2018年12月10日 09:46:52|来源:国际在线|编辑:健互动
B. Youre about to hear an interview from National Public Radio Saturday morning program, Weekend Edition.NPR host Liane Hansen asks two doctors several questions during the discussion.Listen carefully and fill in the charts with the key words on each doctor general response to the interviewer questions.Trust was a word that was used early and often during the campaign, and when it comes to the politicians, people really must think about whether they can trust their representatives to represent them.But when it comes to the relationship between a patient and doctor, the word trust should be a given. Doctors are, after all, supposed to do what best us and this involves telling the truth.However, on occasion, a doctor must choose between being truthful and acting in the patient best interest.We asked our medical commentators, Dr Michael Wilkes and Miriam Shuchman to join us with their opinions on this subject. Good morning to both of you.Good morning, Liane. Miriam, when might a doctor choose not to tell a patient the truth?Well, Liane, there are actually several situations when a doctor might be tempted to deceive a patient.It used to be that if a patient was diagnosed with a serious m of cancer, the doctor wouldnt even tell them. That wouldnt happen anymore...But the doctor might be tempted to paint a more optimistic picture than is really the case, so if this was a cancer where the patient has three to six months to live, the doctor might not tell them that.They might just tell them that it very serious.My worry, though, is that doctors might also paint a more rosy picture in order to convince a patient to undergo a more aggressive treatment, say, say chemotherapy, a treatment that they might not under or choose to undergo if they had more inmation.To, to me, uh, there really is no distinction between withholding inmation from a person and outright lying.In both cases, the doctor is being paternalistic. He deciding what inmation the patient needs to know.I think that as doctors, though, were always in the postion of deciding what inmation to give a patient.We dont want to overburden them with too many details that could just be frightening and not useful.But we want them to have the inmation that really important making decisions.Yeah, but can you ever really know what a patient thinks is important?Every piece of inmation that a doctor gives a patient is filtered through a doctor filter, a filter that includes cultural bias, religious bias, economic bias, and their own personal values.And there some very compelling data that sick people really want much more inmation about the condition than theyre currently being told.Michael, have you ever been tempted to be less than perfectly honest with a patient?Absolutely. There always that temptation, Liane.Telling the truth in medicine is one of the most difficult things to do.The...uh...there is an issue that came up recently when another physician suggested that I prescribe a placebo, or a sugar pill that had no biological effects a patient.A 70-year-old man had just moved to town and he came to see me to get a refill of prescription a sleeping pill that hed been given a long time.In fact, it turned out hed been taking the pill every night since his wife died several years ago.As I spoke with him, it became clear to me that he recognized that he was addicted to the sleeping medicine.In fact, he said he wanted to stop, but every time he tried to stop taking the medicine, he couldnt sleep and ended up taking the sleeping pill.Now, a doctor at the hospital suggested that I use a placebo.He said that hed had great luck using this type of placebo exactly these types of addictions.The problem was that there was no way that I could use the placebo without deceiving the patient.So the issue here me was whether doctors are justified in telling this sort of little white lies in order to benefit the patients.Miriam, as an ethics specialist, what do you say? What does medical ethics tell us is right in the situation?Well, I think the conflict the doctor here is that he really seeing two duties.One is not to lie to a patient, and the other is, uh, to always do what beneficial the patient, not to do the harm.So in this case, the doctor who suggested the placebo may think that it most beneficial to prescribe placebo.It wont have any side effects, uh, and the little white lie he thinks is not as important.So should people be concerned that, uh, when they go to their doctor, that the doctor might be prescribing a placebo?Absolutely not. First, the use of placebos in clinical practice is very rare.Theyre mostly used in research where people are told theyre going to be receiving a placebo.And second, there are doctrines and policies around this.It called inmed consent, and what it means is that bee a patient can agree to a given treatment or procedure, the doctor is obliged to inm them about the risks and benefits about of that treatment, and most doctors are aware of that.You know, it probably worth mentioning here that experts feel that about 30% of medicines that we currently prescribe really have no biologic activity.They work through the power of suggestions.Um, cough medicine are a great example of this sort of drug.Now, that doesnt mean that cough medicines dont work.What I am trying to suggest is that they work through an effect on the mind rather than on the body, say, on the diaphragm or in the lung tissue or muscles themselves.Anyway, I feel there are still far two many times when doctors really arent being truthful with patients because they feel that they know what best the patient.We talked about placebos, but what about lying?How often do doctors lie to their patients?Liane, I cant give you a statistics on that but I dont think it happens very often. Doctors dont intentionally mislead their patients.But what does happen is that patients arent given the inmation they really need to make decisions.Doctors dont give them the chance to ask the questions that would get them that inmation.Michael, what happened to the man that was hooked on the sleeping pill?Liane, we talked about it a long time at the hospital.The bottom line was I, uh, I chose not to use a placebo.The downside of that decision is that the man is still addicted to the medicine although Im slowly weaning him off by using some behavior modification techniques.Weekend Edition medical commentators Dr Michael Wilkes and Dr Miriam Shuchman. 5536

Shakespeare: Soul of the Age莎士比亚:时代的灵魂Shakespeare was born on the 3rd of April 6, at Stratd-upon-Avon, a little town in the heart of England. He was the eldest son of the family and educated at the local grammar school, but his father’s business went from bad to worse, he had to leave school and begin to earn his living.6年月3日,莎士比亚出生于英格兰中部的小镇斯特拉斯特福德他是家中的长子,就读于当地的文法学校,后来父亲的生意每况愈下,他被迫辍学,自己赚钱谋生When eighteen, he was a married man to a local girl. At the age of twenty-one, he set off to seek his tune in the great city of London. There, he was in turn a horse-keeper, a stage-boy, a play mender and finally a playwright.Afterwards Shakespeare joined as an actor one or several companies of players. By 8 he became as a rising playwright in London, and became soon a central figure in London’s leading theater company. During that time he wrote many great plays the group. He was known in his day as very rapid writer: “His mind and hand went together,” his publisher reported, “and what he thought, he uttered with that easiness that we have scarce received from him a blot in his papers.”18岁时,他与当地一个女孩结婚1岁,他离家前往大城市伦敦闯荡在伦敦,他当过马夫,干过杂役,改过剧本,最终他专职从事剧本创作随后,他曾加入多家公司,当过演员到了8年,他在伦敦崭露头角,作为剧作家而开始走红,不久便成为伦敦头号剧团的核心人物那段时间里,他为剧团写了很多了不起的剧本当时,他以思路敏捷见长,他的出版商这样评价他:“他所构思的东西,马上就能跃然纸上,他一有灵感,便脱口而出,他的剧本里找不到一丝涂改的痕迹”Shakespeare was also a great humanist. His interest in the life and people of his time made him watch with an observant eye the scenery of his native country, men and women in all walks of life, their appearances, habits and speech. He was familiar with the traditions of English folklore and showed deep concern his people and his country’s destiny.莎士比亚也是伟大的人文主义者怀着对生活、对世人的兴趣,他用善于观察的眼睛,捕捉故乡风物,观察各行各业的男男女女,观察他们的相貌衣饰、生活习俗和谈吐习惯他对英国的民间传统耳熟能详,对国家和人民的命运也表现出深切的关怀His plays show us basic human flaws played out to their tragic conclusion. But Shakespeare doesn’t judge these faults. He doesn’t preach: he simply tells the story and we our own minds up. That is why they can be so effective because we as an audience draw our own conclusions. Recently, some people have even suggested that because of this, Shakespeare helped shape society.他的戏剧以悲伤的结局向我们展示了人类最根本的缺陷但他没有对这些缺陷进行评判,他不是坐而论道,而只是向我们娓娓道来一个个故事,让我们自己去判断这也是他的戏剧为何感人至深的原因,因为我们观众可以得出自己的结论最近有些人认为,基于这一点,莎士比亚有助于构建社会What’s more, Shakespeare’s contribution went beyond writing some good plays and dramas. He also introduced several hundred works to the English language including: aerial, assassination, countless, hurry, disgraceful and sportive. Besides, he coined phrases and expressions we still use to this day, such as “fair play”,“a egone conclusion” and “to wear your heart on your sleeve”.此外,莎士比亚的贡献,不仅仅是写出了一些好的剧本,他还将数以百计的单词引入了英语,例如:aerial (空气中的),assassination (暗杀),countless, hurry, disgraceful, sportive等等他还创造了许多词组和语, 如 “fair play”、“egone conclusion (预料中的结局)”、 “to wear your heart on your sleeve (十分坦率)”等,它们一直沿用到今天All these came from an ordinary man. He didn’t come from a rich background, and he didn’t go to the best schools. He was from the midlands, went to a good school, but in those days if you were to be taken seriously, as a writer you normally had to go to university. The fact that William Shakespeare’s influence extends from theatre to literature to the English language itself justifies of his famous es: “Be not afraid of greatness: some men are bom great, some are achieve greatness and some have greatness thrust upon them.”所有这一切都源于一个普通人,他没有出生在富裕的家庭,没有去最好的学校读书,他生于英格兰中部, 在一所不错的学校读过中学,但那个时候你要想成为真正的作家,一般都得去读大学莎士比亚的个人影响从戏剧扩展到文学,再渗透到英语这门语言,这本身就印了他那句名言:“不必怵头伟大这个字眼:有的人生就伟大,有的人成就伟大,有的人不得不伟大” 3731

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