醫(yī)學(xué)院校碩士研究生英語讀與寫Unit-6ppt課件

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醫(yī)學(xué)院校碩士研究生英語讀與寫 1 EnglishforMasterStudentsinMedicalUniversities ChinaRenminUniversityPress 2 教材總主編盧鳳香 主編 張海萍張華君殷紅梅編者 閔楠蘇萍任雁鄭守志劉娟謝瑜 3 課件制作主編 鄭守志劉娟課件制作參與人 張海萍張華君盧鳳香課件審閱人 美籍專家JamesBoulton 4 Unit6 TextAWillHeChoosetoSaveYourLife 5 Outline BackgroundinformationtoTextAAnalysisofthetextGlobalanalysisofthetextAnalysisofthetextstructureSummaryofthetextReferenceanswerstotheexercises 6 BackgroundinformationtoTextA 1 IntroductiontotheauthorWesleyJ Smith attorney authororco authorof11booksonissuessuchascloning stemcells assistedsuicide euthanasia andbioethics InMay2004 NationalJournalnamedSmithoneofthenation stopexpertthinkersonbioengineeringbecauseofhisworkinbioethics 7 BackgroundinformationtoTextA 2 IntroductiontothetopicBioethicsisabranchofethicsthatstudiesmoralvaluesinthebiomedicalsciences oradisciplinedealingwiththeethicalimplicationsofbiologicalresearchandapplications Itstudiestheethicalandmoralimplicationsofnewbiologicaldiscoveriesandbiomedicaladvances asinthefieldsofgeneticengineeringanddrugresearch 8 BackgroundinformationtoTextA 3 RelatedbackgroundinformationA TheMedicareDiagnosisRelatedGroup DRG 疾病診斷相關(guān)分類系統(tǒng)Diagnosis RelatedGroup DRG isasystemtoclassifyhospitalcasesintooneofapproximately500groups DRGs thatareexpectedtorequiresimilarhospitalresources TheconceptwasdevelopedforMedicareaspartoftheprospectivepaymentsystem DRGsareassignedbya grouper programbasedonICDdiagnoses procedures age sex andthepresenceofcomplicationsorco morbidities 9 BackgroundinformationtoTextA 3 RelatedbackgroundinformationA TheMedicareDiagnosisRelatedGroup DRG 疾病診斷相關(guān)分類系統(tǒng)DRGshavebeenusedsince1983todeterminehowmuchMedicarepaysthehospital sincepatientswithineachcategoryaresimilarclinicallyandareexpectedtousethesamelevelofhospitalresources DRGsmaybefurthergroupedintoMajorDiagnosticCategories MDCs 10 BackgroundinformationtoTextA 3 RelatedbackgroundinformationB HMO HealthMaintenanceOrganization 衛(wèi)生維護(hù)組織Ahealthmaintenanceorganization HMO isatypeofmanagedcareorganization MCO thatprovidesaformofhealthinsurancecoverageintheUnitedStatesthatisfulfilledthroughhospitals doctors andotherproviderswithwhichtheHMOhasacontract TheHMOActof1973requiredemployerswith25ormoreemployeestoofferfederallycertifiedHMOoptions 11 BackgroundinformationtoTextA 3 RelatedbackgroundinformationB HMO HealthMaintenanceOrganization 衛(wèi)生維護(hù)組織Unliketraditionalindemnityinsurance careprovidedinanHMOgenerallyfollowsasetofcareguidelinesprovidedthroughtheHMO snetworkofproviders Underthismodel providerscontractwithanHMOtoreceivemorepatientsandinreturnusuallyagreetoprovideservicesatadiscount ThisarrangementallowstheHMOtochargealowermonthlypremium whichisanadvantageoverindemnityinsurance providedthatitsmembersarewillingtoabidebytheadditionalrestrictions 12 BackgroundinformationtoTextA 3 RelatedbackgroundinformationC WorldfamousMedicalPeriodicalsBMJ BritishMedicalJournal 英國醫(yī)學(xué)雜志 AMA TheJournaloftheAmericanMedicalAssociation 美國醫(yī)學(xué)會雜志 NewEnglandJournalofMedicine 新英格蘭醫(yī)學(xué)雜志 TheLancet 柳葉刀 Nature英國 自然 周刊Science美國 科學(xué) 周刊 13 Analysisofthetext 1 Whoshouldhavetherighttodecidewhetheryoureceivelife sustainingmedicaltreatmentduringacriticalorterminalillness Paragraph1 sustain v causetocontinueorbeprolongedforanextendedperiodorwithoutinterruption sustainingandsustainableareitsderivatives 14 Analysisofthetext 1 Whoshouldhavetherighttodecidewhetheryoureceivelife sustainingmedicaltreatmentduringacriticalorterminalillness Paragraph1 Example Asiamustfocusonjobcreationtosustaineconomicgrowth Thisconditionofintrinsicmotivationisanexampleofself determinationandcanleadtosustainedgoal orientedbehavior 15 Analysisofthetext 2 yourright to decideisbeingtakenawayfromyou oryourfamily Paragraph2 takesomebodyorsomethingawayfromsomebodyorsomething removeExample Thechildwastakenawayfromschool take away from lessen weaken diminishExample Thesefaultstosomeextenttook away fromhiscreditasabiographer 16 Analysisofthetext 3 andmembersofthemedicalintelligentsiawhobelievethattheirvaluesandprioritiesshouldcountmorethanyourswhendetermining Paragraph2 count tohaveaspecifiedimportanceorvalueExample Theiropinionscountforlittle Eachbasketcountsfortwopoints 17 Analysisofthetext 4 Toputitbluntly evenifyouwanttolive evenifyouwantmedicaltreatmenttoenableyoutofightforyourlife Paragraph2 toputitbluntly franklyspeakingExample Toputitbluntly Idon tcare 18 Analysisofthetext 5 Unfortunately fewpeoplereadthesehighbrowpublications Paragraph3 highbrow usuallydepreciating withtastesandinterestsconsideredtobesuperior oftenusedcontemptuouslytowardintellectuals Example highbrowdrama music 19 Analysisofthetext 6 Thefirsttimemostpatientsandtheirfamiliesbecomeawarethatdoctorsarebeinggiventherighttosay no towantedmedicaltreatment otherthancomfortcare isduringamedicalcrisiswhentheyareattheirmostdefenselessandvulnerable Paragraph3 Mostpeoplearenotawarethatadoctorcanrefusethemtreatment Theyfindoutinthemiddleofanemergencywhentheyareemotionallyunabletoprotectthemselves 20 Analysisofthetext 6 Thefirsttimemostpatientsandtheirfamiliesbecomeawarethatdoctorsarebeinggiventherighttosay no towantedmedicaltreatment otherthancomfortcare isduringamedicalcrisiswhentheyareattheirmostdefenselessandvulnerable Paragraph3 Thefirsttime isduring Example ThefirsttimeIcametoknowthepleasureofworkingoutmathproblemswasduringmyvisittothescienceandtechnologymuseum 21 Analysisofthetext 6 Thefirsttimemostpatientsandtheirfamiliesbecomeawarethatdoctorsarebeinggiventherighttosay no towantedmedicaltreatment otherthancomfortcare isduringamedicalcrisiswhentheyareattheirmostdefenselessandvulnerable Paragraph3 atone s形容詞最高級 最高級可以和物主代詞連用表示最 的情況或狀態(tài) Example FragrantHillisatitsbestinautumnwhenthecolorfulleavesofthemapletreesgreettheeyeeverywhere 22 Analysisofthetext 7 someareahospitalsnowhaverulesinplacethatpermit Paragraph4 inplace intherightorproperplaceExample Iliketohaveeverythinginplace fig instituted existingExample Theproposalisnotquiteinplace 23 Analysisofthetext 8 True whenthereisadispute familiesandpatientshavearighttoahearinginfrontofahospitalethicscommittee Paragraph4 hearing 聽證會 意見聽取會Example toholdahearingintosomethingWatergateHearings 24 Analysisofthetext 9 Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers mostlycomprisedofwell meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile caretheoryistherightthingtodo Paragraph4 Thecommitteemembersarenotimpartial theirdecisionwilllikelybemadeontheirbeliefinthetheoryratherthantheindividualcircumstances 25 Analysisofthetext 9 Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers mostlycomprisedofwell meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile caretheoryistherightthingtodo Paragraph4 stackeddeck preparedinadvanceinordertoinfluencetheoutcome usuallyforthepurposeofcheating 26 Analysisofthetext 9 Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers mostlycomprisedofwell meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile caretheoryistherightthingtodo Paragraph4 well meaning well intentioned 出于好意 但結(jié)果往往不好 dispassionate adj devoidoforunaffectedbypassion emotion orbias 27 Analysisofthetext 9 Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers mostlycomprisedofwell meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile caretheoryistherightthingtodo Paragraph4 culture thepatterns traits andproductsconsideredastheexpressionofaparticularperiod class community orpopulation withrespecttoaparticularcategory suchasafield subject ormodeofexpression 28 Analysisofthetext 9 Suchcommitteescouldeasilybecomemorestackeddecksthandispassionatedecisionmakers mostlycomprisedofwell meaningpeoplewhoeitherarepartoftheinstitutionalcultureorwhohavebeentrainedtobelievethatfutile caretheoryistherightthingtodo Paragraph4 Example musicalculture音樂文化businessculture企業(yè)文化campusculture校園文化Edwardianculture愛德華時代的文化 29 Analysisofthetext 10 Butthiswouldbenoeasytaskgiventhepatientsrefusedtreatmentarelikelytobethemostexpensivetocarefor Paragraph5 given undertheconditionof if since nowthat Example Giventhesameprovision Iwouldhavedoneitbetterthanhedid 30 Analysisofthetext 11 Thatcouldwork butitisnosurebet Paragraph6 Patientscandothat buttheymaynotgetthewantedresult betn oneonwhichastakecanbeplaced被下賭注的對象Example Ourteamisasurebettowin 31 Analysisofthetext 12 Buteventhoughalawsuitcouldbesuccessfulintheory itmightverywellproveutterlyimpracticabletopursue Paragraph7 impracticableimpractical thoughitcanbeusedinthisway alsocanbeweakerinsense suggestingthatthecourseofactionwouldyieldaninsufficientreturnorwouldhavelittlepracticalvalue 32 Analysisofthetext 13 Lawyersoftenchargehundredsofdollarsanhour meaningthatafullylitigatedcase evenwithoutappeals couldcostliterallytens ifnothundredsofthousandsofdollars Paragraph7 ifnot theexpressionshowsaconcessiveimplication Example Laughterisveryimportant ifnotindispensable inourlife 33 Analysisofthetext 14 havingverydeeppockets thehospitaladministrationwouldnotbeconcernedintheleastaboutthecostoftheirlawyers Paragraph8 Consideringtheirrelativelysolidfinances thehospitaladministrationwouldnotmindatallaskingforhelpfromlawyers evenifthecostsarehigh 34 Analysisofthetext 15 Iffullyunleashed thehospital scorporatelawyerscouldfileenoughmotions tothepointthatyou quiteliterally couldlitigateyourselfintobankruptcy Paragraph8 Evenwhentheyarechargedwithalawsuit theycanaffordboththemoneyandthetimetodealwithit untilfinallyyouwouldrunoutofthemoneynecessarytopursuethelawsuit 35 Analysisofthetext 15 Iffullyunleashed thehospital scorporatelawyerscouldfileenoughmotions tothepointthatyou quiteliterally couldlitigateyourselfintobankruptcy Paragraph8 tothepoint untilthestage that finallyliterally informaluse tointensifymeaning withoutexaggerationExample Thechildrenwereliterallystarving corporatelawyers 法律顧問 36 Analysisofthetext 15 Iffullyunleashed thehospital scorporatelawyerscouldfileenoughmotions tothepointthatyou quiteliterally couldlitigateyourselfintobankruptcy Paragraph8 motionn anapplicationmadetoacourtforanorderorarulingExample Themotionwasadopted carried depositionn Law testimonyunderoath esp astatementbyawitnessthatiswrittendownorrecordedforuseincourtatalaterdate 37 Analysisofthetext 16 Beyondthefinancialimpracticalitiesofsuingahospital oneoftheprimaryreasonsforcraftingfutile careprotocolshasbeentoimprovethechancethatthehospitalwouldprevailincourt Paragraph9 craft v tomakeorconstruct something inamannersuggestinggreatcareoringenuityExample ItwasnottheChamberofCommercethatcraftedthepublicpoliciesthathaveresultedina 2 6billionannualsubventiontothefarmers 38 Analysisofthetext 17 puttheseprotocolsinplaceasawaytoprepareforthelitigationbioethicistspresumewouldbefiledbypeoplefuriousathavingwantedmedicaltreatmentrefused Paragraph9 Byusingtheseprotocols bio ethicistscanpreparethemforsomeunfavorablesituations suchaslawsuitsfiledbyfuriouspatientsortheirfamilies 39 Analysisofthetext 18 Theearlybioethicsmovementdeservesgreatthanksforhelpingdoawaywiththatformofabuse Paragraph11 Societyowesadebttotheearlybioethicsmovementforhelpingtoendthistypeofabuse 40 Analysisofthetext 19 Inessence whatisbeingcreatedinfrontofourveryeyes ifwewouldonlysee isadutytodie Paragraph13 Nowthatavaluecanbeplacedonadyingperson slife itcanbesaidthatindividualhasaresponsibilitytodieinordertobenefitsociety 41 Analysisofthetext 19 Inessence whatisbeingcreatedinfrontofourveryeyes ifwewouldonlysee isadutytodie Paragraph13 inessence fundamentallyExample Thetwothingsarethesameinoutwardformbutdifferentinessence very itselfandnoother trulysuchExample Atthatverymoment thephonerang 42 Globalanalysisofthetext Euthanasia isabroadtermformercykilling takingthelifeofahopelesslyillorinjuredindividualinordertoendhisorhersuffering Mercykillingrepresentsaseriousethicaldilemma Peopledonotalwaysdiewell Someafflictionscausepeopletosufferthroughextremephysicalpainintheirlastdays andeuthanasiamayseemlikeacompassionatewayofendingthispain Otherpatientsmayrequesteuthanasiatoavoidtheweaknessandlossofmentalfacultiesthatsomediseasescause andmanypeoplefeelthatthesewishesshouldberespected 43 Globalanalysisofthetext Buteuthanasiaalsoseemstocontradictoneofthemostbasicprinciplesofmorality whichisthatkillingiswrong ViewedfromatraditionalJudeo Christianpointofview euthanasiaismurderandablatantviolationofthebiblicalcommandment Thoushaltnotkill Fromasecularperspective oneoftheprincipalpurposesoflawistoupholdthesanctityofhumanlife Euthanasiaissocontroversial becauseitpitstheplightofsuffering dyingindividualsagainstreligiousbeliefs legaltradition and inthecaseofphysician assisteddeath medicalethics 44 Analysisofthetextstructure Thetextfallsintofourparts PartIParagraphs1 2 Patientsusedtotakeforgrantedtherighttoreceivetreatment butnowtheymaynolongerhavethatright PartIIParagraph3 Futile caretheoryisprevailing PartIIIParagraphs4 9 Thereasonswhyfutile caretheoryhasbecomesowidelyacceptedanditspracticability PartIVParagraphs10 13 Thefutile caretheoryisactuallyakindofhegemony 45 Summaryofthetext Inthepast patientsandtheirfamilieshadtherighttobegivenwantedmedicalcare Withthespreadof futile caretheory accordingtowhichhospitalsmayrefusetoofferlife sustainingmedicaltreatment patientsarelosingthisright Manyhospitalshaveadoptedsuchtheories Afterbeingrefusedwantedmedicaltreatment patientsandtheirfamiliesarefacedwithtwochoices totransfertoanotherhospitalortoseeklegalhelp Butthetwomethodscreatefurtherobstacles Bioethicswasoncehelpfulinitsearlystage butnowitsupportsanewhegemony whichsupportshospitalsanddoctors buthurtspatients 46 Referenceanswerstotheexercises TextA1 1 T2 F3 T4 F5 F3 1 hearing2 dispassionate3 scrupulous4 hegemony5 sustained6 priority7 futile8 inexorably9 impracticality10 craft 47 Referenceanswerstotheexercises 4 WritingexerciseAIseuthanasiamoralornot Manydoctorsandethicistsabroadquitefavorit takingitasareleasefromagony Sointheinterestsofpatients itispermissible Otherscholarsdisagreeonit Theybelievethateveryonehastherighttolive andit sthedoctors moraldutytohealthewoundedandrescuethedying Anykindofeuthanasiaisimmoral Allviewpointsfallintothreegroups thefirstisforeuthanasia thesecondagainstit andthethirddepends 48 Referenceanswerstotheexercises TextB1 1 T2 F3 T4 F5 F2 1 A2 A3 C4 B5 D6 D7 A8 C9 D10 D 49 Referenceanswerstotheexercises TextB3 1 facilities2 surrounded3 elite4 housed5 rash6 invariably7 sub clinical8 incubation9 developing10 specific11 note12 threatening13 marginally14 minimally15 interdiction16 emergency17 employs18 manageable19 relentless20 expected 50 Questionsarewelcome Thankyou 51