医学院校硕士研究生英语读与写课件Unit6

EnglishforMasterStudentsinMedicalUniversitiesChinaRenminUniversityPress第一页，共50页。教材总主编卢凤香主编：张海萍张华君殷红梅编者：闵楠苏萍任雁郑守志刘娟谢瑜第二页，共50页。课件制作主编：郑守志刘娟课件制作参与人：张海萍张华君卢凤香课件审阅人：美籍专家JamesBoulton第三页，共50页。Unit6TextAWillHeChoosetoSaveYourLife?第四页，共50页。OutlineBackgroundinformationtoTextAAnalysisofthetextGlobalanalysisofthetextAnalysisofthetextstructureSummaryofthetextReferenceanswerstotheexercises第五页，共50页。BackgroundinformationtoTextA1)IntroductiontotheauthorWesleyJ.Smith：attorney,authororco-authorof11booksonissuessuchascloning,stemcells,assistedsuicide,euthanasia,andbioethics.InMay2004,NationalJournalnamedSmithoneofthenation’stopexpertthinkersonbioengineeringbecauseofhisworkinbioethics.第六页，共50页。BackgroundinformationtoTextA2)IntroductiontothetopicBioethicsisabranchofethicsthatstudiesmoralvaluesinthebiomedicalsciences,oradisciplinedealingwiththeethicalimplicationsofbiologicalresearchandapplications.Itstudiestheethicalandmoralimplicationsofnewbiologicaldiscoveriesandbiomedicaladvances,asinthefieldsofgeneticengineeringanddrugresearch.第七页，共50页。BackgroundinformationtoTextA3)RelatedbackgroundinformationA.TheMedicareDiagnosisRelatedGroup(DRG)疾病诊断相关分类系统Diagnosis-RelatedGroup(DRG)isasystemtoclassifyhospitalcasesintooneofapproximately500groups(DRGs)thatareexpectedtorequiresimilarhospitalresources.TheconceptwasdevelopedforMedicareaspartoftheprospectivepaymentsystem.DRGsareassignedbya"grouper"programbasedonICDdiagnoses,procedures,age,sex,andthepresenceofcomplicationsorco-morbidities.第八页，共50页。BackgroundinformationtoTextA3)RelatedbackgroundinformationA.TheMedicareDiagnosisRelatedGroup(DRG)疾病诊断相关分类系统DRGshavebeenusedsince1983todeterminehowmuchMedicarepaysthehospital,sincepatientswithineachcategoryaresimilarclinicallyandareexpectedtousethesamelevelofhospitalresources.DRGsmaybefurthergroupedintoMajorDiagnosticCategories(MDCs).第九页，共50页。BackgroundinformationtoTextA3)RelatedbackgroundinformationB．HMO（HealthMaintenanceOrganization）卫生维护组织Ahealthmaintenanceorganization(HMO)isatypeofmanagedcareorganization(MCO)thatprovidesaformofhealthinsurancecoverageintheUnitedStatesthatisfulfilledthroughhospitals,doctors,andotherproviderswithwhichtheHMOhasacontract.TheHMOActof1973requiredemployerswith25ormoreemployeestoofferfederallycertifiedHMOoptions.第十页，共50页。BackgroundinformationtoTextA3)RelatedbackgroundinformationB．HMO（HealthMaintenanceOrganization）卫生维护组织Unliketraditionalindemnityinsurance,careprovidedinanHMOgenerallyfollowsasetofcareguidelinesprovidedthroughtheHMO'snetworkofproviders.Underthismodel,providerscontractwithanHMOtoreceivemorepatientsandinreturnusuallyagreetoprovideservicesatadiscount.ThisarrangementallowstheHMOtochargealowermonthlypremium,whichisanadvantageoverindemnityinsurance,providedthatitsmembersarewillingtoabidebytheadditionalrestrictions.

第十一页，共50页。BackgroundinformationtoTextA3)RelatedbackgroundinformationC.WorldfamousMedicalPeriodicalsBMJ-BritishMedicalJournal《英国医学杂志》AMA-TheJournaloftheAmericanMedicalAssociation《美国医学会杂志》NewEnglandJournalofMedicine《新英格兰医学杂志》TheLancet《柳叶刀》Nature英国《自然》周刊Science美国《科学》周刊第十二页，共50页。Analysisofthetext

1)Whoshouldhavetherighttodecidewhetheryoureceivelife-sustainingmedicaltreatmentduringacriticalorterminalillness?(Paragraph1)sustain:v.causetocontinueorbeprolongedforanextendedperiodorwithoutinterruption(sustainingandsustainableareitsderivatives)第十三页，共50页。Analysisofthetext

1)Whoshouldhavetherighttodecidewhetheryoureceivelife-sustainingmedicaltreatmentduringacriticalorterminalillness?(Paragraph1)Example:

Asiamustfocusonjobcreationtosustaineconomicgrowth.Thisconditionofintrinsicmotivationisanexampleofself-determinationandcanleadtosustainedgoal-orientedbehavior.第十四页，共50页。Analysisofthetext

2)…yourright-to-decideisbeingtakenawayfromyou(oryourfamily)(Paragraph2)

takesomebodyorsomethingawayfromsomebodyorsomething:removeExample:Thechildwastakenawayfromschool.take(away)from:lessen,weaken,diminishExample:Thesefaultstosomeextenttook(away)fromhiscreditasabiographer.第十五页，共50页。Analysisofthetext

3)…….andmembersofthemedicalintelligentsiawhobelievethattheirvaluesandprioritiesshouldcountmorethanyourswhendetermining…(Paragraph2)

count:tohaveaspecifiedimportanceorvalueExample:Theiropinionscountforlittle.Eachbasketcountsfortwopoints.第十六页，共50页。Analysisofthetext

4)Toputitbluntly,evenifyouwanttolive,evenifyouwantmedicaltreatmenttoenableyoutofightforyourlife…(Paragraph2)toputitbluntly:franklyspeakingExample:Toputitbluntly,Idon'tcare.第十七页，共50页。Analysisofthetext

5)Unfortunately,fewpeoplereadthesehighbrowpublications.(Paragraph3)

highbrow:(usuallydepreciating)withtastesandinterestsconsideredtobesuperior(oftenusedcontemptuouslytowardintellectuals)Example:highbrowdrama/music第十八页，共50页。Analysisofthetext

6)Thefirsttimemostpatientsandtheirfamiliesbecomeawarethatdoctorsarebeinggiventherighttosay"no"towantedmedicaltreatment(otherthancomfortcare)…isduringamedicalcrisiswhentheyareattheirmostdefenselessandvulnerable.(Paragraph3)Mostpeoplearenotawarethatadoctorcanrefusethemtreatment.Theyfindoutinthemiddleofanemergencywhentheyareemotionallyunabletoprotectthemselves.第十九页，共50页。Analysisofthetext

6)Thefirsttimemostpatientsandtheirfamiliesbecomeawarethatdoctorsarebeinggiventherighttosay"no"towantedmedicaltreatment(otherthancomfortcare)…isduringamedicalcrisiswhentheyareattheirmostdefenselessandvulnerable.(Paragraph3)Thefirsttime…isduring…:Example:ThefirsttimeIcametoknowthepleasureofworkingoutmathproblemswasduringmyvisittothescienceandtechnologymuseum.第二十页，共50页。Analysisofthetext

6)Thefirsttimemostpatientsandtheirfamiliesbecomeawarethatdoctorsarebeinggiventherighttosay"no"towantedmedicaltreatment(otherthancomfortcare)…isduringamedicalcrisiswhentheyareattheirmostdefenselessandvulnerable.(Paragraph3)atone’s形容词最高级:(最高级可以和物主代词连用表示最……的情况或状态)Example:FragrantHillisatitsbestinautumnwhenthecolorfulleavesofthemapletreesgreettheeyeeverywhere.第二十一页，共50页。Analysisofthetext

7)…someareahospitalsnowhaverulesinplacethatpermit…(Paragraph4)inplace:intherightorproperplaceExample:Iliketohaveeverythinginplace.(fig)instituted,existingExample:Theproposalisnotquiteinplace.第二十二页，共50页。Analysisofthetext

8)True,whenthereisadispute,familiesandpatientshavearighttoahearinginfrontofahospitalethicscommittee...(Paragraph4）

hearing:听证会；意见听取会Example:toholdahearingintosomethingWatergateHearings第二十三页，共50页。Analysisofthetext

9)Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers,mostlycomprisedofwell-meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile-caretheoryistherightthingtodo.(Paragraph4)Thecommitteemembersarenotimpartial;theirdecisionwilllikelybemadeontheirbeliefinthetheoryratherthantheindividualcircumstances.第二十四页，共50页。Analysisofthetext

9)Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers,mostlycomprisedofwell-meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile-caretheoryistherightthingtodo.(Paragraph4)stackeddeck:preparedinadvanceinordertoinfluencetheoutcome;usuallyforthepurposeofcheating第二十五页，共50页。Analysisofthetext

9)Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers,mostlycomprisedofwell-meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile-caretheoryistherightthingtodo.(Paragraph4)well-meaning:well-intentioned(出于好意，但结果往往不好)dispassionate：adj.devoidoforunaffectedbypassion,emotion,orbias第二十六页，共50页。Analysisofthetext

9)Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers,mostlycomprisedofwell-meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile-caretheoryistherightthingtodo.(Paragraph4)culture:thepatterns,traits,andproductsconsideredastheexpressionofaparticularperiod,class,community,orpopulation;withrespecttoaparticularcategory,suchasafield,subject,ormodeofexpression.第二十七页，共50页。Analysisofthetext

9)Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers,mostlycomprisedofwell-meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile-caretheoryistherightthingtodo.(Paragraph4)Example:musicalculture音乐文化businessculture企业文化campusculture校园文化Edwardianculture爱德华时代的文化第二十八页，共50页。Analysisofthetext

10)Butthiswouldbenoeasytaskgiventhepatientsrefusedtreatmentarelikelytobethemostexpensivetocarefor.(Paragraph5)

given:undertheconditionof,if,since,nowthat...Example:Giventhesameprovision,Iwouldhavedoneitbetterthanhedid.第二十九页，共50页。Analysisofthetext

11)Thatcouldwork,butitisnosurebet.(Paragraph6)Patientscandothat,buttheymaynotgetthewantedresult.betn.oneonwhichastakecanbeplaced被下赌注的对象Example:Ourteamisasurebettowin.第三十页，共50页。Analysisofthetext

12)Buteventhoughalawsuitcouldbesuccessfulintheory,itmightverywellproveutterlyimpracticabletopursue.（Paragraph7）impracticable&impractical:Impracticableappliestoacourseofactionthatisimpossibletocarryoutorputintopractice;impractical,thoughitcanbeusedinthisway,alsocanbeweakerinsense,suggestingthatthecourseofactionwouldyieldaninsufficientreturnorwouldhavelittlepracticalvalue.第三十一页，共50页。Analysisofthetext

13)Lawyersoftenchargehundredsofdollarsanhour,meaningthatafullylitigatedcase,evenwithoutappeals,couldcostliterallytens,ifnothundredsofthousandsofdollars.(Paragraph7)...,ifnot...:theexpressionshowsaconcessiveimplication.Example:Laughterisveryimportant,ifnotindispensable,inourlife.第三十二页，共50页。Analysisofthetext

14)...havingverydeeppockets,thehospitaladministrationwouldnotbeconcernedintheleastaboutthecostoftheirlawyers.(Paragraph8)Consideringtheirrelativelysolidfinances,thehospitaladministrationwouldnotmindatallaskingforhelpfromlawyers,evenifthecostsarehigh.第三十三页，共50页。Analysisofthetext

15)Iffullyunleashed,thehospital'scorporatelawyerscouldfileenoughmotions...tothepointthatyou,quiteliterally,couldlitigateyourselfintobankruptcy.（Paragraph8）Evenwhentheyarechargedwithalawsuit,theycanaffordboththemoneyandthetimetodealwithit…untilfinallyyouwouldrunoutofthemoneynecessarytopursuethelawsuit.第三十四页，共50页。Analysisofthetext

15)Iffullyunleashed,thehospital'scorporatelawyerscouldfileenoughmotions...tothepointthatyou,quiteliterally,couldlitigateyourselfintobankruptcy.（Paragraph8）tothepoint:untilthestage(that),finallyliterally:(informaluse,tointensifymeaning)withoutexaggerationExample:Thechildrenwereliterallystarving.corporatelawyers:法律顾问第三十五页，共50页。Analysisofthetext

15)Iffullyunleashed,thehospital'scorporatelawyerscouldfileenoughmotions...tothepointthatyou,quiteliterally,couldlitigateyourselfintobankruptcy.（Paragraph8）motionn.anapplicationmadetoacourtforanorderorarulingExample:Themotionwasadopted/carried.depositionn.(Law)testimonyunderoath,esp.astatementbyawitnessthatiswrittendownorrecordedforuseincourtatalaterdate.第三十六页，共50页。Analysisofthetext

16）Beyondthefinancialimpracticalitiesofsuingahospital,oneoftheprimaryreasonsforcraftingfutile-careprotocolshasbeentoimprovethechancethatthehospitalwouldprevailincourt.（Paragraph9）craft：v.tomakeorconstruct(something)inamannersuggestinggreatcareoringenuityExample:ItwasnottheChamberofCommercethatcraftedthepublicpoliciesthathaveresultedina$2.6billionannualsubventiontothefarmers.第三十七页，共50页。Analysisofthetext

17)…puttheseprotocolsinplaceasawaytoprepareforthelitigationbioethicistspresumewouldbefiledbypeoplefuriousathavingwantedmedicaltreatmentrefused.(Paragraph9)Byusingtheseprotocols,bio-ethicistscanpreparethemforsomeunfavorablesituations,suchaslawsuitsfiledbyfuriouspatientsortheirfamilies.第三十八页，共50页。Analysisofthetext

18)Theearlybioethicsmovementdeservesgreatthanksforhelpingdoawaywiththatformofabuse…(Paragraph11)Societyowesadebttotheearlybioethicsmovementforhelpingtoendthistypeofabuse.第三十九页，共50页。Analysisofthetext

19)Inessence,whatisbeingcreatedinfrontofourveryeyes(ifwewouldonlysee)isadutytodie.(Paragraph13)Nowthatavaluecanbeplacedonadyingperson’slife,itcanbesaidthatindividualhasaresponsibilitytodieinordertobenefitsociety.第四十页，共50页。Analysisofthetext

19)Inessence,whatisbeingcreatedinfrontofourveryeyes(ifwewouldonlysee)isadutytodie.(Paragraph13)inessence:fundamentallyExample:Thetwothingsarethesameinoutwardformbutdifferentinessence.very:itselfandnoother;trulysuchExample:Atthatverymoment,thephonerang.第四十一页，共50页。Globalanalysisofthetext“Euthanasia”isabroadtermformercykilling:takingthelifeofahopelesslyillorinjuredindividualinordertoendhisorhersuffering.Mercykillingrepresentsaseriousethicaldilemma.Peopledonotalwaysdiewell.Someafflictionscausepeopletosufferthroughextremephysicalpainintheirlastdays,andeuthanasiamayseemlikeacompassionatewayofendingthispain.Otherpatientsmayrequesteuthanasiatoavoidtheweaknessandlossofmentalfacultiesthatsomediseasescause,andmanypeoplefeelthatthesewishesshouldberespected.第四十二页，共50页。GlobalanalysisofthetextButeuthanasiaalsoseemstocontradictoneofthemostbasicprinciplesofmorality,whichisthatkillingiswrong.ViewedfromatraditionalJudeo-Christianpointofview,euthanasiaismurderandablatantviolationofthebiblicalcommandment“Thoushaltnotkill.”Fromasecularperspective,oneoftheprincipalpurposesoflawistoupholdthesanctityofhumanlife.Euthanasiaissocontroversial,becauseitpitstheplightofsuffering,dyingindividualsagainstreligiousbeliefs,legaltradition,and,inthecaseofphysician-assisteddeath,medicalethics.第四十三页，共50页。

Analysisofthetextstructure

Thetextfallsintofourparts.PartI

Paragraphs1-2:Patientsusedtotakeforgrantedtherighttoreceivetreatment,butnowtheymaynolongerhavethatright.PartII

Paragraph3:Futile-caretheoryisprevailing.PartIII

Paragraphs4-9:Thereasonswhyfutile-caretheoryhasbecomesowidelyacceptedanditspracticability.PartIV

Paragraphs10-13:Thefutile-caretheoryisactuallyakindofhegemony.第四十四页，共50页。Summaryofthetext

Inthepast,patientsandtheirfamilieshadtherighttobegivenwantedmedicalcare.Withthespreadof“futile-caretheory,”accordingtowhichhospitalsmayrefusetoofferlife-sustainingmedicaltreatment,patientsarelosingthisright.Manyhospitalshaveadoptedsuchtheorie