学术英语医学Unit7

学术英语医学AcademicEnglishforMedicine第一页，共67页。Unit7Physician-PatientRelationshipLifecanbehard.Relationshipsareoftendifficult.Inaneraoffastadvancingmedicaltechnology,rapidlychangingmedicalethics,andinincreasinglylitigioussociety,goodphysician-patientrelationshipiscriticallyimportantforeffectivehealthcaredelivery.Thisunitshedssomelightonhowtobuildsucharelationshiptohelpusthroughtheunpredictabilityinlife.第二页，共67页。Unit7LifeandMedicineUnitContentsLead-inTextATextBTextCListeningSpeakingWritingGet

readingforUnit8第三页，共67页。Lead-inIssuestobecoveredTaskUnit7LifeandMedicine第四页，共67页。Lead-inIssuestobecoveredTheshiftfrompaternalisticparadigmtopatient-centerparadigminmedicaldecisionmakingTheimportanceofgoodphysician-patientrelationshipinboththemedicalpracticeandthepatient’srecoveryThingsthatcountsinmaintainingaamiablephysician-patientrelationshipThewaytocommunicateproperlyandeffectivelywiththepatientsUnit7LifeandMedicine第五页，共67页。Lead-inDecidewhetherlife-supportsystemshouldbecontinuedorwithdrawn;Decidewhethereuthanasiashouldbeconsidered;Decidewhetheranewtherapyshouldbetried;Decidewhethersurgeryshouldbethefirstchoiceorthelastresort;Decidewhethertransferorreferralisneeded.Task:ReadthetitleofTextAandimaginethreedifferentsituationsinwhichdoctorsmaybeaskedtomake“toughdecisions〞fortheirpatients.Thenwritethemdown.Unit7LifeandMedicine第六页，共67页。TextACriticalreadingandthinking–Topicsforpresentation–Usefulexpressions–DifficultsentencesLanguagebuilding-up–Signpostlanguage–VocabularytestSuggestedanswersUnit7LifeandMedicine第七页，共67页。TextA

CriticalreadingandthinkingTopicsforpresentation1Whatdifficultsituationistheyoungdoctorfacing??AdyingpatientDecisionwhethertowithdrawlife-supportmachinesandmedicationandstartcomfortmeasuresThefamily’srefusaltomakeanydecisionorwithdrawanytreatmentsUnit7LifeandMedicine第八页，共67页。TextA

Usefulexpressions护士站nursingstation停顿使用呼吸机并停药/停顿治疗withdrawlife-supportmachinesandmedications/treatment…whowasimpressivenotonlyforhisclinicalskillsbutalsoforhisdevotiontopatients…whowasimpressivenotonlyforhisclinicalskillsbutalsoforhisdevotiontopatientsItoldthemsufferingorcomfort—itwastheirdecision.Butintheend,theymadenodecisionandjustwalkedrightoutoftheroom

CriticalreadingandthinkingUnit7LifeandMedicine第九页，共67页。2Whatispaternalisticdecision-makinginmedicine?TopicsforpresentationTextA

CriticalreadingandthinkingDoctorsasexclusivedecisionmakerPatientsasparticipantswithoutlittlesayinthefinalchoiceUnit7LifeandMedicine第十页，共67页。TextA

UsefulexpressionsThewaydoctorsandpatientsapproachmedicaldecisionshaschangedsharplyoverthelast50years.…andpatients,iftheyparticipated,oftenhadlittlesayinthefinalchoice.CriticalreadingandthinkingUnit7LifeandMedicine第十一页，共67页。TextA

Topicsforpresentation3Inwhatwaycanpatientempowermentbegoodforthepatient?CriticalreadingandthinkingRespectforthepatient,especiallythepatient’sautonomyPatient-centercareThePatientsasdecisionmakerbasedontheinformationprovidedbythedoctorUnit7LifeandMedicine第十二页，共67页。TextA

Topicsforpresentation3Inwhatwaycanpatientempowermentbegoodforthepatient?CriticalreadingandthinkingTwoprinciples/tenets/notionsinvolvedinthedecision-makingprocessrespectforthepersonanewclinicalideal:patient-centeredcareinwards,clinicsandoperatingroomsrespectforaperson’sautonomylettingpatientsmaketheirowndecisionsUnit7LifeandMedicine第十三页，共67页。TextA

Topicsforpresentation4Whydoestheauthorsaytoomuchphysicianrestraintmaynotbethatgoodforthepatient?CriticalreadingandthinkingThepatientsareforcedtomakedecisionstheyneverwantto.Patients,atleastalargemajority,prefertheirdoctorstomakefinaldecisions.Shiftingresponsibilityofdecisionmakingtothepatientswillbringaboutmorestresstothepatientsandtheirfamilies,especiallywhenthebestoptionforthepatientisuncertainUnit7LifeandMedicine第十四页，共67页。TextA

Usefulexpressions…amajorityofpatientsarebeinglefttomakedecisionsthattheyneverwantedtointhefirstplace.Whenitcametomedicaldecisions,almostalltherespondentswantedtheirdoctorstoofferchoicesandconsidertheiropinions.Butamajorityofpatients—twooutofthree—alsopreferredthattheirdoctorsmakethefinaldecisionsregardingtheirmedicalcare.…notwhenthemedicalchoicesareobvious,butwhenthebestoptionforapatientisuncertain…whendoctorspasstheburdenofdecision-makingtoapatientorfamily,itcanexacerbateanalreadystressfulsituation.CriticalreadingandthinkingUnit7LifeandMedicine第十五页，共67页。TextA

Topicsforpresentation5.Whatkindofconsiderationsmayhavepreventeddoctorsfrommakingdecisionsfortheirpatients?CriticalreadingandthinkingDoctorsareverymuchcautiousaboutcommittingsomekindofethicaltransgression.‘WhoamItopresumetoknowwhatmypatientsneed?’Unit7LifeandMedicine第十六页，共67页。TextA

ACaseinPoint:LanguageMakesaDifferenceTellrelativesthatitistheirchoicetowithdrawlifesupportfromadyingpatient.Butthatdoctormayalsousevalue-ladenlanguagetodescribetheoptions.Onealternativemaybedescribedtothefamilyas“reasonable〞or“comforting,〞whiletheotherisdepictedas“invasive,〞“aggressive〞or“painful〞.CriticalreadingandthinkingUnit7LifeandMedicine第十七页，共67页。TextA

ACaseinPoint:LanguageMakesaDifferenceDr.Curlin’sWisdomIBizarredishonestofcommunicationPatientsendupfeelingmanipulatedandwillresistmakinganydecisionatall.CriticalreadingandthinkingUnit7LifeandMedicine第十八页，共67页。TextA

ACaseinPoint:LanguageMakesaDifferenceDr.Curlin’sWisdomII“Wehavetostopdrawingacirclearoundpatientsandtheirfamilies,〞“Wehavetostopsubjectingthemtothelonelinessandburdenofautonomyandinsteadbeginstandinginthatcirclewiththem.〞CriticalreadingandthinkingUnit7LifeandMedicine第十九页，共67页。6Doyouagreethatdoctorsshouldbepreparedtomakeanydecisionstogetherwiththeirpatients?TextA

TopicsforpresentationCriticalreadingandthinkingShoulderingresponsibilitytogetherwiththepatientmaybebetterthanhavingthepatientmakedecisionontheirownalone.Balancingbetweenpaternalismandrespectforpatient’sautonomyconstitutesalargepartofmedicalpractice.Unit7LifeandMedicine第二十页，共67页。TextA

Usefulexpressionsthekeytopreservingpatientautonomy—andpatient-centeredcare—liesnotinlettingpatientsmakethefinaldecisionsalonebutinrespectingtheiropinionsandshoulderingtheresponsibilitytogether.Iadmit,myself,willneedtobemoremindfulofwhetherpatientswantthemtoshareinformation,bedirectiveorhandovertheresponsibilityofthedecision.CriticalreadingandthinkingUnit7LifeandMedicine第二十一页，共67页。TextA

AdditionalActivityWatchtheVideoandseewhataretipsgivenbyDr.ThaddeusBelltobuildaAmiablePPRelationshipDoctor-PatientRelationshipCriticalreadingandthinkingUnit7LifeandMedicine第二十二页，共67页。TextA

DifficultsentencesHewaslargeandpowerfullybuiltbutneverseemedtoloomoverhispatients…Criticalreadingandthinking他身材高大伟岸，但是从来不让病人有咄咄逼人的感觉Unit7LifeandMedicine第二十三页，共67页。TextA

Difficultsentences…asmovementscallingforpatientempowermentgrewandmedicalethicistsbeganarticulatingprinciplesregardingtheethicalcareofpatients.Criticalreadingandthinking…要求病人受权的呼声越来越高，而且医学伦理学家也开场阐述病人伦理关心的相关原那么。Unit7LifeandMedicine第二十四页，共67页。TextA

DifficultsentencesOnetenetthatgainedparticulartractionamongclinicians…Criticalreadingandthinking临床医生们尤为拥护的一条宗旨…thisethicalprincipleledtoanewclinicalideal:patient-centeredcare…这条伦理原那么导致了一种新的临床理念的出现：以病人为中心的医护。Unit7LifeandMedicine第二十五页，共67页。TextA

Difficultsentences…youngdoctors,myselfincluded,wouldbetrainedtorestrainourselvesfrommakinganythingbutemergencyormundanedecisionsforpatients.Criticalreadingandthinking…包括我在内，年轻医生将承受培训，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。Unit7LifeandMedicine第二十六页，共67页。TextA

Difficultsentences…andthatinterpretationwouldworkitswayintotheteachingprogramsofmedicalschoolsandintostatelawsthatmandateddiscussionoftreatmentoptionswithpatients.Criticalreadingandthinking…而且，对病人自主性的解释逐渐进入了医学院校的课程，也被写进各州的法律，规定医生必须与病人讨论治疗方案的选择。Unit7LifeandMedicine第二十七页，共67页。TextA

DifficultsentencesWhiledoctorsmightequatelettingpatientsmaketheirowndecisionswithrespect…Criticalreadingandthinking虽然医生也许认为让病人自己作决定就是尊重病人…Unit7LifeandMedicine第二十八页，共67页。TextA

DifficultsentencesSomewillresorttoveilingtheirownopinionsinahalfheartedattempttodirectthedecision.Criticalreadingandthinking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。Unit7LifeandMedicine第二十九页，共67页。TextA

DifficultsentencesWhilethedoctorsmightbeconvincedthattheyarebeingobjectiveanddispassionate,moreoftenthannottheyaresendingmixedmessages.Criticalreadingandthinking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。Unit7LifeandMedicine第三十页，共67页。anursing________(护士站)___________machines(生命维持系统)comfort_________(舒适护理措施)to_________treatment(停顿治疗)___________decision-makingprocess(家长式决策程序)patient______________(给病人受权)medical___________(医学伦理学家)ethical__________(伦理准那么)clinical_________(临床理念)________________care(以病人为中心的护理)

TextA

LanguageBuilding-up

VocabularyTeststationlife-supportmeasureswithdrawpaternalisticempowermentethicistsprinciplesidealUnit7LifeandMedicinepatient-centered第三十一页，共67页。patient_________(病人自主权)treatment___________(治疗选择)__________purview(专属领域)__________decisions(紧急情况下做的决定)physician__________(对医生的限制)_________andconfusion(焦虑与困惑)ethical_____________(违犯伦理)family________(家庭医疗)

TextA

LanguageBuilding-up

VocabularyTestautonomyoptionsexclusiveemergencyrestraintanxietytransgressionpracticeUnit7LifeandMedicine第三十二页，共67页。TextASuggestedanswersTask1OverviewThistextcanbebrieflydividedintothreeparts:introductionofthetopicandthetheme,argumentationforthetheme,andconclusion.Readthetextcarefullyandfillinthemissinginformationforeachpartinthefollowingdiagram.CriticalreadingandthinkingUnit7LifeandMedicine第三十三页，共67页。TextASuggestedanswersTask1OverviewCriticalreadingandthinkingBackgroundinformation:Changefromthepaternalisticcaretothepatient-centered

careTwounderlyingethicalprinciples:respectfortheperson

andrespectfortheperson’sautonomy

Conclusion:Thekeyforpreservingpatientautonomyliesinrespectingtheiropinionsandshoulderingtheresponsibilitytogether.Theme:Toomuchphysicianrestraintisharmfulorunethical.

LettingDoctorsMaketheToughDecisionsAnecdote:ayoungdoctor’sexperienceMainSupports:Studyfindings:mostpatients’positionTwoarguments:ExacerbatingthestressfulsituationCreatingdishonestyincommunicationPartI(P1-P8)PartII(P9-P14)PartIII(P15-P16)Unit7LifeandMedicine第三十四页，共67页。TextATask1/MedicalterminologyMatcheachdefinitionwithitscorrespondingEnglishtermandChineseequivalent.EnglishChineseDefinition1medicineordrugsgiventopeoplewhoareill2theconditionorqualityofbeingautonomous;independence3anexpertclinicalphysician4of,pertainingto,orcorrectablebysurgery5causingpain,fullofpainmedication药物，药物治疗自主性

autonomy临床医生cliniciansurgical外科的painful疼痛的SuggestedanswersLanguagebuilding-up2Unit7LifeandMedicine第三十五页，共67页。TextAEnglishChineseDefinition6of,relatingto,orconnectedwithaclinic7aspecialistinethics8notethical9apersonlicensedtopracticemedicine;amedicaldoctor10admitorsend(aperson)intoahospitalfortreatmentphysician医生，内科医生clinical临床的ethicist伦理学家unethical不道德的hospitalize住院Task1/MedicalterminologyMatcheachdefinitionwithitscorrespondingEnglishtermandChineseequivalent.Suggestedanswers2Languagebuilding-upUnit7LifeandMedicine第三十六页，共67页。TextATask2/SignpostlanguageUnderlinethefirstsentencesofparagraphs4,5,6,8,11and12,analyzehowtheauthormanagestobringanewtopicandmaintaincoherence,andcompletethefollowingtable.Languagebuilding-upSuggestedanswersKeywordsrepeatedtoachievesmoothtransitionKeywordsusedtointroduceanewtopic1stsentenceofPara.4decisionschanged1stsentenceof.5tenetrespectfortheperson1stsentenceof.6ethicalprinciplerespectforaperson’sautonomy1stsentenceof.8physicianrestraintnotbeallthatgood,unethical1stsentenceof.11medicalchoices,optionchallenge,uncertain1stsentenceof.12patientsandtheirfamilies(doctors’)ownsetofworriesUnit7LifeandMedicine第三十七页，共67页。TextATask3/FormalEnglishThefollowingsentencesaretakenfromTextA.Replacetheunderlinedformalwordswithlessformalones.Forgenerations,thesedecisionsweretheexclusive

purviewofdoctors…(para.4)Onetenetthatgainedparticulartractionamongclinicianswasrespectfortheperson.(para.5)…andthatinterpretationwouldworkitswayintotheteachingprogramsofmedicalschoolsandintostatelawsthatmandateddiscussionoftreatmentoptionswithpatients.(para.6)Languagebuilding-upSuggestedanswersbelief/ideaarea/fieldorderedUnit7LifeandMedicine第三十八页，共67页。TextATask3/FormalEnglishThefollowingsentencesaretakenfromTextA.Replacetheunderlinedformalwordswithlessformalones.Whenitcametomedicaldecisions,almostalltherespondentswantedtheirdoctorstoofferchoicesandconsidertheiroptions.(para.9)Butamajorityofpatients—twooutofthree—alsopreferredthattheirdoctorsmakethefinaldecisionsregardingtheirmedicalcare.(para.9)6…doctors,likemyyoungcolleaguesand,Iadmit,myself,willneedtobemoremindfulofwhetherpatientswantthemtoshareinformation…(para.15)

Languagebuilding-upSuggestedanswersconscious/awarerelatingto/aboutanswerersUnit7LifeandMedicine第三十九页，共67页。

TextA

Additionalactivity

GrouppresentationHospicemovementhasbeenapopularconceptinrecentdecadesinthefieldofhealthcare.Workinasmallgroupandexplorerelevantinformationaboutthissubjectinthefollowingaspects:

1.definition2.history3.advantages4.developmentinChinaUnit7LifeandMedicine第四十页，共67页。TextBCriticalreadingandthinkingLanguagebuilding-upSuggestedanswersUnit7LifeandMedicine第四十一页，共67页。TextB

CriticalReadingandThinking1.Pat’sPersonalStatus(P181)A78-year-oldwomansufferingfromlungcancerwithwidespreadmetastasesandreceivingpalliativecarefromhospiceAdairyfarmerMotherofsixInteriordesignerOneofthebestpiebakersinthecountyWritedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine第四十二页，共67页。TextB

CriticalReadingandThinkingKnowledgeofSubjectMatter

Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.lungcancerReportsfromthehospitalandoncologistconfirmedwidespreadmetastases.Pathaddeclinedaggressivetreatment.Shewasreceivingpalliativecarefromhospiceunderthesupervisionofanoncologist.1.Pat’sPersonalStatus(P181)Unit7LifeandMedicine第四十三页，共67页。TextB

CriticalReadingandThinking2.Pat’selectronicrecord(P181)Thecomputerizedtomography(CT):extensivebilateralinfiltratesandapossiblesmallnoduleinthebaseoftheleftlungwithfollow-uprecommendedbutnotobtainedAchestX-raymorethanayearago:aleftlower-lobepneumoniawithfollow-upsuggestedbutnotobtained

Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine第四十四页，共67页。TextB

CriticalReadingandThinking2.thereasonsforherhavingproblemswithdoctors(P154)KnowledgeofSubjectMatter

Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.pulmonaryembolicomputerizedtomography(CT)extensivebilateralinfiltratesapossiblesmallnoduleinthebaseoftheleftlungAchestX-rayreportfromavisitmorethanayearagowithoneofmypartnersrevealedaleftlower-lobepneumoniaandsuggestedfollow-uptoensureresolutionUnit7LifeandMedicine第四十五页，共67页。TextB

CriticalReadingandThinking3.themedicalmistake(P181)Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Theabnormalitynotnoted.FrequentvisitstodoctorsbutnotinformedofthefindingsUnit7LifeandMedicine第四十六页，共67页。TextB

CriticalReadingandThinking4.theauthor’sself-reflection(P181)Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Whotoblame?Noneofthehospitalteam,mypartners,ortheradiologiststotaketheblame.AsPat’sfamilyphysician,theauthor’sresponsibilitytofollowupabnormaltests;theauthormadetheseriousmistake.Allsortsofquestionsrunningthroughtheauthor’smind:pat’sresponse,possibilitiesofothermistakes,problemswithhealthcaresystem,causesofmedicalmistakesorerrors,what-ifs,andnextactionsUnit7LifeandMedicine第四十七页，共67页。TextB

CriticalReadingandThinking5.theauthor’sthevisittoPat(P181)PatlyinginbedinadarkenedroomwithmildlylaboredbreathingTheauthorkneelingatthebedsidelisteningtoPat’sstoriesTheauthorapologizingfortheseriousmistakePat’sforgivenessfortheauthor’smistakeWritedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine第四十八页，共67页。TextB

CriticalReadingandThinking6.thelessonthewriterlearnedfromPat(P181)AcceptingunexpectedForgivingCelebratingHopingLivinganddyingwithcourageanddignityWritedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine第四十九页，共67页。TextB

UsefulexpressionsCriticalreadingandthinkingTheprimarylesionwasdetectedyearsago,buttherewasnofollow-up.Someonedroppedtheball.reportsfromahospitalstaymorethan3yearsagoPatpresentedinfrequentlyforcareandusuallyonlyifsomethingwaswrong.sortoutmythoughtsmildlylaboredbreathingdistraughtaboutconflictswithmanyfamilymemberswhowerenotonspeakingtermsnotfulfilledmyresponsibilityto…madeadifferenceintheoutcomeAtremendousloadwasliftedfrommyshoulders.Unit7LifeandMedicine第五十页，共67页。widespread___________(广泛转移)___________treatment(积极治疗)_________lesion(原发病灶)torecommend_________(建议随访)electronic_________(电子病历)pulmonary__________(肺栓塞)computerized___________(CT,计算机断层扫描)bilateral__________(双侧浸润)a(n)_________X-ray(X线胸片)left__________pneumonia(左下叶肺炎)__________breathing(呼吸困难)thehospice_______(临终关心团队)

TextB

LanguageBuilding-up

VocabularyTestmetastasesaggressiveprimaryfollow-uprecordembolitomographyinfiltrateschestUnit7LifeandMedicinelower-lobelaboredteam第五十一页，共67页。TextB

SuggestedanswersCriticalreadingandthinkingTask1Reflection1.B2.B3.C4.D5.C6.AUnit7LifeandMedicine第五十二页，共67页。TextCLanguagebuilding-upSuggestedanswersUnit7LifeandMedicine第五十三页，共67页。________illness(慢性病)____________aspects(社会心理学领域)evidence-based__________(询证临床指南)to___________aplanofcare(施行治疗方案)TextC

LanguageBuilding-up

VocabularyTestchronicpsychosocialguidelinesimplementUnit7LifeandMedicine第五十四页，共67页。TextC

Task:Completethefollowingbriefsummaryofthetextaftercarefulreading.Suggestedanswers答案有误Unit7LifeandMedicine第五十五页，共67页。ListeningRecognizingdigressionsSuggestedanswersUnit7LifeandMedicine第五十六页，共67页。Listening

RecognizingdigressionsRecognizingthestart:Irememberonce…Thatremindsme…Bytheway…Recognizingtheend:So,asIwassaying…Anyway,wherewasI?Backtothepoint…Unit7LifeandMedicine第五十七页，共67页。Listening

SuggestedanswersExpressionforthestartofadigression:Expressionfortheendofadigression:Task1Listentoalectureonceandnotedowntheexpressionsthespeakerusestosignaladigression.AsI