[英语考试]复旦研究生综合英语2修订版_Unit4

1、U8Additional lnformation for the Teachers Reference Text Active and Passive EuthanasiaWarm-up ActivitiesFurther ReadingWriting SkillsAdditional WorkWarm-up Activities1. Try to give a definition of euthanasia.2. Brainstorm about the pros and cons of euthanasia.3. Collect references to this issue and

2、take down notes. 4. Order information and work out your own opinion. Warm-up James Rachels was an American professor of moral philosophy and medical ethics who was particularly concerned with ethical issues. Born in Columbus, Georgia, he earned degrees at Mercer University and the University of Cali

3、fornia before joining the University of Alabama, Birmingham Department of Philosophy faculty in 1977. The popularity of his groundbreaking textbook anthology Moral Problems (1971), which sold 100,000 copies, influenced American universities to move away from more traditional philosophically oriented

4、 undergraduate moral philosophy courses toward more practical undergraduate courses in ethics. Additional lnformation for the Teachers Reference1. James Rachels (1941 - 2003)2. EuthanasiaEuthanasia is a practice of mercifully ending a persons life in order to release the person from an incurable dis

5、ease, intolerable suffering, or undignified death. The word euthanasia derives from the Greek for “good death and originally referred to intentional mercy killing. Proponents of euthanasia believe that unnecessarily prolonging life in terminally ill patients causes suffering to the patients and thei

6、r family members. Many societies now permit passive euthanasia, which allows physicians to withhold or withdraw life-sustaining treatment when directed to do so by the patient or an authorized representative. Euthanasia differs from assisted suicide, in which a patient voluntarily brings about his o

7、r her own death with the assistance of another person, typically a physician. In this case, the act is a suicide (intentional self-inflicted death), because the patient actually causes his or her own death.A. Related Laws As laws have evolved from their traditional religious underpinnings, certain f

8、orms of euthanasia have been legally accepted. In general, laws attempt to draw a line between passive euthanasia (generally associated with allowing a person to die) and active euthanasia (generally associated with killing a person). While laws commonly permit passive euthanasia, active euthanasia

9、is typically prohibited. Laws in the United States and Canada maintain the distinction between passive and active euthanasia. While active euthanasia is prohibited, courts in both countries have ruled that physicians should not be legally punished if they withhold or withdraw a life-sustaining treat

10、ment at the request of a patient or the patients authorized representative. These decisions are based on increasing acceptance of the doctrine that patients possess a right to refuse treatment. Until the late 1970s, whether or not patients possessed a legal right of refusal was highly disputed. One

11、factor that may have contributed to growing acceptance of this right is the ability to keep individuals alive for long periods of time even when they are permanently unconscious or severely brain-damaged. Proponents jets of legalized euthanasia believe that prolonging life through the use of modern

12、technological advances, such as respirators and kidney machines, may cause unwarranted suffering to the patient and the family. As technology has advanced, the legal rights of the patient to forgo such technological intervention have expanded. Every U.S. state has adopted laws that authorize legally

13、 competent individuals to make advanced directives, often referred to as living wills. Such documents allow individuals to control some features of the time and manner of their deaths. In particular, these directives empower and instruct doctors to withhold life-support systems if the individuals be

14、come terminally ill. Furthermore, the federal Patient Self-Determination Act, which became effective in 1991, requires federally certified health-care betfacilities to notify competent adult patients of their right to accept or refuse medical treatment. The facilities must also inform such patients

15、of their rights under the applicable state law to formulate an advanced directive. Patients in Canada have similar rights to refuse life-sustaining treatments and formulate advanced directives. As of mid-1999, only one U.S. state, Oregon, had enacted a law allowing physicians to actively assist pati

16、ents who wish to end their lives. However, Oregons law concerns assisted suicide rather than active euthanasia. It authorizes physicians to prescribe lethal amounts of medication that patients then administer themselves. In response to modern medical technology, physicians and lawmakers are slowly d

17、eveloping new professional and legal definitions of death. Additionally, experts are formulating rules to batimplement these definitions in clinical situations, for example, when procuring organs for transplantation. The majority of states have accepted a definition of brain death the point when cer

18、tain parts of the brain cease to function as the time when it is legal to turn off a patients life-support system, with permission from the family. In 1995 the Northern Territory of Australia became the first jurisdiction to explicitly legalize voluntary active euthanasia. However, the federal parli

19、ament of Australia overturned the law in 1997. In 2001 The Netherlands became the first country to legalize active euthanasia and assisted suicide, formalizing medical practices that the government had tolerated for years. Under the Dutch law, euthanasia is justified (not legally punishable) if the

20、mustphysician follows strict guidelines. Justified euthanasia occurs if (1) the patient makes a voluntary, informed, and stable request; (2) the patient is suffering unbearably with no prospect of improvement; (3) the physician consults with another physician, who in turn concurs with the decision t

21、o help the patient die; and (4) the physician performing the euthanasia procedure carefully reviews the patients condition. Officials estimate that about 2 percent of all deaths in The Netherlands each year occur as a result of euthanasia.B. Prevalence Although establishing the actual prevalence of

22、active euthanasia is difficult, studies suggest that the practice is not common in the United States. In a study published in 1998 in the New England Journal of Medicine, only about 6 percent of basketballphysicians surveyed reported that they had helped a patient hasten his or her own death by admi

23、nistering a lethal injection or prescribing a fatal dose of medication. (Eighteen percent of the responding physicians indicated that they had received requests for such assistance.) However, one-fifth of the physicians surveyed indicated that they would be willing to assist patients if it were lega

24、l to do so. No comparable data are available for Canada. However, in 1998 the Canadian Medical Association (CMA) proposed that a study of euthanasia and physician-assisted suicide be undertaken due to poor information on the subject.C. Ethical Concerns The issue of euthanasia raises ethical question

25、s for physicians and other health-care providers. The ethical code of physicians in theUnited States has long been based in part on the Hippocratic Oath, which requires physicians to do no harm. However, medical ethics are refined over time as definitions of harm change. Prior to the 1970s, the righ

26、t of patients to refuse life-sustaining treatment (passive euthanasia) was controversial. As a result of various court cases, this right is nearly universally acknowledged today, even among conservative bioethicists (see Medical Ethics). The controversy over active euthanasia remains intense, in par

27、t because of opposition from religious groups and many members of the legal and medical professions. Opponents of voluntary active euthanasia emphasize that health-care providers have professional obligations that prohibit killing. These opponents maintain that active euthanasia is inconsistent with

28、 the roles of nursing, basketballcaregiving, and healing. Opponents also argue that permitting physicians to engage in active euthanasia creates intolerable risks of abuse and misuse of the power over life and death. They acknowledge that particular instances of active euthanasia may sometimes be mo

29、rally justified. However, opponents argue that sanctioning the practice of killing would, on balance, cause more harm than benefit. Supporters of voluntary active euthanasia maintain that, in certain cases, relief from suffering (rather than preserving life) should be the primary objective of health

30、-care providers. They argue that society is obligated to acknowledge the rights of patients and to respect the decisions of those who elect euthanasia. Supporters of active euthanasia contend that since society has mutualacknowledged a patients right to passive euthanasia (for example, by legally re

31、cognizing refusal of life-sustaining treatment), active euthanasia should similarly be permitted. When arguing on behalf of legalizing active euthanasia, proponents emphasize circumstances in which a condition has become overwhelmingly burdensome for a patient, pain management for the patient is ina

32、dequate, and only a physician seems capable of bringing relief. They also point out that almost any individual freedom involves some risk of abuse and argue that such risks can be kept to a minimum by using proper legal safeguards.3. American Medical Association The American Medical Association (AMA

33、), founded in 1847 and incorporated 1897, is the largest association of physicians and medical students in the United States. It is a nonprofit professional association of physicians, including all medical specialties. The AMAs purpose is to promote the art and science of medicine for the betterment

34、 of the public health, to advance the interests of physicians and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, to raise money for medical education and to serve as an advocate for the advancement of the profession. The Association also publ

35、ishes the Journal of the American Medical Association (JAMA), which has the largest circulation of any weekly medical journal in the world. The AMA also publishes a list of Physician Specialty Codes which are a standard method in the U.S. for identifying physician and practice specialties.Text Activ

36、e and Passive EuthanasiaNotesIntroduction to the Author and the ArticlePhrases and ExpressionsExercisesMain Idea of the Text Main Idea of the Text 1Main Idea of the Text Rachelsessay “Active and Passive Euthanasia first appeared in the New England Journal of Medicine in 1975. In it, Rachels argues t

37、hat killing is not morally worse than letting a person die of natural causes, when done for humanitarian reasons. Therefore, active euthanasia is not any worse than passive euthanasia, and in cases where a patient is spared needless pain, arguably better. James Rachels (1941 2003) was an American pr

38、ofessor of moral philosophy and medical ethics who was particularly concerned with ethical issues. Born in Columbus, Georgia, he earned degrees at Mercer University and the University of California before joining the University of Alabama, Birmingham Department of Philosophy faculty in 1977. The pop

39、ularity of his groundbreaking textbook anthology Moral Problems (1971), which sold 100,000 copies, influenced American universities to move away from more traditional philosophically oriented undergraduate moral philosophy courses toward more practical undergraduate courses in ethics. Introduction t

40、o the Author and the articleIntroduction to the Author and the ArticleRachelsessay “Active and Passive Euthanasia first appeared in the New England Journal of Medicine in 1975. In it, Rachels argues that killing is not morally worse than letting a person die of natural causes, when done for humanita

41、rian reasons. Therefore, active euthanasia is not any worse than passive euthanasia, and in cases where a patient is spared needless pain, arguably better.Introduction to the Author and the articlePart2_T1 The distinction between active and passive euthanasia is thought to be crucial for medical eth

42、ics. The idea is that it is permissible, at least in some cases, to withhold treatment and allow a patient to die, but it is never permissible to take any direct action designed to kill the patient. This doctrine seems to be accepted by most doctors, and it is endorsed in a statement adopted by the

43、American Medical Association on December 4, 1973:James RachelsActive and Passive EuthanasiaText The intentional termination of the life of one human being by another mercy killing is contrary to that for which the medical profession stands and is contrary to the policy of the American Medical Associ

44、ation. The cessation of the employment of extraordinary means to prolong the life of the body when there is irrefutable evidence that biological death is imminent is the decision of the patient and/or his immediate family. The advice and judgment of the physician should be freely available to the pa

45、tient and/or his immediate family.Part2_T2 However, a strong case can be made against this doctrine. In what follows I will set out some of the relevant arguments, and urge doctors to reconsider their views on this matter. To begin with a familiar type of situation, a patient who is dying of incurab

46、le cancer of the throat is in terrible pain, which can no longer be satisfactorily alleviated. He is certain to die within a few days, even if present treatment is continued, but he does not want to go on living for those days since the pain is unbearable. So he asks the doctor for an end to it, and

47、 his family joins in the request. Part2_T3 Suppose the doctor agrees to withhold treatment, as the conventional doctrine says he may. The justification for his doing so is that the patient is in terrible agony, and since he is going to die anyway, it would be wrong to prolong his suffering needlessl

48、y. But now notice this. If one simply withholds treatment, it may take the patient longer to die, and so he may suffer more than he would if more direct action were taken and a lethal injection given. This fact provides a strong reason for thinking that, once the initial decision not to prolong his

49、agony has been made, active euthanasia is actually preferable to passive euthanasia, rather than the reverse. To say otherwise is to endorse the option that leads to more suffering rather than less, and is contrary to the humanitarian impulse that prompts the decision not to prolong his life in the

50、first place.Part2_T4 Part of my point is that the process of being “allowed to die can be relatively slow and painful, whereas being given a lethal injection is relatively quick and painless. Let me give a different sort of example. In the United States about one in 600 babies is born with Downs syn

51、drome.1 Most of these babies are otherwise healthy that is, with only the usual pediatric care, they will proceed to an otherwise normal infancy. Some, however, are born with congenital defects such as intestinal obstruction that require operations if they are to live. Sometimes, the parents and the

52、 doctor will decide not to operate, and let the infant die. Anthony Shaw describes what happens then:Part2_T5Part2_T6 . When surgery is denied the doctor must try to keep the infant from suffering while natural forces sap the babys life away. As a surgeon whose natural inclination is to use the scal

53、pel to fight off death, standing by and watching a salvageable baby die is the most emotionally exhausting experience I know. It is easy at a conference, in a theoretical discussion, to decide that such infants should be allowed to die. It is altogether different to stand by in the nursery and watch

54、 as dehydration and infection wither a tiny being over hours and days. This is a terrible ordeal for me and the hospital staff much worse so than for the parents who never set foot in the nursery.Part2_T7I can understand why some people are opposed to all euthanasia and insist that such infants must

55、 be allowed to live. I think I can also understand why other people favor destroying these babies quickly and painlessly. But why should anyone favor letting “dehydration and infection wither a tiny being over hours and days? The doctrine that says that a baby may be allowed to dehydrate and wither,

56、 but may not be given an injection that would end its life without suffering, seems so patently cruel as to require no further refutation. The strong language is not intended to offend, but only to put the point in the clearest possible way. My second argument is that the conventional doctrine leads

57、 to decisions concerning life and death made on irrelevant grounds.Part2_T8 Consider again the case of the infants with Downs syndrome who need operations for congenital defects unrelated to the syndrome to live. Sometimes, there is no operation, and the baby dies, but when there is no such defect,

58、the baby lives on. Now, an operation such as that to remove an intestinal obstruction is not prohibitively difficult. The reason why such operations are not performed in these cases is, clearly, that the child has Downs syndrome and the parents and doctor judge that because of the fact it is better

59、for the child to die. But notice that this situation is absurd, no matter what view one takes of the lives and potentials of such babies. If the life of such an infant is worth preserving, what does it matter if it needs a simple operation? Or, if one thinks it better that such a baby should not liv

60、e on, what difference does it make that it happens to have an unobstructed intestinal tract? In either case, the matter of life and death is being decided on irrelevant grounds. It is the Downs syndrome, and not the intestines, that is the issue. The matter should be decided, if at all, on that basi