医学院校硕士研究生英语读与写课件unit 9

医学院校硕士研究生英语读与写,中国人民大学出版社,English for Master Students in Medical Universities,China Renmin University Press,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,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James Boulton,Unit 9,Text A Organ Transplantation: Ethical Dilemmas and Policy Choices,Outline,Background information to Text AAnalysis of the textGlobal analysis of the textAnalysis of the text structureSummary of the textReference answers to the exercises,Background information to Text A,Introduction to the topic Transplantation is the transfer of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species.,Background information to Text A,Introduction to the topic In most cases, human material for transplantation is obtained from a deceased donor. Successful programs for the procurement of human material for transplantation from deceased donors from various cultural, religious and economic backgrounds constitute potential models. The need for communities, including health professionals, to become better educated about transplantation is widely recognized as a key to the success of such programs.,Background information to Text A,Introduction to the topic However, despite the frequent use of materials donated from deceased donors, the donation of materials from living donors is necessary for some types of transplants or to compensate for the limited supply of material available from deceased donors in order to meet patient needs. Living donation is thus practiced despite the fact that it involves risks for the donor that may not be negligible.,Background information to Text A,Introduction to the topic The procurement of human material for transplantation from deceased or living donors and the subsequent allogeneic transplantation entail ethical and safety risks for both the donor and the recipient.,Background information to Text A,Introduction to the topic Health authorities must provide effective oversight of all aspects of transplantation in order to control these risks. This oversight is also essential for gaining public support by developing and justifying trust in the procurement organization, particularly since donations are often motivated by altruism and generosity. In addition, the decision to be a donor is often based on the understanding that a contribution to the availability of transplant resources may someday benefit the health needs of the donors family.,Background information to Text A,Introduction to the topic (Source: /transplantation/donation/en/index.html/topics/transplantation/zh/ ),Background information to Text A,The History of Transplantation Throughout history people have always been intrigued by the possibility of transplanting organs and tissues from one body to another. During the 15th century we can find references in historical medical literature of attempted blood transfusions as well as the transplantation of teeth (presumably from cadavers). A skin transplant and a corneal transplant were reported in medical journals dating as far back as 1880. Of course, these early attempts at transplantation were usually unsuccessful. It was not until early in the 20th century that transplantation offered the promise of renewed health and life envisioned by our ancestors.,Background information to Text A,The Timeline of Transplantation:1906 -First corneal transplant by Austrian ophthalmologist Dr. Edward Zim.1908 -First skin allograft by Swiss surgeon Jacques Louis Reverdin.1908 -First successful cadaver knee joint transplant by Dr Eric Lexer.1911 -Initial use of homologous vein tissue in arterial reconstruction.1918 -First blood transfusion.,Background information to Text A,The Timeline of Transplantation:1949 -Establishment of US Navy Tissue Bank.1954 -First successful living-related kidney transplant from identical twins performed by Dr. Joseph Murray and Dr. David Hume in Boston, MA. The recipient had normal kidney function for eight years. 1955 -Initial fresh heart valve allograft put into descending aorta. 1955 -Frozen venous allograft for femoral artery bypass. 1962 -First fresh heart valves implanted into cardiac position.,Background information to Text A,The Timeline of Transplantation:1962 -First successful cadaveric kidney transplant by Dr. Joseph Murray and Dr. David Hume in Boston, MA. The recipient had normal kidney function for 21 months.1963 -First liver transplant performed by Dr. Thomas Starzl.1963 -First lung transplant performed by Dr. James Hardy at the University of Mississippi Medical Center, Jackson, MS.,Background information to Text A,The Timeline of Transplantation:1967 -First heart transplant performed by Dr. Christian Bernard at Groate Shure Hospital, South Africa. The recipient had normal heart function for 19 months.1967- First successful pancreas transplant performed by Dr. Richard C. Lillehei at the University of Minnesota.1968 -Brain death criteria created.,Background information to Text A,The Timeline of Transplantation:1968 -The Uniform Anatomical Gift Act. Legislation allows gift of organs to others.1971 -Frozen heart valves used in allograft.1971 -Introduction of cryopreserved human skin allografts.,Background information to Text A,The Timeline of Transplantation:1972 -The Uniform Anatomical Gift Act establishes the Uniform Organ Donor Card as a legal document in all 50 states making it possible for anyone 18 years or older to legally donate his or her organs upon death.1972 -End Stage Renal Disease Act paves way for Medicare coverage of all kidney transplants.1974 -First use of cryopreserved venous allograft.,Background information to Text A,The Timeline of Transplantation:1978 -Cyclosporin begins testing.1979 -Living related pancreas transplanted, Minneapolis, MN.1981 -Brain death criteria expanded by Presidents Commission for Study of Ethical Problems in Medicine and Biomedical Research.1981 -First heart and lung transplant performed by Dr. Norman Shumway at Stanford University Medical Center, Stanford, CA.,Background information to Text A,The Timeline of Transplantation:1982 -Barney Clark receives the first permanent artificial heart at the University of Utah.1983 -FDA approval of cyclosporine, the most successful anti-rejection medication developed to date.1984 -First heart/liver transplant performed by Dr. Starzl at the Childrens Hospital of Pittsburgh.,Background information to Text A,The Timeline of Transplantation:1984 -Baby Fae receives a walnut-sized baboon heart in an operation at Loma Linda University Medical Center. She was the first infant to receive an animal organ. Baby Fae lived for 21 days.1984 -National Organ Transplant Act (Public Law 98.507) establishes nationwide computer registry operated by the United Network for Organ Sharing (UNOS). The Act also authorizes financial support for organ procurement organizations and outlaws purchase or sale of organs.,Background information to Text A,The Timeline of Transplantation:1985 -New York State, Oregon, and Pennsylvania pass Required Request Law. Mandates all potential organ and tissue donors be approached for donation. Soon thereafter, all remaining 47 states follow suit.1986 -Consolidated Omnibus Budget Reconciliation Act passed. Requires all potential donors to be approached, superseding state laws and adding hospitals must comply to receive Medicare benefits.1988 -FDA approval of Viaspan or UW solution, greatly extends preservation time for livers.,Background information to Text A,The Timeline of Transplantation:1988 -Joint Commission on Accreditation of Health Care Organizations sets donor identification and notification standards. Requires the hospitals to have policies and procedures in place for the identification, referral and procurement of organs and tissues.1989 -Dr. Thomas Starzl at the University of Pittsburgh reports clinical success of promising new anti-rejection drug, FK-506.,Background information to Text A,The Timeline of Transplantation:1989 -First liver transplant from a living related donor.1990 -Lung transplantation attempted as cure for Cystic Fibrosis.1990 -Dr. Joseph Murray (performed first kidney transplant) awarded Nobel Prize for Medicine.1990 -Dr. Thomas (pioneered bone marrow transplants as a cure for leukemia) awarded Nobel Prize for Medicine.,Background information to Text A,The Timeline of Transplantation:1990 -First successful heart related lung transplant.1991 -First attempt at partial lung transplant.1991 -First successful small intestine transplant.1996 -U.S. surgeons at Barnes Hospital in St. Louis, University of California, San Francisco, and Stanford University Hospital perform split-liver transplants.,Background information to Text A,The Timeline of Transplantation:/History.htm,Analysis of the text,1) Many individuals have given themselves (literally) to save the life of another, and yet the unequivocal protection of those who are not-yet-dead (but would be useful if they were) has been called into question. (Paragraph 3) Many people have donated their organ(s) to save other people. However, questions remain about the best way to protect those who are close to death. Protection is necessary because the persons death will benefit others through transplanted organs.,Analysis of the text,1) Many individuals have given themselves (literally) to save the life of another, and yet the unequivocal protection of those who are not-yet-dead (but would be useful if they were) has been called into question. (Paragraph 3) unequivocal: adj. completely clear and without any possibility of doubtExample: To such a rude question, his answer is an unequivocal “no.” call something into/in question: cast doubt on something Example: These findings call into question the legitimacy of the proceedings.,Analysis of the text,2) The human body (dead or alive) has not been reduced to mere property, and yet the desperation of watching thousands of individuals die every year while whether monetary incentives should be used in an effort to increase organ supply (Paragraph 3)The human body cannot be considered as property. However we feel despair when we notice many people die every year while waiting for suitable organs. This situation has aroused a debate about whether money could be given (to donors) in order to increase the organ supply.,Analysis of the text,3) it suggests that an individuals body has meaning only because it is useful; that the body is a tool individuals have rather than what individuals are. (Paragraph 5) The statement that organs are no use to dead individuals implies that human bodies are utilitarian but not connected to our inner beings.,Analysis of the text,4) if saving the most possible lives while inflicting the least harm on the living were the only significant human obligation, then our policy on organ transplantation (not to mention human experimentation) would be very different. (Paragraph 7) Our policy on organ transplantation would be different, and human experimentation would also be different, if the only criteria for our actions were to save the maximum amount of people through the minimum amount of harm to the living.,Analysis of the text,4) if saving the most possible lives while inflicting the least harm on the living were the only significant human obligation, then our policy on organ transplantation (not to mention human experimentation) would be very different. (Paragraph 7) inflicton: make someone suffer by imposing an unpleasant circumstanceExample: That pitiful man inflicted a great deal of suffering on his wife and children.,Analysis of the text,5) The obligation to heal as fundamental as it is to the good life and good society exists in concert (and sometimes in conflict) with other human values. (Paragraph 7)The obligation to heal is essential to a good life and a good society, but it works together with and sometimes against other human values.,Analysis of the text,5) The obligation to heal as fundamental as it is to the good life and good society exists in concert (and sometimes in conflict) with other human values. (Paragraph 7)In concert: jointly, together. This expression uses concert in the sense of “an agreement of two or more persons.” Example: When the mind is in concert with the body, one can accomplish a great deal.,Analysis of the text,6) Does autonomy mean having the right to dispose of ones body (or enter into contracts for ones body) in any way an individual sees fit? (Paragraph 8)dispose of: get rid of, throw outExample: The Green Box project aims to collect unwanted mobile phones and electronic accessories, and dispose of them in an environmentally friendly way.,Analysis of the text,7) proposals to compensate individuals for providing organs potentially entail their right to sell their organs to the highest bidders. (Paragraph 9) The proposals to compensate organ donors could lead to organ donors selling their organs to those who give the highest price. entail: v. to make it necessary to do something Example: This complex plan for rescuing the pregnant woman entails considerable risks.,Analysis of the text,8) this means that their claims can neither be written off in advance nor accepted at face value. (Paragraph 9) that is to say that the claims associated with the policies cant be discarded/disregarded or accepted without further investigation, because they have never been tested.,Analysis of the text,8) this means that their claims can neither be written off in advance nor accepted at face value. (Paragraph 9)write off: to accept the loss or failure ofExample: We will just have to write off the arrangement if we cant find the money for it.,Analysis of the text,8) this means that their claims can neither be written off in advance nor accepted at face value. (Paragraph 9)accept/take something at face value: to accept a situation or accept what someone says, without thinking there may be a hidden meaning. Example: You shouldnt always take his remarks at face value, you know, he is quite eccentric.,Analysis of the text,9) We must, as we judge these different policies, think about the meaning of organ transplantation in its fullness. (Paragraph 10) When we comment on different policies, we should think about the meaning of organ transplantation in all aspects.fullness: completenessExample: In the fullness of her joy, she could hardly speak.,Analysis of the text,10) Thinking about public policy in this area means balancing these different realities and facing soberly the moral costs and benefits of different policies. (Paragraph 10)When thinking about the policies for an organ procurement system, we must take various realities into account and fully understand the moral costs and benefits of each policy as well.,Analysis of the text,10) Thinking about public policy in this area means balancing these different realities and facing soberly the moral costs and benefits of different policies. (Paragraph 10)sober: adj. having a serious attitude to something Example: Please feel relaxed, he is a sober and intelligent young man. To be more exact, he is your Mr. Right.,Analysis of the text,11) since an individual might rationally decide that the satisfaction of providing money for his family outweighs his desire to continue living. (Paragraph 11)because a person might think about and decide that providing for his family through the sale of an organ is more important than life.,Global analysis of the text,The ethics of organ transplantation have been a hot topic since the first human kidney transplantation in 1954. In the US, the current organ transplant policy is far from a full success, even though the present laws have been in place for a long time. Some ethical dilemmas concerning organ transplant still exist; for example, who can donate their organs, who has the final right to decide the donation-the dead person himself while he is living or his family members after his death-should payment be given for the donation? If payment is given for donations, how much and in what way should the payment be made? These ethical considerations make organ transplants a long-standing problem in society. Generally speaking, there is no independent way to solve the problem. The problem needs a comprehensive approach that considers a number of different elements.,Analysis of the text structure,The text falls into three parts.Part I Paragraphs 14 introduce the background information about organ transplants in the US with the application of two laws.,Analysis of the text structure,Part II Paragraphs 58 analyze organ transplants from the human context.Part III Paragraphs 912 describe a number of different systems for governing the procurement of cadaveric organs and list the public policies considering organ transplant.,Summary of the text,The text introduces the heated problem concerning organ transplants. The current policies on organ transplants cannot solve all of the problems that occur in this field. The organ supply is far from sufficient.,Summary