首医研究生英语unite3讲解 文档资料

1、医学院校硕士研究生英语,读写译综合教程,首都医科大学应用语言学系,Unit 3,Text A,Patients Have Rights, but Doctors Have,Rights, Too,Outline,Background information to Text A,Analysis of the text,Global analysis of the text,Analysis of the text structure,Summary of the text,Reference answers to the exercises,Background information to

2、Text A,Introduction to the topic,With the development of medical technology, some patients who,in the past would have died can now be kept alive by artificial,means. Sometimes patients may have a strong desire for such,treatment, because it is a temporary measure potentially leading to,the restorati

3、on of health. At other times, such treatment may be,undesirable, because it may only prolong the process of dying,rather than restore the patient to an acceptable quality of life. In,any case, each person is seen, under the law, as having the,personal right to decide whether to continue or terminate

4、 such,treatment. As long as a patient is mentally competent, he or she,can be consulted about desired treatment. However, when a,patient has lost the capacity to communicate the situation is,different and that is what makes a living will necessary,Background information to Text A,Related background

5、information,Elements of a Will,Here are the basic elements generally included in a will,Your name and place of residence,A brief description of your assets,Names of spouse, children and other beneficiaries, such,as charities or friends,Alternate beneficiaries, in the event a beneficiary dies,before

6、you do,Specific gifts, such as an auto or residence,Background information to Text A,Related background information,Elements of a Will,Establishment of trusts, if desired,Cancellation of debts owed to you, if desired,Name of an executor to manage the estate,Name of a guardian for minor children,Name

7、 of an alternative guardian, in the event your first,choice is unable or unwilling to act,Your signature,Witnesses signatures,Two of the most important items included in a will are the,naming of a guardian for minor children and the naming of,Background information to Text A,Examples of a Living Wil

8、l,I, _, of _, being of,sound mind, do hereby willfully and,voluntarily make known my desire that my,life not be prolonged under any of the,following conditions, and do hereby further,declare,Background information to Text A,Examples of a Living Will,1. If I should, at any time, have an incurable,con

9、dition caused by any disease or illness, or by any,accident or injury, and be determined by any two or,more physicians to be in a terminal condition,whereby the use of heroic measures” or the,application of life-sustaining procedures would only,serve to delay the moment of my death, and where,my att

10、ending physician has determined that my,death is imminent whether or not such heroic,measures or life-sustaining measures are,employed, I direct that such measures and,procedures be withheld or withdrawn and that I be,permitted to die naturally,Background information to Text A,Examples of a Living W

11、ill,2. In the event of my inability to give,directions regarding the application of life,sustaining procedures or the use of heroic,measures,” it is my intention that this,directive shall be honored by my family and,physicians as my final expression of my right,to refuse medical and surgical treatme

12、nt, and,my acceptance of the consequences of such,refusal,Background information to Text A,Examples of a Living Will,3. I am mentally, emotionally and legally competent to,make this directive and I fully understand its import,4. I reserve the right to revoke this directive at any time,5. This direct

13、ive shall remain in force until revoked,IN WITNESS WHEREOF, I have hereto set my hand and,seal this _ day of _, 20 _,Signed: _,Background information to Text A,Declaration of Witnesses,The declarant is personally known to me and I believe him to be,of sound mind and emotionally and legally competent

14、 to make the,herein,confined,Directive,to,Physicians,I,am,not,related,to,the,declarant,by,blood,or,marriage,nor,would,I,be,entitled,to,any,portion,of,the,declarants,estate,upon,his,decease,nor,am,I,an,attending,physician,of,the,declarant,nor,an,employee,of,the,attending,physician,nor,an,employee,of,

15、a,health,care,facility,in,which,the,declarant,is,a,patient,nor,a,patient,in,a,health,care,facility in which the declarant is a patient, nor am I a person who,has,any,claim,against,any,portion,of,the,estate,of,the,declarant,upon his death,Signed: _,Source: lectlaw/forms/f115.htm,Background informatio

16、n to Text A,C. Durable Powers of Attorney,This means that the power of the agent to act on,the principals behalf continues despite the,principals incapacity, whether or not a court,decrees the principal to be incapacitated,Background information to Text A,D. The Patient Self Determination Act,PSDA,T

17、he Patient Self Determination Act (PSDA,scheduled to go into effect in December 1991,will change considerably the manner in which,health care facilities offer patient care. The,overall purpose of the act seems to increase the,use of advance directives for health care,Background information to Text A

18、,E. Code Blue,A technical, jargon term for medical emergencies in the,United States. An alternate term is Code 99. Sometimes,it is abbreviated into simply code. Most healthcare,facilities utilize a system of codes to represent the,presence of an emergency or disaster. These codes are,most commonly s

19、ignified by a color or number. Code,blue is often used to represent a real or suspected,imminent loss of life, for example, the patient has,stopped breathing and their heart has stopped beating,Background information to Text A,F. DNR,Do Not Resuscitate. It is a request to not have,cardiopulmonary re

20、suscitation (CPR) if the,patients heart stops or if the patient stops,breathing, unless given other instructions,hospital staff will try to help all patients whose,heart has stopped or who have stopped breathing,Analysis of the text,1). Anyone who watches any amount of,television on a regular basis

21、has noticed that,TV commercials repeat themselves,Paragraph 1,Anyone watching TV regularly is likely to notice,that the same advertisements are shown,repeatedly to the public,on a regular basis,habitually,Example,The big problem for most people is,to establish the habit of doing the practices on a,A

22、nalysis of the text,2). And to a large extent, they are right,Paragraph 1,to a large extent,used to say that something is,mainly true,Example,These policies are to a large extent,responsible for the regions economic decline,Analysis of the text,3). In essence, this piece of legislation,mandates that

23、 all hospitals, nursing homes,and home health care providers to make,an advance directive (living will) regarding,their health care prior to treatment,Paragraph 3,in essence,used when talking about the most basic and,important part of something; especially an idea, belief or,argument,Example,In esse

24、nce, crime is growing at a rapid rate,with the development of science and technology,Analysis of the text,3). In essence, this piece of legislation,mandates that all hospitals, nursing homes,and home health care providers to make,an advance directive (living will) regarding,their health care prior t

25、o treatment,Paragraph 3,inform sb. of something,to formally tell,somebody about something,Example,Please inform us of any change of,address as soon as possible,Analysis of the text,3). In essence, this piece of legislation,mandates that all hospitals, nursing homes,and home health care providers to

26、make,an advance directive (living will) regarding,their health care prior to treatment,Paragraph 3,in advance,planning that is done before an event,Example,It has been reported that the weather broadcast will,give advance warnings of dust storms from this year on,prior to,before,Example,All the arra

27、ngements should be completed prior to,your departure,Analysis of the text,4). A living will is a document which tells,your physician or health care provider what,types of treatment you want if you become,terminally ill,Paragraph 4,A living will is a document in which you declare,to your physician or

28、 health care provider the,types of treatment you want in case of a terminal,illness,Analysis of the text,5). Perhaps some clarity can be brought to,the situation by understanding when and,how these advance directives are used,Paragraph 5,Questions and doubts about a Living Will might,be resolved thr

29、ough an understanding of its,ultimate purpose,bring clarity to,make something clear,Example,The Congressmans speech has,brought clarity to the governments position on,Analysis of the text,6). Another situation where living wills are,not enforced is in the realm of surgery,Paragraph 9,Living wills ar

30、e not binding in case of surgery,in the realm of,in a particular area of,knowledge, experience, interest etc,Example,This is not really within the realm of,my experience,Analysis of the text,7). While the trend in health care over the,past twenty years has been toward patient,empowerment, physicians

31、 are still ultimately,responsible for the health care decisions,made in a patients treatment,(Paragraph 12,Physicians still make the final treatment decisions,not the patients; although the tendency in health,care over the past twenty years is towards,offering the patients more choice regarding,trea

32、tment,Analysis of the text,7). While the trend in health care over the,past twenty years has been toward patient,empowerment, physicians are still ultimately,responsible for the health care decisions,made in a patients treatment,(Paragraph 12,empower,to give the organization the power or,right to do

33、 something,Example,The college is empowered to grant,degrees,Analysis of the text,8,In this scenario, the physician was,approached in much the same way as one,would contract an engineer,Paragraph 15,In the Engineering Model, the relationship,between a physician and a patient is much like a,contract

34、between a person and an engineer,Analysis of the text,8,In this scenario, the physician was,approached in much the same way as one,would contract an engineer,Paragraph 15,in much the same way,very similar to,Example,In much the same way that a tiny acorn,橡实,can grow to become a mighty oak tree,some

35、of the most significant accomplishments in,business begin as tiny, simple ideas,scenario,an outline of the plot of a dramatic or,literary work. It means model in this text,Analysis of the text,9,But the physician knows what he is able or,willing to do, both in accordance with his own,personal morali

36、ty and with his knowledge of,the practice of sound medicine,Paragraph 18,But the physician knows what he is able or willing,to do and what he does is based on his own moral,values and the reliable rules in the field of,medicine,Analysis of the text,9,But the physician knows what he is able or,willin

37、g to do, both in accordance with his own,personal morality and with his knowledge of,the practice of sound medicine,Paragraph 18,in accordance with,according to; on the basis of,Example,In accordance to the terms of the,contract, her first novel should be published by,the end of this year,Analysis o

38、f the text,9,But the physician knows what he is able or,willing to do, both in accordance with his own,personal morality and with his knowledge of,the practice of sound medicine,Paragraph 18,sound,reliable and sensible,Example,Firms wishing to take part in the,programme must be able to show that the

39、y are,financially sound,Analysis of the text,10,It would do real violence to him to have to,go against either of those,Paragraph 18,If a doctor were to act in opposition to his own,personal morality or his knowledge of how to,practice medicine, it would be very harmful to him,Analysis of the text,10

40、,It would do real violence to him to have to,go against either of those,Paragraph 18,do violence to,(fml) to spoil; to have a harmful,effect on,These modern boxlike buildings do violence to,the beauty of the old city,go against,to act in opposition to,Example,She went against her mothers will,Analys

41、is of the text,11,I wouldnt feel totally secure that the,durable power of attorney for medical care,潷汵?敢映汯潬敷,Paragraph 22,I am not absolutely certain that the durable power,of attorney would be binding when applied to the,context of medical care,Analysis of the text,12,So there are two schools of th

42、ought on that,Paragraph 23,So there are two different opinions on a living will,school,a group of people who share the same,opinions or ways of thinking,Analysis of the text,13,For example, if desired you may skip,everything and simply indicate the name of,your proxy, the person who will speak on yo

43、ur,behalf should you become incapable of,making your treatment decisions known,Paragraph 25,The only information that must be given is the,name of someone to make decisions for you if,you are unable to decide for yourself because of,illness or injury,Analysis of the text,14,A lot of people equate a

44、living will with,pulling the plug.,Paragraph 27,A lot of people consider a living will as pulling the,plug. Pulling the plug means to end ones life when,kept alive by artificial means. Here in the text it is,a figurative usage which indicates that the,treatment will be ceased in the same way the an,

45、electric plug is pulled from its socket to stop a,machine, as long as the wishes of the living will,are fulfilled,Analysis of the text,14,A lot of people equate a living will with,pulling the plug.,Paragraph 27,to equate with,to consider something to be,the same as something else,Example,Market rate

46、s dont always equate with,reasonable prices,Some people equate dishonesty with wickedness,Analysis of the text,15,Another concern being raised has to do,with the effect ones Living Will might have,on insurance premiums,Paragraph 28,Another public concern is that a Living Will may,have potential impa

47、ct on ones insurance,premiums,Analysis of the text,16,Having ones intentions in black and,white helps clarify what one truly believes,Paragraph 29,By officially documenting your wishes you will,make your true beliefs clear to your doctors and to,yourself and this clarity will ultimately help in the,

48、decision making process in the case of a terminal,disease or injury,Analysis of the text,16,Having ones intentions in black and,white helps clarify what one truly believes,Paragraph 29,spell out,explain something clearly,Example,The minister will spell out exactly how,he intends to finance these tax

49、 cuts,Analysis of the text,16,Having ones intentions in black and,white helps clarify what one truly believes,Paragraph 29,in black and white,in written form and,therefore definite,Example,Youd better get a commitment in,black and white before you cooperate with them,Analysis of the text,17,In any c

50、ase doctors are still committed to,utilizing their training and experience toward,making the best decisions possible in every,aspect of your care,Paragraph 30,Anyhow, it is the doctors intention to maximize,the benefit to their patients in every aspect of care,by means of their training and experien

51、ce,commit to doing,promise to do something,Example,The contract commits him to playing,for the team for the next three years,Global analysis of the text,This text talks mainly about living wills, patients rights and self,determination in terminal health care in the United States,Although the Federal Patients Self Determination Act went into,effect in December of 1991, there are still many questions and,concerns about what a living will means. According to the author, a,living will is an option. Only the patients ca