Accidents, Suicide, and Euthanasia

英语专业四级（新闻）听力重点词汇1.教育用词:curriculum课程*academy (高等)专科院校，研究院，学会，学术团体，学院*semester学期guest professor客座教授*statistics统计学*president校长ethics伦理学plagiarism剽窃，剽窃物*assistant助教*lecture讲师*associate professor副教授*post graduate研究生*scholarship奖学金illiteracy文盲*bachelor学士dean系主任*faculty全体教学人员2.能源、交通用词van有篷货车trolley电车，（电车）滚轮，手推车shuttle往返汽车（列车、飞机），航天飞机unleaded无铅的*nuclear原子能的*petroleum石油lorry铁路货车vehicular车的，用车辆运载的*commuter通勤者，经常往返者*solar energy太阳能heat energy热能3.社会、家庭*adult成年人*ancestor祖先*community团体、同一地区的全体居民*descendant后代*divorce离婚*gay同性恋者*generation gap代沟*homosexual同性恋的*illegitimacy非法、私生lesbian女同性恋者4.环境用语5.健康卫生用语air quality monitoring system空*life-span寿命气质量监测系统thermal pollution热污染*tropical island effect热岛效应*acid rain酸雨desertification(土壤)荒漠化，沙漠化soil erosion水土流失*acid rain酸雨*atmosphere大气*carbon dioxide二氧化碳*conservation保护区*EI Nino厄尔尼诺现象*green-house effect温室效应*nuclear radiation核辐射*ozone layer臭氧层*solar energy太阳能mortality死亡率*chronic慢性的non-infection非传染avian influenza禽流感taint感染venom毒；毒物*toxin毒素noxious有害的placebo安慰剂immunize使免疫fungus真菌*remedy药物，治疗法sanitary（有关）卫生的，（保持）清洁的，清洁卫生的*HIV (human immunodeficiency virus)人体免疫缺损病毒，艾滋病病毒*sustainable development可持续*after effect后遗症发展*waste废物、废料*ecological balance生态平衡*extinction绝种habitat栖息地、住处poacher偷猎者*allergy过敏症coma昏迷*complication并发症dehydration脱水euthanasia安乐死infect传染inflammation发炎malnutrition营养不良obesity肥胖症*wound伤、伤口*addict上瘾的人*addiction吸毒成瘾6.常见国家及地区名称*Afghanistan阿富汗Kabul喀布尔（阿富汗首都）*Pakistan巴基斯坦Palestine巴勒斯坦7.常见国际组织机构名称United Nations Food and Agriculture Organization联合国粮食农业组织*Security Council联合国安理会Economic and Social Council经济与*Democratic People’s Republic of社会理事会Korea (North Korean)朝鲜Pyongyang平壤Philippines菲律宾United Nation Children’s Fund联合国儿童基金组织United Nations Development ProgramSeoul首尔Lebanon黎巴嫩Maldives马尔代夫Nepal尼泊尔*Iraq伊拉克*Iran伊朗*Israel以色列Jordan约旦Congo刚果Ghana加纳Uganda乌干达*Haiti海地Venezuela委内瑞拉Antarctica南极洲Arctic Ocean北极洲联合国开发计划处International Atomic Energy Agency 国际原子能组织ITU=International Telecommunications Union国际电信同盟UNIDO=United Nations Industrial Development Organization联合国工业开发组织IBRD=International Bank for Reconstruction and Development国际复兴与开发银行*IOC=International Olympic Committee国际奥林匹克委员会（=CIO）Capitol Hill国会山（美国国会所*IMF=International Monetary Fund国在地）Jerusalem耶路撒冷Pacific Rim环太平洋地区Pentagon五角大楼际货币基金组织GATT=General Agreement on Tariffs and Trade关贸总协定*G-7 summit七国首脑会议*Red Cross红十字会8.常见巴以冲突问题新闻词汇Jewish settler犹太定居者*assassination暗杀*cease-fire停火Gaza Strip加沙地带*conflict冲突*withdrawal撤退9.国际关系*ambassador大使ambassadress女大使permanent Member常任理事国*diplomat外交人员*embassy大使馆*accord协议P.L.O(缩)Palestine Liberation*charter宪章Organization巴勒斯坦解放组织memorandum备忘录Fatah法塔赫（巴解组织最大的*protest抗议书一支游击队）West Bank约旦河西岸Oslo agreement奥斯陆协定evacuate疏散Likud party利库德集团*Middle East中东targeted elimination定点清除unilateral action单边行动10.政治活动*Communist Party共产党*Conservative Party保守党*treaty条约a courtesy call礼节性访问a focal point焦点a viable proposal一项可靠的建议bilateralism双边的/互惠主义*adversary对手，敌手*nuclear club核俱乐部（指有核武器的国家）*refugee camp难民营11.火灾、风灾、水灾、旱灾、地震等灾难地震*Labor Party工党*Liberal Party自由党Radical Party激进党*Republican Party共和党Ruling party执政党*extremist极端分子humanitarian人道主义者*racism种族主义Assembly议会*Cabinet内阁*commission委员会*Congress国会*Council委员会*Department部、院*Foreign Ministry外交部*parliament议会regime政权*Senate参议院chief justice首席法院inaugural address就职演说*premier总理*prime minister首相natural calamity自然灾害*earthquake地震fatality不幸，灾祸，天命*plague瘟疫，麻烦，苦恼，灾祸doom厄运，毁灭，死亡*after shock余震derris碎片、瓦砾堆、废墟*earthquake belt地震带*landslide塌方、滑坡、山崩*mudslide泥石流tsunami海啸volcano eruption火山爆发*flood洪水crest洪峰*dam大坝deluge洪水、大雨、暴雨*drown淹死gale狂风*hurricane飓风*typhoon台风*drought干旱*secretary of state国务卿*absence缺席、不在*abstain弃权*ballot无记名投票*election选举*forum论坛12.交通事故aground搁浅*rescue official援救人员capsize (特指船)倾覆death toll死亡人数*collide（车、船等）猛撞*crash碰撞、坠落derail火车出轨*fragment碎片life vest救生背心raft救生筏*rescue营救、援救depredate掠夺，毁坏*snowstorm暴风雪*humanitarian人道主义者afflicted district受灾地区*sandstorm沙尘暴tornado龙卷风13.经济人员与组织board of directors董事会branch分公司broker经纪人、中间人、代理人consortium国际财团enterprise企业单位entrepreneur企业家joint venture合资企业subsidiary子公司division部门tycoon（企业、财界的）巨头an economic forum经济论坛wreck（船只等）失事、失事的船14.常用犯罪、法律类新闻词汇agitate煽动、捣乱*assassinate暗杀15.常见经济用词venture投机，风险trade disputes贸易争端*blackmail敲诈、勒索*bombing爆炸*mob暴徒*slaughter屠杀*smuggle私运、偷带、走私deficit赤字appreciate增值、涨价currency货币lottery彩票depreciation贬值verdict(律)（陪审团的）裁决，devaluation（货币）贬值判决*guilty犯罪的，有罪的jurisdiction权限appeal上诉*penalty处罚，罚款accusation谴责，（律）指控robbery抢掠，抢夺rape强奸*fraud欺骗*corruption腐败，贪污，堕落immunity豁免权extradite引渡*assassination暗杀*sanction制裁*trial审讯，审判budget预算amortize分期清偿launch投放市场brand商标，牌子debenture债券deflate紧缩（通货）depression萧条，不景气bankroll资金arbitrage套汇antitrust反托拉斯的，反垄断的常见财经证券新闻词汇DOW:Dow Jones industrial average (DJIA)道琼斯工业指数Tokyo’s Nikkei average东京日经平defence（律）（被告的）答辩、均指数辩护*execute处死bail保释，保证金，保证人procurator代理人*kidnapping诱拐，拐骗*bribe贿赂arson纵火罪defalcation挪用公款，贪污*hijack劫机right of asylum避难权amnesty特赦repatriate遣返felony (律)重罪a bull market牛市bonus share红股The standard and Poor’s500标准普尔500指数NYSE,New York Stock Exchange纽约证券交易所NASDAQ:National Association of Securities *Deal Automated Quotations 纳斯达克指数Hang Seng Index香港恒生指数nosedive（价格等）暴跌*a bear market熊市blue chip绩优股inscribed shares记名式股票discount贴现16.与恐怖主义有关的词汇*explode爆炸17.政治用词consulate领事，领事馆*sponsor terrorism赞助恐怖主义*ally同盟*body bomb人体炸弹*suicide attacks自杀性袭击sympathizers of AI Qaeda基地组织的支持者cabinet <美>内阁*demonstration游行示威removal免职*protest抗议*hostage人质*terrorism’s financer恐怖主义资助者casualty伤亡dignitary高官chancellor长官，大臣poll投票选举，民意测验*rally集会*terrorist suspects恐怖主义嫌疑*rebel造反，反叛犯*abduct绑架loot抢劫ransom敲诈，勒索反恐常用词汇the bomb squad防爆小组Britain’s 2000 Terrorism Act英国《2000年反恐怖主义法案》bulletproof防弹的convoy护航suffrage投票，选举权，参政权stump在（某地）做政治巡回演说caucus (政党的)领导人秘密会议，核心小组会议bureaucracy官僚作风，官僚机构despotism专制containment围堵政策，牵制政策impeach <主美>弹劾，怀疑prerogative特权anarchism无政府主义*summitry高峰会*campaign竞选运动bicameral两院制的，有两个议院的hegemony霸权enfranchise给予选举权，给予自治权propaganda宣传multi-party elections多党选举18.网络科技新闻用词*online service在线服务*searching engine搜索引擎*digital divide数字鸿沟*Internet-based以网络为基础的*e-commerce电子商务*SPAM messages垃圾电子邮件cyber phobia计算机恐惧症19.其他科学、科技词汇*fossil化石*evolution演变，进化semiconductor半导体radiation放射线，放射物handset手机，手持机*dinosaur恐龙*origin起源，由来online transaction网上交易BBS*relic遗物，遗迹电子布告栏系统*browser浏览器electronic platform电子化平台community portal社区门户online consultation在线咨询*electronic banking电子银行*e-government电子政务*junk-e-mail垃圾电子邮件interface界面20．航天科技新闻用词unmanned probe无人探测the launch tower发射塔*breakthrough突破voice recognition system语音识别系统mechanistic机械论学说的，机械论的videophone电视电话21.娱乐、文化、艺术、旅游用词*theme park主题公园showgirl歌舞女郎shuttle航天飞机definitive orbit既定轨道external tank外壳lunar module登月舱manned spacecraft载人宇宙飞船the re-entry capsule返回舱*emergency landing紧急降落Telstar通讯卫星command module指令舱multistage rocket多级火箭DINK丁克一族：有双薪收入而没有孩子的夫妇Emmy艾美奖videoporn <口>色情电视，黄色录像Warner Brothers华纳兄弟娱乐公司choreographer舞蹈指导*Broadway百老汇baroque巴洛克时期艺术和建筑风格telecopter空中电视台tent pole movie大片*Hollywood好莱坞*film fans影迷premiere初次公演，初演主角pop chart流行榜*box office票房Soap Opera肥皂剧*signature签名show tour巡演22.比赛有关用词tournament锦标赛，联赛*final决赛23.体育用词*stadium露天大型运动场judo<日>柔道*riot 球场骚动round-robin 循环赛*world record 世界纪录Master ’s Champion 大师赛j avelin throwing 标枪*billiards 台球，桌球Karate 空手道*grand slam(棒球)大满贯*count out 数十：从一秒数到十*hockey 曲棍球秒，在此期间被击倒的拳手必须站起来，不然便被宣布失败Grand Prix 国际汽车大奖赛cheerleader 啦啦队队长elimination match,knock-out 淘汰赛*grouping 分组*ranking 排名*Championship 冠军赛Formula One 一级方程式赛车24.体育组织名称25.社会、家庭discus 铁饼，掷铁饼*rugby 橄榄球archery 剑术*Olympic Games 奥林匹克运动会aerobics 有氧运动*soccer 英式足球taekwondo 跆拳道smash 扣球*FIFA=Federation Internationale de *adult 成年人Football Association ，国际足球联*ancestor 祖先盟*IOC=International*community 团体、同一地区的全体居Olympic 民Committee 国际奥林匹克委员会*descendant 后代（=CIO ）*divorce 离婚International Amateur Athletics *gay 同性恋者Federation 国际运动员协会*generation gap 代沟*homosexual 同性恋的*illegitimacy 非法、私生lesbian 女同性恋者26.工业*cargo 货物*crude oil 原油*engine 发动机*fossil fuel 矿物燃料*fossil oil 石油*gasoline 汽油*handicraft 手工业*mining 采矿*petroleum 石油*refinery 炼油厂*robot 机器人*textile 纺织品28.合成词dusk-to-dawn curfew 彻夜宵禁face-to-face talk 会晤；面晤ground-to-air missile 地对空导弹touch-and-go affair 一触即发的局势27.农、林、牧、副、渔*aquiculture 水产养殖*breed 繁殖、生育、饲养chemical fertilizer 化学肥料cross-breeding 杂交*dairy farm 奶牛场fibre 纤维irrigation 灌溉*livestock 牲畜photosynthesis 光合作用*raise 饲养middle-of-the-road policy中立政策on-the-job training在职培训；岗位培训On-the-spot interview现场采访One-country-two-system policy一国两制的政策arms-reduction talks裁军谈判labour-management conflict 劳资冲突supply-demand imbalance供求失调highly-sophisticated technology尖端技术cancer-causing drug制癌药物oil-producing country产油国peace-keeping force维和部队policy-making body决策机构far-reaching significance深远意义high-ranking official高级官员long-standing issue由来己久的问题wide-spreading AIDS到处蔓延的艾滋病export-oriented economy外向型经济poverty-stricken area贫困地区foreign-owned enterprise外资企业deep-rooted social problems 根深蒂固的社会问题interest-free loan无息贷款labour-intensive enterprise 劳动力密集型企业fair-trade agreement互惠贸易协定long-range nuclear missile 远程核导弹。

CEJA Report B – A-91Decisions Near the End of LifeINTRODUCTIONThere is a long-standing tradition in medicine that physicians must do everything medically possible to keep a patient alive. In recent years, the issue of allowing and even helping patients to die has been opened up to vigorous debate. At present do-not-resuscitate orders are commonplace.1,2 Courts have upheld the right of patients to refuse life-sustaining treatment in over 130 cases, and the U.S. Supreme Court recently indicated that a right to refuse life-sustaining treatment can be found in the U.S. Constitution.3 There is a surprising amount of support even for the proposition that physicians should be allowed to deliberately end a patient's life upon the patient's request. In one poll conducted in 1988 in New York City, 58% of the physicians responded that physicians should be lawfully able to end the life of terminally ill patients at the patients' request.14Since the turn of the century, there has been a dramatic shift in the places where people die. Sixty years ago, the vast majority of deaths occurred at home. Now most people die in hospitals or long-term care facilities. Approximately 75% of all deaths in 1987 occurred in hospitals and long-term care institutions,5 up from 50% in 1949, 61% in 1958 and 70% in 1977.6 This move of the locale of death from the privacy of the home to medical institutions has increased public awareness and concern about medical decisions that lead to patients' deaths. "Since deaths which occur in institutions are more subject to scrutiny and official review, decisions for death made there are more likely to enter public consciousness."7A related phenomenon, the advance of life-saving medical technologies, also has contributed to the increased attention to medical decisions that lead to the deaths of patients. These advances have resulted in a lengthening of the average life span, which has had the effect of increasing the proportion of deaths caused by chronic conditions. One study in 1968 found that half of all deaths are caused by an illness diagnosed at least 29 months earlier. Another study found that a chronic condition was the cause of 75% of all deaths in 1986.8 In addition, with the development of sophisticated life support technologies, medicine now has the capacity to intervene and forestall death for almost any case. The Office of Technology Assessment Task Force estimated in 1988 that 3775 to 6575 persons were dependent on mechanical ventilation and 1,404,500 persons were receiving artificial nutritional support.9 Bioethicist Alexander Capron has argued:There is no such thing as a "natural" death. Somewhere along the way for just about every patient, death is forestalled by human choice and human action, or death is allowed to occur because of human choice. Life-support techniques make death a matter of human choice and hence a matter that provokes ethical concern.7As a result, the public has become increasingly concerned about the prospect of protracted deaths marked by incapacitation, intolerable pain and indignity, and invasion by machines and tubes. In a public opinion poll 68% of respondents believed that "people dying of an incurable painful disease should be allowed to end their lives before the disease runs its course. "1,10 A number of comparable surveys indicate similar public sentiment.lThe Council has previously issued opinions on withdrawing and withholding life-prolonging treatment from patients who are terminally ill or permanently unconscious (2.20 and 2.21 in Current Opinions) and reports concerning do-not-resuscitate orders,11,12 euthanasia,13 and withdrawal of life-prolonging treatment from permanently unconscious patients.14A version of this report was published as "Decisions Near the End of Life" (JAMA. 1992; 267 (16): 2229-2233)© 1991 – 1992 American Medical Association. All Rights Reserved.At the 1990 Annual Meeting of the AMA's House of Delegates, Resolution 267, "Suicide-Assisting Devices," was referred for decision. This report will examine the Council's existing positions and will expand the analysis to include physician-assisted suicide and withdrawing/withholding life-sustaining treatment for patients who are neither terminally ill nor permanently unconscious.DEFINITIONSThe four categories of medical actions that can lead to the death of a patient are:withholding/withdrawing life-sustaining treatment, the provision of palliative treatment that may foreseeably hasten death, euthanasia, and assisted suicide.Life-sustaining treatment is any medical treatment that serves to prolong life without reversing the underlying medical condition. Life-sustaining treatment includes, but is not limited to, mechanical ventilation, renal dialysis, chemotherapy, antibiotics and artificial nutrition and hydration. At one time, the term "passive euthanasia" was commonly used to describe withholding or withdrawing life sustaining treatment, However, most experts now refrain from using the term "passive euthanasia."The provision of a palliative treatment that may foreseeably hasten death is also described as "double effect euthanasia”. The Intent of the treatment is to relieve pain and suffering, not to end the patient's life, but the patient's death is a foreseeable side effect of the treatment. For example, a physician may gradually increase the morphine dosage for a patient to relieve severe cancer pain, realizing that large enough doses of morphine may depress respiration and cause death.Since the term "euthanasia" has various meanings, it is important to specify the definition the Council intends in this report. In this country, euthanasia is commonly defined as the act of bringing about the death of a hopelessly ill and suffering person in a relatively quick and painless way for reasons of mercy. In this report, the term "euthanasia" will signify the medical administration of a lethal agent to a patient for the purpose of relieving the patient's intolerable and incurable suffering.The terms "voluntary" and "nonvoluntary" will be used to modify euthanasia. Voluntary euthanasia is euthanasia which is provided to a competent person upon his or her informed request. Non-voluntary euthanasia is the provision of euthanasia to an incompetent person according to a surrogate's decision. Involuntary euthanasia, in theory, would be euthanasia performed against a person's will. However, the term "involuntary euthanasia" will not be used since it is difficult to imagine a merciful assistance to death ever occurring against a competent person's will.Euthanasia and assisted suicide differ in the degree of physician participation. Euthanasia entails a physician performing the immediate life-ending action (e.g., administering a lethal injection). Assisted suicide occurs when a physician facilitates a patient's death by providing the necessary means and/ or information to enable the patient to perform the life-ending act (e.g., the physician provides sleeping pills and information about the lethal dose, while aware that the patient is intending to commit suicide). Discussions about life-ending acts by physicians often refer to the patient's "competence" or "decision making capacity." The two terms are of-ten used interchangeably. However, "competence" can refer to a legal determination of a person's soundness of mind. "Decision making capacity" is a more specific term that is not determined in the courts and signifies the ability to make a particular decision. The term "competence" for the purposes of this ethical analysis is intended to mean "decision making capacity." The evaluation of a person's decision making capacity is an assessment of the person's capabilities for understanding, communicating and reasoning. Patients should not be determined to lack decision makingcapacity based on the view that what they decide is unreasonable.15 For example, a considered refusal of a blood transfusion by a Jehovah's Witness should generally be respected even though it may be viewed as an unreasonable choice by most people. People are entitled to make decisions that others think are foolish as long as their choices pose no significant harm to others.ETHICAL FRAMEWORKDetermining the ethical responsibilities of physicians when patients wish to die requires a close examination of the physician's role in society. Physicians are healers of disease and injury, preservers of life and relievers of suffering. Ethical judgments become complicated, however, when these duties conflict. The four instances discussed in this report in which physicians might act to hasten death or refrain from prolonging life involve conflicts between the duty to relieve suffering and the duty to preserve life.The considerations that must be weighed in each case are 1) the principle of patient autonomy and the corresponding obligation of physicians to respect patients' choices, 2) whether what is offered by the physician is sound medical treatment, and 3) the potential consequences of a policy that permits physicians to act in a way that would lead to a patient's death.PATIENT AUTONOMYThe principle of patient autonomy requires that patients who possess decision making capacity have the opportunity to choose among medically sound treatments and to refuse any unwanted treatment offered by their physicians. Absent countervailing obligations, physicians must respect patients' decisions. This ethical principle has been consistently upheld in the courts and is the basis of the doctrine of informed consent.16 Justice Cardozo pronounced in 1914, "[e]very human being of adult years and sound mind has a right to determine what shall be done with his [sic] own body."17Treatment decisions often involve personal value judgments and preferences in addition to objective medical considerations. We demonstrate respect for human dignity when we acknowledge "the freedom [of individuals] to make choices in accordance with their own values."18SOUND MEDICAL TREATMENTThe physician's obligation to respect a patient's decision does not require a physician to provide a treatment that is not medically sound. Indeed, a physician is ethically prohibited from offering or providing medically unsound treatments. Sound medical treatment is defined as the use of medical knowledge or means to cure a medical disorder, relieve distressing symptoms, and/or prevent the occurrence of either.This criterion of soundness arises from the well-established medical ethical principles of beneficence and nonmaleficence. The principle of nonmaleficence requires that physicians not use their medical knowledge nor skills to harm patients, while the principle of beneficence requires that medical knowledge and skills be used to benefit patients.The criterion of soundness is particularly relevant to the discussion of physician participation In treatments, or non-treatments, that can lead to deaths of patients. Generally, a treatment that is likely to cause the death of a patient is considered unsound, and a failure to save a patient's life is negligent. However, the situations which will be examined in this report are extremely complicated because they involve the unique circumstance where the patient does not consider his or her death to be an undesirable outcome.PRACTICAL CONSIDERATIONSPolicies governing the care of patients who wish to die must also be evaluated in terms of their practical consequences. The ethical acceptability of a policy depends upon the benefits and costs that result from the policy. In addition to the impact on individual cases {e.g., patients will die according to their decision to have life supports withdrawn), there are likely to be serious societal consequences from policies regarding physicians' responsibilities to dying patients. For example, while the withdrawal of artificial nutrition and hydration facilitates the relief of suffering, some commentators believe that it undermines society's commitment to feed those who cannot feed themselves.WITHHOLDING AND WITHDRAWING LIFE-SUSTAINING TREATMENTThe principle of patient autonomy requires that physicians respect a competent patient's decision to forgo any medical treatment. This principle is not altered when the likely result of withholding or withdrawing a treatment is hastening the patient's death.6 The right of competent patients to forgo life-sustaining treatment has been upheld in the courts and is generally accepted by medical ethicists.19 The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research stated in 1983:[t]he voluntary choice of a competent and informed patient should determine whether or not life sustaining therapy will be under taken, just as such choices provide the basis for other decisions about medical treatment. Health care institutions and professionals should try to enhance patients' abilities to make decisions on their own behalf and to promote understanding of the available treatment options.6In part, the reasoning behind the right of competent patients to forgo life-sustaining treatment is that decisions which so profoundly affect a patient's well-being cannot be made independent of a patient's subjective preferences and values.20 Many types of life-sustaining treatments are burdensome and invasive, so that the choice for the patient is not simply a choice between life and death.9 When a patient is dying of cancer, for example, a decision may have to be made whether to use a regimen of chemotherapy that might prolong life for several additional months but also would be painful, nauseating and debilitating. Similarly, when a patient is dying, there may be a choice between returning home to a natural death or remaining in the hospital, attached to machinery, where the patient's life might be prolonged a few more days or weeks. In both cases, individuals might weigh differently the value of additional life versus the burden of additional treatment.The physician must ensure that the patient has the capacity to make medical decisions before carrying out the patient's decision to forgo (or receive) life-sustaining treatment. In particular, physicians need to be aware of the possibility that the patient's decision making capacity can be diminished by a misunderstanding of the medical prognosis and options or by a treatable state of depression.The withdrawing or withholding of life-sustaining treatment is not contrary to the physician’s obligation to provide only medically sound treatments. The physician is obligated only to offer treatment. Withdrawing or withholding are not treatments but the forgoing of treatments. Physicians are not entitled to impose treatment on patients who do not want them.Some commentators argue that, if a physician has a strong moral objection to withdrawing or withholding life sustaining treatment, the physician may transfer the patient to another physician who is willing to comply with the patient's wishes. It is true that a physician does not have to provide atreatment, such as an abortion, that is contrary to his or her moral values. However, if a physician objects to withholding or withdrawing the treatment and forces unwanted treatment on a patient, the patient'sautonomy will be inappropriately violated even if it will take only a short time for the patient to be transferred to another physician.Withdrawing or withholding some life-sustaining treatments may seem less acceptable than others. For example, some have objected to the right to refuse artificial nutrition and hydration, while accepting the right to refuse mechanical ventilation because food and water are considered basic patient care. The distinction between extraordinary and ordinary medical treatments has been proposed as a standard to determine whether a life sustaining treatment can be refused by a patient. The Council, along with most experts, believes that the difference between extraordinary and ordinary treatment is not a valid ethical distinction.6 If "ordinary" care is defined as treatment that provides a basic requirement of life regardless of the underlying condition, ventilators which provide oxygen to patients would also be "ordinary" care. Moreover, the standard of extraordinary versus ordinary treatment implies that ordinary, unlike extraordinary life sustaining treatment is not burdensome to the patient. To the contrary, artificial nutrition and/or hydration immobilize the patient td a large degree, can be extremely uncomfortable (restraints are sometimes used to prevent patients from removing nasogastric tubes), and can entail serious risks (for example, surgical risks from insertion of a gastrostomy tube and the risk of aspiration pneumonia with a nasogastric tube).The right to refuse artificial nutrition and hydration has also been contested by some because the provision of food and water has a symbolic significance as an expression of care and compassion. These commentators argue that withdrawing or withholding food and water is a form of abandonment and will cause the patient to die of starvation and/ or dehydration. However, it is far from evident that providing nutrients through an IV line to a patient for whom it is unwanted is comparable to the typical human ways of feeding those who are hungry.21 In addition, discomforting symptoms can be palliated so that a death that occurs after forgoing artificial nutrition and/ or hydration is not marked by substantial suffering.22 Such care requires constant attention to the patient and the patient's needs. Therefore, respecting a patient's decision to forgo artificial nutrition and hydration will not constitute an abandonment of the patient, symbolic or otherwise, when comfort care is maintained.There is also no ethical distinction between withdrawing and withholding life-sustaining treatment. Withdrawing life support may seem ethically more difficult than withholding life support because the physician performs an action which hastens death. When life-sustaining treatment is withheld, on the other hand, death occurs because of an omission rather than an action. This action/omission distinction has been used to differentiate between killing and allowing to die. However, as most bioethicists now recognize, the action/omission distinction lacks ethical significance.6 First, the distinction is often meaningless. For example, if a physician fails to provide a tube feeding at the scheduled time, would it be a withholding or a withdrawing of treatment? Second, ethical relevance does not lie with theaction/omission distinction, but on other factors such as the motivation and professional obligations of the physician. For example, refusing to start a ventilator despite the patient's need and request because the patient's heir has promised the physician a share of the inheritance is clearly ethically worse than stopping the ventilator for a patient who has decided to forgo it. Third, prohibiting the withdrawal of life support would inappropriately affect a patient's decision to initiate such treatment. If treatment cannot be stopped once it is initiated, patients and physicians may decide not to begin treatment.6The practical benefit of respecting patients' choices is that decisions will maximize patient interest and well-being. Patients are in the best position to determine what is in their interests. In addition, if patients did not have control over decisions about life-sustaining treatment the principle of patient self-determination over health care would be eroded.There are negative consequences of a policy to withhold or withdraw life support upon a patient's request.First, deaths may occur as a result of uninformed decisions or from pain and suffering that could be relieved with measures that would not cause the patient's death. And second, there may exist pressures, whether subtle or overt, from family, physicians or society to forgo life-sustaining treatment, rendering the patient's choice less than free. These pressures could revolve around beliefs that such patients' lives no longer possess social worth and are an unjustifiable drain of limited health resources.It is the responsibility of physicians to provide sufficient information to ensure patient understanding. It is also essential that all efforts be made to maximize the comfort and dignity of patients who are dependent on life-sustaining treatment and that patients be assured that these efforts will be made. With such assurances, patients will be less likely to forgo life support because of suffering or anticipated suffering that could be palliated.The risks associated with potential pressures on patients to forgo life- sustaining treatments are an important concern. The Council believes that the medical profession must be vigilant against such tendencies, but that the greater policy risks are of undermining patient autonomy.In summary, according to the principle of respect for patient autonomy, patients who possess an adequate decision making capacity have the right to forgo any life-sustaining treatment. Physicians must respect the decisions of patients, and they must ensure that patients both are well informed about their prognoses and treatment options and understand that comfort and dignity will be a top priority whether or not they decide to forgo life support.PROVIDING PALLIATIVE TREATMENT WHICH MIGHT HASTEN DEATHThe Council stated in its 1988 report on "Euthanasia" that "the administration of a drug necessary to ease the pain of a patient who is terminally ill and suffering excruciating pain may be appropriate medical treatment even though the effect of the drug may shorten life."13 The Council maintains this position and further emphasizes that a patient possessing a decision making capacity must be the one who decides whether the relief of pain and suffering is worth the danger of hastening death. The principle of respect for patient autonomy and self-determination requires that patients decide about such treatment.The ethical distinction between this situation and euthanasia lies in the difference between administering a medically sound pain relief treatment which will likely shorten the patient's life and providing a treatment to cause death as the means by which relief of suffering is achieved. The distinction is subtle because in both cases the action that causes death is performed with the purpose of relieving suffering, but the distinction is ethically significant. Most medical treatments entail some undesirable side effects. In general it should be the decision of the patient with the help of his or her physician to decide to either risk the side effects or forgo the treatment. A patient competent to make this decision has the right to weigh the risk of hastening death against the potential for relief of pain and suffering.The concrete benefit of allowing physicians to provide palliative treatments is the relief of unrelenting and intolerable suffering. For many patients, relief may be worth even a great risk of death. An important concern is that patients who are not fully informed about their prognosis and options may make decisions that unnecessarily shorten their lives. In addition, severe pain might diminish the patient's capacity to decide whether to choose a treatment that risks death. Caution when determining decision-making capacity in this situation, therefore, must be exercised, and patients should be fully informed. EUTHANASIAEuthanasia is the medical administration of a lethal agent to a patient in order to relieve intolerable and untreatable suffering of the patient. The issue of whether or not a physician may use the skills orknowledge of medicine to cause an "easy" death in a patient who requests such assistance has been debated since the time of Hippocrates. Recently, euthanasia has been gaining support from the public and some in the medical profession. In the Netherlands, for example, since 1984 euthanasia by physicians is not prosecuted when a case falls within certain established criteria.23 These criteria include that (1) euthanasia is explicitly and repeatedly requested by the patient and there is no doubt that the patient wants to die; (2) the mental and physical suffering is severe with no prospect for relief; (3) the patient's decision is well informed, free and enduring; (4) all options for alternate care have been exhausted or refused by the patient and (5) the physician consults another physician.24 Though currently there are no official statistics on the frequency of euthanasia in the Netherlands, it has been estimated to range from 2,000 to 10,000 persons per year.23In the United States there has been growing public support for legalized euthanasia. The Hemlock Society, an organization dedicated to legalizing voluntary euthanasia and physician-assisted suicide, has doubled its membership in the past five years to approximately 33,000.25 Currently, an initiative in Washington state that would legalize euthanasia has gained 35,000 signatures over the 150,001 needed to put the initiative on the ballot this November.26 This apparent increase in support for euthanasia poses a difficult question for the medical profession. What is the physician's role in treating patients who are suffering intolerably and are not dependent on life-sustaining treatment?Though the principle of patient autonomy requires that patients who possess decision-making capacity be given the opportunity to choose among offered medical treatments and to forgo any treatment, it does not give patients the right to demand euthanasia. At issue is whether it is ever ethical for physicians to offer euthanasia in certain circumstances. On the other hand, there is an autonomy interest in directing one's death. But this interest does not override considerations of professional responsibility.In the United States there is currently little data regarding the number of euthanasia or assisted suicide requests, the concerns behind the requests, the types and degree of intolerable and unrelievable suffering, or the number of requests that have been granted by health care providers. Before euthanasia can ever be considered a legitimate medical treatment in the United States, the needs behind the demand for physician-provided euthanasia must be examined more thoroughly and addressed more effectively. A thorough examination would require a more open discussion of euthanasia and the needs of patients who are requesting it. The existence of patients who find their situations so unbearable that they request help from their physicians to die must be acknowledged, and the concerns of these patients must be a primary focus of medicine. Instead of condoning physician-provided euthanasia, medicine must first respond by striving to identify and address the concerns and needs of dying patients.There is evidence to suggest that most requests for euthanasia or assisted suicide would be eliminated if patients were guaranteed that their pain and suffering will be eased and their dignity and self-sufficiency promoted.27 The success of the hospice movement illustrates the extent to which aggressive pain control and close attention to patient comfort and dignity can ease the transition to death.28 Health care professionals have an ethical duty to provide optimal palliative care to dying patients. At the present, many physicians are not informed about the appropriate doses, the frequency of doses and alternate modalities of pain control for patients with severe chronic pain.28 In particular, addiction should not be a concern when providing analgesia to these patients. Physicians should inform the patient and the family that concentrated efforts will be a priority in the care of the patient, since fear of pain is "one of the most pervasive causes of anxiety among patients, families and the public."1There may be cases, however, where a patient's pain and suffering is not reduced to a tolerable level and the patient requests a physician to help him or her die.1,28 If a physician cannot ease the pain and suffering of a patient, by means short of death, using medical expertise to aid an "easy" death may seem to be the humane and appropriate treatment for the patient.。

安乐死是否构成犯罪，是否应该合法化这个问题越来越受到社会的关注。

国外已有很多国家承认安乐死合法化并加以立法完善，我国到目前为止发生的几起安乐死案例仍表明我国安乐死尚无法律规制。

我认为安乐死不构成刑法上的犯罪，为了适应社会的发展，我国应加快对安乐死合法化的立法步伐，但是应该对实施安乐死的条件加以严格限制。

Whether euthanasia should be legalized crime, this problem more and more attention of the society. Abroad already had a lot of national recognition of the legalization of euthanasia and to perfect legislation, our country so far occurred euthanasia case still showed no legal regulation of euthanasia in china. I think it does not constitute a criminal law on the crime, in order to adapt to social development, China should accelerate the pace of the legalization of euthanasia legislation to euthanasia, but should be strictly limited conditions.“安乐死”一词源自希腊文，由安逸和死两个词素构成。

其原意是“无痛地、仁慈地处死”，后来泛指“无痛地、安乐地死去”。

我国学者对安乐死的定义是：“患不治之症的病人在垂危状态下，由于精神和躯体的极端痛苦。

在病人和亲友的要求下，经过医生认可，用人道方法使病人在无痛苦状态中结束生命。

死的失去生命的英文单词英文回答：Death, the cessation of life, is a universal phenomenon that all living beings must face. It is the irreversible end of an organism's existence, marked by the absence of vital signs such as breathing, heartbeat, and brain activity.Death can occur naturally through a variety of causes, including aging, disease, injury, and accidents. It can also be induced intentionally through suicide, euthanasia, or capital punishment. Regardless of the cause, death is the ultimate fate of all living things.The concept of death has been explored throughout history and across cultures. In many cultures, death is viewed as a transition to an afterlife, while in others it is seen as the final end of existence. The way in which a culture views death can have a profound impact on itsattitudes towards life and mortality.For many individuals, the prospect of death can be a source of anxiety and fear. However, it is also possible to confront death with courage and acceptance. Byunderstanding the inevitability of death, we can learn to appreciate the preciousness of life and to live each day to the fullest.中文回答：死亡，生命的终止，是所有生物都必须面对的普遍现象。

Euthanasia is to kill people. Life is so important for every one. People don’t only live for themselves, but they also live for their families and the society. If they choose to leave the world, they are not responsible for themselves, their families and the society.Euthanasia is disparagement of life. Life is so precious. Patients should cherish their life. They should try their best to prevail incurable disease. Everyone should show basic respect for life. No matter what happens, we should face up to the facts, we should live on with great courage, we should believe in wonder. Nothing is impossible.Euthanasia stops the medicine developing. If the patients require using euthanasia, doctors won’t try their best to save patients. The medicine will stop progress. If making euthanasia is made legal, patients who use euthanasia will be protected by law. The doctors’ right will be obvious. Doctors are given too much power, and can be wrong or unethical. Patients put their faith and trust in the opinions of their doctor.people abuse euthanasia when it is legalized, it can harm people lives. In the name of euthanasia, carry out committing suicide. Miracle cures or recoveries can occur. You can never underestimate the power of the human spirit.It demeans the value of human life. In this country, human life means something.It could open the floodgates to non-critical patient suicides and other abuses. Any loosening of theassisted-suicide laws could eventually lead to abuses of the privilege.Many religions prohibit suicide and the intentional killing of others. The most basic commandment is "You shall not kill".Insurance companies may put undue pressure on doctors to avoid heroic measures or recommend the assisted-suicide procedure. Health insurance providers are under tremendous pressure to keep premiums down. Euthanasia can become a means of health care cost containment..Physicians and other medical care people should not be involved in directly causing death.Mercy killing is morally incorrect and should be forbidden by 's a homicide and murdering another human cannot be rationalized under any circumstances.Human life deserves exceptional security and protection. Advanced medical technology has made it possible to enhance human life span and quality of life. Palliative care and rehabilitation centers are better alternatives to help disabled or patients approaching death live a pain-free and better life.Family members influencing the patient's decision into euthanasia for personal gains like wealth inheritance is another issue. There is no way you can be really sure if the decision towards assisted suicide is voluntary or forced by others.Mercy killing would cause decline in medical care and cause victimization of the most vulnerable society. Would mercy killing transform itself from the "right to die" to "right to kill"How would one assess whether a disorder of mental nature qualifies mercy killing What if the pain threshold is below optimum and the patient perceives the circumstances to be not worthy of living How would one know whether the wish to die is the result of unbalanced thought process or a logical decision in mentally ill patients What if the individual chooses assisted suicide as an option and the family wouldn't agreeAs to face the parting, helplessness, loss of self-control, fear of death and sorrow and so the majority of patients will experience mental suffering. In this psychological requirement under the "Euthanasia", we can say that he is reasonable "According to the study of suicide, suicide and treatable mental illness is intrinsically related, but not the fatal disease, a study found that in 44 patients with advanced cancer, only three thought about suicide, but are there is a serious depression. Another study shows that 85 suicides, only one person suffering from terminal illness, and 90-100% of the suicides were suffering from obvious mental illness.Undeniably, the modern medical practice slow death process, often cited the loss of personal characteristics of patients Mei, dignity, independence and autonomy.However, the expression of active euthanasia as acts of personal autonomy, it is wrong. Reasons: (a) Since active euthanasia need help, then it is not an individual matter, but the open or in the public thing. (B) under the public recognition to self-defense, capital punishment and justice in the form of war, murder, only to defend the life for everyone, not to the benefit of those killed. So, even if death is painful relief, can not be lightly taken away the right to life committed to personal. (C) even if the person's self-determination recognized the right to choose to die, that does not mean the right to ask others to kill themselves, does not include the right to authorize self to kill others. (D) autonomy, including the right of slavery has never been their own, in other words, the right to freedom does not mean the right not to freedom.So to maintain the autonomy, the need to protect life, to give others their right to life is not trampling the principle of maintaining independence. Therefore, individual autonomy and social need and public objectives and values to be consistent.active euthanasia may gradually lose its spontaneity, and thus out of (i) "secret euthanasia", meaning that without their own consent, to be a doctor euthanized. (Ii) "forced euthanasia", meaning patients suffering from terminal illness would be coercion to lure choose euthanasia to relieve their families in the economic and psychological pressures, and save limited resources of society, the patients chose to die, do not feel life is a burden or tired of life, but he felt the burden of someone else, and that others dislike. (Iii) "Deputy euthanasia" means to allow patients who lack capacity to self-determination by the people "proxy decision" to euthanasia. (Iv) "Discrimination against euthanasia," the crisis is the number of types of patients such as the poverty stricken or belonging to ethnic minorities, may be "clever" to force that "euthanasia" requirement, the mercy of others. Made ill patients caught in the dilemma of both the opposition between the yield, resulting in additional unnecessary fear and anxiety. The information may be heard: "Death is terrible! Your best choice of euthanasia."of the slip waves, is once the "euthanasia" is legalized, its use will inevitably extend to other types of patients but not the dying, if not cure patients, but not incurable disease, then the risk of Alzheimer's disease or brain degradation, even those born with severe disabilities Down syndrome baby. . And so on. So, if this argument, once established, will only create panic and fear that they will be forcibly sent to "euthanasia" in the ranks. Therefore, I agree Frasen say, "human life, merely the possibility of error, is enough to completely reject the" euthanasia. " "。

A:Hello ！welcome to our discussion . I’m joined today by B and C.i’m soleil B:And I’m BC:I’m C.A:oh , Hello, C. do you know about Euthanasia ?B:Yes.that is people who are attacked by incurable disease can’t surffer fromthepains anddecidetoemploy a humaneway toendtheir lives withoutpain.C：do you think Euthanasia Should Be Legalized正方： We think it’s necessary. On one hand, we can save our limiting medical resources for those who need treatment thanany other people. Ontheother hand, we can keep patients from endless paint.我们认为这是有必要的。

一方面，我们可以节约有限的医疗资源给其他更需要的治疗的病人。

另一方面，我们可以解脱这些受着无尽的痛苦的病人。

补充观点：1.Euthanasia canrelease the stress of the society,if the patients can’tdoany contribution.如果那个病人无法做出任何贡献，那么安乐死可以减轻社会的负担。

2. Euthanasiacan free the patients who are under heavy paint. 安乐死可以解脱那些正承受着巨大痛苦的病人。

3. A person’s life belongs to himself, he has access to end his life. 一个人的生命属于他自己，他有权结束自己的生命。

Instructions1.Understand that opponents of euthanasia use arguments that center on the idea that life should be held as sacred and that no one has the right to take a life.2.Know one of the main arguments against euthanasia deals with how to manage pain. Proponents of assisted suicide site extreme pain as a viable reason for euthanasia. Opponents of euthanasia insist that pain management is the answer--not death. With the drugs offered today, pain can be controlled and virtually eliminated.3.Realize that euthanasia allows one person to have physical control over another person's life. Euthanasia gives doctors, family and friends the right to kill. Although suicide is not considered an illegal act, helping someone else to die is consider a crime.4.Understand that although someone shouldn't be forced to stay alive--drawing out the inevitable outcome of death with extreme measures--extraordinary steps shouldn't be taken to claim life either. Pain management and letting nature take its course are the ethical ways to act.5.Argue that the debate over euthanasia is a slippery slope. Where is the line drawn in regards to who should have the right to die? Who makes the criteria?6.Offer a religious perspective. God did not intend for the life He created to be taken by others. Understand that the religious perspective, whilevalid, might not be taken seriously by those who have no spiritual life.The word euthanasia comes from two Greek words, "eu" meaning good, and thanatos meaning death. Euthanasia cannot be a "private matter of self-determination and personal beliefs, because it is an act that requires two people to make it possible and a complicit society to make it acceptable". Euthanasia is equivalent of murder, and is against the law everywhere in civilized society, and medicine and law are the "principal institutions that maintain respect for human life in a secular pluralistic society." Euthanasia proponents just want to make death a purely technical issue, strip it of all its humanity, and allow us to control the time, place, and manner of our death to make it as cheap and efficient as possible. Life is meant to be lived and savored, instead of being forsaken, even if in a legal way.First, although it seems reasonable for those who can no longer bear the sufferance of pain from sickness, it would still be too hasty to let them adopt euthanasia. For example, if a patient chooses to abandon life three months before the predicted lethal date; and then just one month before the date, a way of curing the disease is found out by researchers, it will be completely useless to regret the patient’s choice; and what’s more, not only the patient’s family members, but also the doctor will feel remorseful for consenting to the patient’s euthanasia apply, however, invain.Second, once euthanasia is legalized, there is no guarantee that it will not be overused or even employed by evil spirit. It is no news that an ungrateful child maltreats his parent, who may or may not be in sober state. If euthanasia is legalized, a will could be forged to prove that the parent adopts euthanasia of his or her own accord. And the parent is simply murdered. The story sounds threatening, but is in no way unrealistic.Third, it is against the moral values of doctors to conduct euthanasia. It is agreed that a doctor’s holy responsibility is to save the dying and aid the wounded. If a doctor is allowed to apply euthanasia for patients, it would completely overthrow the conception of a doctor, and even endangers the moralities of medical world.诚然，生命不是为了死亡的终结而存在。

suicide英文作文英文：Suicide is a serious and sensitive topic that affects many people around the world. It is a complex issue with various underlying causes, such as mental illness, trauma, and social pressures. As someone who has experienced the impact of suicide in my own life, I understand the pain and confusion that comes with it.I remember when I found out that a close friend had taken their own life. It was a devastating blow, and I struggled to understand why they felt so hopeless. I was left with so many unanswered questions, and I wished I had known how to help them before it was too late. The experience made me realize the importance of being aware of the signs of someone in distress and reaching out to offer support.Suicide is often a result of feeling overwhelmed andalone, and it's crucial for individuals to know that they are not alone in their struggles. It's important to have open and honest conversations about mental health and to create a supportive environment where people feel comfortable seeking help. This could be as simple as checking in on a friend who seems withdrawn or offering a listening ear to someone who is going through a tough time.中文：自杀是一个严肃而敏感的话题，影响着世界各地的许多人。

中西方对死亡看法英语作文In the Western world, death is often seen as a natural part of life. It is accepted that everyone will eventually die, and this belief is reflected in the way death is discussed and dealt with. People in the West tend to have a more pragmatic and matter-of-fact attitude towards death.Death is often viewed as a taboo subject in many Asian cultures. It is considered impolite or even disrespectfulto talk about death openly. There is a belief that discussing death can bring bad luck or even hasten its arrival. As a result, death is often avoided as a topic of conversation, and people may feel uncomfortable or uneasy when confronted with the reality of mortality.In the West, death is often seen as a natural progression and a part of the cycle of life. It is viewedas the end of one's physical existence, but not necessarily the end of their impact on the world. Westerners may focus more on the legacy and contributions a person leaves behind,rather than dwelling on the loss and grief associated with death.In contrast, many Eastern cultures place a strong emphasis on the afterlife and the spiritual journey that follows death. There is a belief in reincarnation or an afterlife where the soul continues to exist in some form. Death is seen as a transition rather than an end, and there is often a focus on preparing for the journey to the next life.In the West, death is often seen as a personal and individual experience. There is a belief in personal autonomy and the right to make decisions about one's own end-of-life care. Concepts such as euthanasia and assisted suicide are often debated and discussed openly. Westerners may have more control over the circumstances of their death and may choose to die with dignity and on their own terms.In many Eastern cultures, the concept of death is often intertwined with family and community. There is a strong sense of duty and responsibility towards one's ancestorsand elders. Death is seen as a communal event, and there may be elaborate rituals and ceremonies to honor the deceased and ensure their smooth transition to the afterlife.Overall, the Western and Eastern perspectives on death differ in their attitudes, beliefs, and cultural practices. While the West tends to have a more pragmatic and individualistic approach, the East often emphasizes spirituality and community. These differences reflect the diverse ways in which different cultures understand and cope with the universal experience of death.。