMPLEDEFINITION OF EXAMPLEdextr/orightDextrocardiadekstrk:djlocation of the heart (cardi/o) in th右位心e right side of the chestsinistr/oleftsinistradsinistrdt

8、oward the leftadv.向左ec-,ecto-out; outsideectodermektud:moutermost layer of the developing embryo外胚层ex/oaway from; outsideexciseto cut out切除，删去TABLE7 Prefixes for Position ContinuedPREFIXMEANINGEXAMPLEDEFINITION OF EXAMPLEend/o-in; withinEndoscopeenduskupdevice for viewing the inside of a cavity oror

9、gan内窥镜mes/omiddlemesencephalonmesenseflnmidbrain中脑syn-,sym-(used beforeb, m, p,)togetherSynapsesnpsa junction between two nerve cells(神经元的)突触tel/e-, tel/o-endtelangiona terminal vessel (root angi/o)终动脉Unit 7Physician-Patient RelationshipLife can be hard. Relationships are often difficult. In an era

10、of fast advancing medical technology, rapidly changing medical ethics, and in increasingly litigious society, good physician-patient relationship is critically important for effective health care delivery. This unit sheds some light on how to build such a relationship to help us through the unpredic

11、tability in life.Unit 7 Life and MedicineUnit ContentsLead-inText AText BText CListeningSpeakingWritingGet reading for Unit 8Lead-inDecide whether life-support system should be continued or withdrawn;Decide whether euthanasia should be considered;Decide whether a new therapy should be tried;Decide w

12、hether surgery should be the first choice or the last resort;Decide whether transfer or referral is needed.Task: Read the title of Text A and imagine three different situations in which doctors may be asked to make “tough decisions” for their patients. Then write them down.Unit 7 Life and MedicineTe

13、xt A Critical reading and thinking Topics for presentation Useful expressions Difficult sentencesLanguage building-up Signpost language Vocabulary testSuggested answersUnit 7 Life and MedicineText A Critical reading and thinkingTopics for presentation1 What difficult situation is the young doctor fa

14、cing? A dying patientDecision whether to withdraw life-support machines and medication and start comfort measuresThe familys refusal to make any decision or withdraw any treatmentsUnit 7 Life and MedicineText A Useful expressions护士站 nursing station停止使用呼吸机并停药/停止治疗 withdraw life-support machines and m

15、edications / treatmentwho was impressive not only for his clinical skills but also for his devotion to patientswho was impressive not only for his clinical skills but also for his devotion to patientsI told them suffering or comfort it was their decision.But in the end, they made no decision and jus

16、t walked right out of the room Critical reading and thinkingUnit 7 Life and Medicine2 What is paternalistic decision-making in medicine? Topics for presentationText A Critical reading and thinkingDoctors as exclusive decision makerPatients as participants without little say in the final choiceUnit 7

17、 Life and MedicineText A Useful expressionsThe way doctors and patients approach medical decisions has changed sharply over the last 50 years.and patients, if they participated, often had little say in the final choice. Critical reading and thinkingUnit 7 Life and MedicineText A Topics for presentat

18、ion3 In what way can patient empowerment be good for the patient? Critical reading and thinkingRespect for the patient, especially the patients autonomyPatient-center careThe Patients as decision maker based on the information provided by the doctorUnit 7 Life and MedicineText A Topics for presentat

19、ion3 In what way can patient empowerment be good for the patient? Critical reading and thinkingTwo principles /tenets / notions involved in the decision-making processrespect for the person a new clinical ideal: patient-centered care in wards, clinics and operating roomsrespect for a persons autonom

20、y letting patients make their own decisionsUnit 7 Life and MedicineText A Topics for presentation4 Why does the author say too much physician restraint may not be that good for the patient? Critical reading and thinkingThe patients are forced to make decisions they never want to.Patients, at least a

21、 large majority, prefer their doctors to make final decisions.Shifting responsibility of decision making to the patients will bring about more stress to the patients and their families, especially when the best option for the patient is uncertainUnit 7 Life and MedicineText A Useful expressionsa maj

22、ority of patients are being left to make decisions that they never wanted to in the first place.When it came to medical decisions, almost all the respondents wanted their doctors to offer choices and consider their opinions. But a majority of patients two out of three also preferred that their docto

23、rs make the final decisions regarding their medical care. not when the medical choices are obvious, but when the best option for a patient is uncertainwhen doctors pass the burden of decision-making to a patient or family, it can exacerbate an already stressful situation.Critical reading and thinkin

24、gUnit 7 Life and MedicineText A Topics for presentation5. What kind of considerations may have prevented doctors from making decisions for their patients? Critical reading and thinkingDoctors are very much cautious about committing some kind of ethical transgression. Who am I to presume to know what

25、 my patients need?Unit 7 Life and MedicineText A A Case in Point: Language Makes a Difference Tell relatives that it is their choice to withdraw life support from a dying patient. But that doctor may also use value-laden language to describe the options. One alternative may be described to the famil

26、y as “reasonable” or “comforting,” while the other is depicted as “invasive,” “aggressive” or “painful” .Critical reading and thinkingUnit 7 Life and MedicineText A A Case in Point: Language Makes a Difference Dr. Curlins Wisdom IBizarre dishonest of communicationPatients end up feeling manipulated

27、and will resist making any decision at all.Critical reading and thinkingUnit 7 Life and MedicineText A A Case in Point: Language Makes a Difference Dr. Curlins Wisdom II “We have to stop drawing a circle around patients and their families,” “We have to stop subjecting them to the loneliness and burd

28、en of autonomy and instead begin standing in that circle with them.”Critical reading and thinkingUnit 7 Life and Medicine6 Do you agree that doctors should be prepared to make any decisions together with their patients? Text A Topics for presentationCritical reading and thinkingShouldering responsib

29、ility together with the patient may be better than having the patient make decision on their own alone.Balancing between paternalism and respect for patients autonomy constitutes a large part of medical practice.Unit 7 Life and MedicineText A Useful expressionsthe key to preserving patient autonomy

30、and patient-centered carelies not in letting patients make the final decisions alone but in respecting their opinions and shouldering the responsibility together.I admit, myself, will need to be more mindful of whether patients want them to share information, be directive or hand over the responsibi

31、lity of the decision.Critical reading and thinkingUnit 7 Life and MedicineText A Difficult sentencesHe was large and powerfully built but never seemed to loom over his patientsCritical reading and thinking他身材高大伟岸，但是从来不让病人有咄咄逼人的感觉Unit 7 Life and MedicineText A Difficult sentencesas movements calling

32、for patient empowerment grew and medical ethicists began articulating principles regarding the ethical care of patients. Critical reading and thinking要求病人授权的呼声越来越高，而且医学伦理学家也开始阐述病人伦理关怀的相关原则。Unit 7 Life and MedicineText A Difficult sentencesOne tenet that gained particular traction among cliniciansCri

33、tical reading and thinking临床医生们尤为拥护的一条宗旨this ethical principle led to a new clinical ideal: patient-centered care这条伦理原则导致了一种新的临床理念的出现：以病人为中心的医护。Unit 7 Life and MedicineText A Difficult sentencesyoung doctors, myself included, would be trained to restrain ourselves from making anything but emergency

34、or mundane decisions for patients.Critical reading and thinking包括我在内，年轻医生将接受培训，学会除了一些紧急状况或日常琐事，不为病人作其他任何决定。Unit 7 Life and MedicineText A Difficult sentencesWhile doctors might equate letting patients make their own decisions with respectCritical reading and thinking虽然医生也许认为让病人自己作决定就是尊重病人Unit 7 Life

35、 and MedicineText A Difficult sentencesSome will resort to veiling their own opinions in ahalfhearted attempt to direct the decision.Critical reading and thinking有些医生采取的做法是隐藏自己的观点，用隐隐约约的方式引导病人作决定。Unit 7 Life and MedicineText A Difficult sentencesWhile the doctors might be convinced that they are bei

36、ng objective and dispassionate, more often than not they are sending mixed messages.Critical reading and thinking虽然医生坚信自己的态度客观冷静，但往往他们在向病人发出莫衷一是的信息。Unit 7 Life and Medicinea nursing _ (护士站)_machines (生命维持系统)comfort _(舒适护理措施)to _ treatment (停止治疗)_ decision-making process(家长式决策程序)patient _ (给病人授权)medi

37、cal _ (医学伦理学家)ethical_ (伦理准则)clinical _ (临床理念) _ care (以病人为中心的护理) Text A Language Building-up Vocabulary Teststation life-support measureswithdrawpaternalisticempowermentethicistsprinciplesidealUnit 7 Life and Medicinepatient-centeredpatient _ (病人自主权)treatment _ (治疗选择)_purview(专属领域)_ decisions (紧急情况

38、下做的决定)physician_ (对医生的限制)_ and confusion (焦虑与困惑)ethical _ (违背伦理)family _ (家庭医疗) Text A Language Building-up Vocabulary Testautonomy options exclusiveemergencyrestraintanxietytransgressionpracticeUnit 7 Life and MedicineText A Suggested answersTask 1 OverviewThis text can be briefly divided into thre

39、e parts: introduction of the topic and the theme, argumentation for the theme, and conclusion. Read the text carefully and fill in the missing information for each part in the following diagram.Critical reading and thinkingUnit 7 Life and MedicineText A Suggested answersTask 1 OverviewCritical readi

40、ng and thinkingBackground information:Change from the paternalistic care to the patient-centered care Two underlying ethical principles: respect for the person and respect for the persons autonomy Conclusion: The key for preserving patient autonomy lies in respecting their opinions and shouldering t

41、he responsibility together.Theme: Too much physician restraint is harmful or unethical. Letting Doctors Make the Tough DecisionsAnecdote: a young doctors experience Main Supports: Study findings: most patients positionTwo arguments: Exacerbating the stressful situationCreating dishonesty in communic

42、ationPart I(P1-P8)Part II(P9-P14)Part III(P15-P16)Unit 7 Life and MedicineText A Task 1/ Medical terminology Match each definition with its corresponding English term and Chinese equivalent.EnglishChinese Definition1medicine or drugs given to people who are ill2the condition or quality of being auto

43、nomous; independence3an expert clinical physician4of, pertaining to, or correctable by surgery5causing pain, full of painmedication药物，药物治疗自主性 autonomy临床医生cliniciansurgical外科的painful 疼痛的Suggested answersLanguage building-up2Unit 7 Life and MedicineText A EnglishChinese Definition6of, relating to, or

44、connected with a clinic7a specialist in ethics8not ethical9a person licensed to practice medicine; a medical doctor10admit or send (a person) into a hospital for treatmentphysician医生，内科医生clinical临床的ethicist伦理学家unethical不道德的hospitalize住院Task1 / Medical terminologyMatch each definition with its corres

45、ponding English term and Chinese equivalent.Suggested answers2Language building-upUnit 7 Life and MedicineText A Task 2 / Signpost language Underline the first sentences of paragraphs 4,5,6,8,11 and 12, analyze how the author manages to bring a new topic and maintain coherence, and complete the foll

46、owing table.Language building-upSuggested answersKey words repeated to achieve smooth transitionKey words used to introduce a new topic1st sentence of Para.4decisionschanged 1st sentence of . 5tenetrespect for the person1st sentence of . 6ethical principlerespect for a persons autonomy1st sentence o

47、f . 8physician restraintnot be all that good, unethical1st sentence of . 11medical choices, optionchallenge, uncertain1st sentence of . 12patients and their families(doctors) own set of worriesUnit 7 Life and MedicineText A Task 3 / Formal EnglishThe following sentences are taken from Text A. Replac

48、e the underlined formal words with less formal ones.For generations, these decisions were the exclusive purview of doctors(para.4)One tenet that gained particular traction among clinicians was respect for the person.(para.5)and that interpretation would work its way into the teaching programs of med

49、ical schools and into state laws that mandated discussion of treatment options with patients.(para.6)Language building-upSuggested answersbelief / ideaarea / fieldorderedUnit 7 Life and MedicineText A Task 3 / Formal EnglishThe following sentences are taken from Text A. Replace the underlined formal

50、 words with less formal ones.When it came to medical decisions, almost all the respondents wanted their doctors to offer choices and consider their options. (para.9)But a majority of patientstwo out of threealso preferred that their doctors make the final decisions regarding their medical care.(para

51、.9)6 doctors, like my young colleagues and, I admit, myself, will need to be more mindful of whether patients want them to share information(para.15) Language building-upSuggested answersconscious / awarerelating to/ aboutanswerersUnit 7 Life and Medicine Text A Additional activity Group presentatio

52、nHospice movement has been a popular concept in recent decades in the field of health care. Work in a small group and explore relevant information about this subject in the following aspects: 1. definition2. history 3. advantages 4. development in ChinaUnit 7 Life and MedicineText BCritical reading

53、and thinkingLanguage building-upSuggested answersUnit 7 Life and MedicineText B Critical Reading and Thinking1. Pats Personal StatusA 78-year-old woman suffering from lung cancer with widespread metastases and receiving palliative care from hospiceA dairy farmerMother of sixInterior designerOne of t

54、he best pie bakers in the countyWrite down the information on the following topics. Then compare your answers with your partner.Unit 7 Life and MedicineText B Critical Reading and ThinkingKnowledge of Subject Matter Write down the information on the following topics. Then compare your answers with y

55、our partner.lung cancerReports from the hospital and oncologist confirmed widespread metastases.Pat had declined aggressive treatment.She was receiving palliative care from hospice under the supervision of an oncologist.1. Pats Personal StatusUnit 7 Life and MedicineText B Critical Reading and Think

56、ing2. Pats electronic recordThe computerized tomography (CT) : extensive bilateral infiltrates and a possible small nodule in the base of the left lung with follow-up recommended but not obtainedA chest X-ray more than a year ago: a left lower-lobe pneumonia with follow-up suggested but not obtained

57、 Write down the information on the following topics. Then compare your answers with your partner.Unit 7 Life and MedicineText B Critical Reading and Thinking2. the reasons for her having problems with doctorsKnowledge of Subject Matter Write down the information on the following topics. Then compare

58、 your answers with your partner.pulmonary embolicomputerized tomography (CT)extensive bilateral infiltratesa possible small nodule in the base of the left lungA chest X-ray report from a visit more than a year ago with one of my partners revealed a left lower-lobe pneumonia and suggested follow-up t

59、o ensure resolutionUnit 7 Life and MedicineText B Critical Reading and Thinking3. the medical mistakeWrite down the information on the following topics. Then compare your answers with your partner.The abnormality not noted.Frequent visits to doctors but not informed of the findingsUnit 7 Life and Me

60、dicineText B Critical Reading and Thinking4. the authors self-reflection Write down the information on the following topics. Then compare your answers with your partner.Who to blame? None of the hospital team, my partners, or the radiologists to take the blame.As Pats family physician, the authors r