We discuss the issue of when to help a patient die. Doctors of our generation are not newcomers to this question. Going back to my internship(实习)days, I can remember many patients in pain, sometimes in coma(昏迷), with late, hopeless cancer. For many of them, we wrote an order for heavy medication—morphine(吗啡)by the clock. This was not talked about openly and little was written about it. It was essential, not controversial.
The best way to bring the problem into focus is to describe two patients whom I cared for. The first, formerly a nurse, had an automobile accident. A few days later her lungs seemed to fill up; her heart developed dangerous rhythm disturbances. So there she was: in coma, on a breathing machine, her heartbeat maintained with an electrical device. One day after rounds, my secretary said the husband and son of the patient wanted to see me. They told me their wife and mother was obviously going to die; she was a nurse and had told her family that she never wanted this kind of terrible death, being maintained by machines. I told them that while I respected their view, there was nothing deadly about her situation. The kidney(肾) failure she had was just the kind for which the artificial kidney was most effective. While possibly a bit reassured, they were disappointed. Here was the head surgeon seemingly determined to keep everybody alive, no matter what.
Within a few days the patient's pacemaker(起搏器) could be removed and she awoke from her coma. About six months later, the door of my office opened and in walked a gloriously fit woman. After some cheery words of appreciation, the father and son asked to speak to me alone. As soon as the door closed, both men became quite tearful. All that came out was, “We want you to know how wrong we were.”
The second patient was an 85-year-old lady whose hair caught fire while she was smoking. She arrived with a deep burn; I knew it would surely be deadly. As a remarkable coincidence there was a meeting for discussion going on at the time in medical ethics(道德). The speaker asked me if I had any sort of ethical problem I could bring up for discussion. I described the case and asked the students their opinion. After the discussion, I made a remark that was, when looking back, a serious mistake. I said, "I'll take the word back to the nurses about her and we will talk about it some more before we decide." The instructor and the students were shocked: "You mean this is a real patient?" The teacher of ethics was not accustomed to being challenged by actuality. In any event, I went back and met with the nurses. A day or two later, when she was making no progress and was suffering terribly, we began to back off treatment. Soon she died quietly and not in pain. As a reasonable physician, you had better move ahead and do what you would want done for you. And don't discuss it with the world first. There is a lesson here for everybody. Assisting people to leave this life requires strong judgment and long experience to avoid its misuse.The first patient’s husband and son wanted the doctor_____.
| A．to save her life |
| B．to end her life |
| C．use an artificial kidney |
| D．to maintain her life with machines |
In the early days when a patient had got a deadly, hopeless illness, _______.
| A．doctors would inject more morphine into the patient to end his life |
| B．doctors would turn him away and ask him to go back home and wait for death |
| C．doctors would write a new order for their medical treatment to ease their pain |
| D．doctors would discuss their treatment plan with the patient and write down the solution |
At the meeting, the author discussed with the students_____.
| A．the importance of mercy killing |
| B．the relationship between mercy killing and ethics |
| C．the case about an old lady |
| D．the process to practice mercy killing |
The author suggested that doctors_____ before they assist a patient in killing himself.
| A．do what they are wanted to do |
| B．discuss with the others about the decision first |
| C．be required to do so first by the patient |
| D．make sure there is no other choice left |
Through the two patients mentioned in the text, the author thinks that on the issue of helping a patient die, doctors need to be _________.
| A．cruel and cautious |
| B．experienced and thoughtful |
| C．pessimistic and determined |
| D．considerate and optimistic |
Low-Cost Gifts for Mother's Day
Gift No. 1
Offer to be your mother's health friend. Promise to be there for any and all doctor's visits whether a disease or a regular medical check-up. Most mothers always say “no need，” but another set of eyes and ears is always a good idea at a doctor's visit. The best part? This one is free.
Gift No. 2
Help your mother organize all of her medical records, which include the test results and medical information. Put them all in one place. Be sure to make a list of all of her medicines and what times she takes them.“Having all this information in one place could end up saving your mother's life，”Dr Marie Savard said.
Gift No. 3
Enough sleep is connected to general health conditions. “Buy your mother cotton sheets and comfortable pillows to encourage better sleep，” Savard said. “We know that good sleep is very important to our health.”
Gift No. 4
Some gift companies such as Presents for Purpose allow you to pay it forward this Mother's Day by picking gifts in which 10 percent of the price you pay goes to a charity. Gift givers can choose from a wide variety of useful but inexpensive things—many of which are “green”—and then choose a meaningful charity from a list. When your mother gets the gift, she will be told that she has helped the chosen charity.What are you advised to do for your mother at doctor's visits?
| A．Take notes. | B．Be with her. |
| C．Buy medicine. | D．Give her gifts. |
What can be a gift of organization for your mother?
| A．Keeping her medical information together. |
| B．Buying all gifts for her from one company. |
| C．Making a list of her medical check-ups. |
| D．Storing her medicines in a safe place. |
Buying gifts from Presents for Purpose allows mothers to________．
| A．enjoy good sleep | B．be well-organized |
| C．get extra support | D．give others help |
I'm seventeen. I had worked as a box boy at a supermarket in Los Angeles. People came to the counter and you put things in their bags for them and carried things to their cars. It was hard work.
While working, you wear a plate with your name on it. I once met someone I knew years ago. I remembered his name and said, "Mr Castle, how are you?" We talked about this and that. As he left, he said, "It was nice talking to you, Brett." I felt great, he remembered me. Then I looked down at my name plate. Oh, no. He didn't remember me at all, he just read the name plate. I wish I had put "Irving" down on my name plate. If he'd have said, "Oh yes, Irving, how could I forget you?" I'd have been ready for him. There's nothing personal here.
The manager and everyone else who were a step above the box boys often shouted orders. One of these was: you couldn't accept tips. Okay, I'm outside and I put the bags in the car. For a lot of people, the natural reaction is to take a quarter and give it to me. I'd say, "I'm sorry, I can't." They'd get angry. When you give someone a tip, you're sort of being polite. You take a quarter and you put it in their hand and you expect them to say, "Oh, thanks a lot." When you say, "I'm sorry, I can't." They feel a little put down. They say, "No one will know." And they put it in your pocket. You say, "I really can't." It gets to a point where you almost have to hurt a person physically to prevent him from tipping you. It was not in agreement with the store's belief in being friendly. Accepting tips was a friendlything and made the customer feel good. I just couldn't understand the strangeness of some people's ideas.
One lady actually put it in my pocket, got in the car, and drove away. I would have had to throw the quarter at her or eaten it or something.
I had decided that one year was enough. Some people needed the job to stay alive and fed. I guess I had the means and could afford to hate it and give it up.What can be the best title for this text?
| A．How Hard Life Is for Box Boys | B．Getting along with Customers |
| C．Why I Gave up My Job | D．The Art of Taking Tips |
From the second paragraph, we can infer that ________.
| A．the writer didn't like the impersonal part of his job |
| B．with a name plate, people can easily start talking |
| C．Mr Castle mistook Irving for Brett |
| D．Irving was the writer's real name |
The box boy refused to accept tips because ________.
| A．customers only gave small tips |
| B．some customers had strange ideas about tipping |
| C．the store didn't allow the box boys to take tips |
| D．he didn't want to fight with the customers |
The underlined phrase "put down" in the third paragraph probably means_______.
| A．misunderstood | B．defeated |
| C．hateful | D．hurt |
Most Americans would have a difficult time telling you, specifically, what are the values which Americans live by. They have never given the matter any thought.
Over the years I have introduced thousands of international visitors to life in the United States. This has caused me to try to look at Americans through the eyes of foreign visitors. I am confident that the values listed in this booklet describe most ( but not all) Americans, and that understanding these values can help you, the international visitor, understand Americans.
It is my belief that if foreign visitors really understand how deeply these 13 values are ingrained in Americans, they will then be able to understand 95% of American actions-actions which might otherwise appear "strange", "confusing", or "unbelievable" when evaluated from the perspective of the foreigner's own society and its values.
The different behaviors of a people or a culture make sense only when seen through the basic beliefs, assumptions and values of that particular group. When you encounter ( meet) an action, or hear a statement in the United States which surprises you, try to see it as an expression of one or more of the values listed in this booklet.An ordinary American can't tell you his/her value system because _____.
| A．this is something an American lives by |
| B．everyone will have his/her own value system |
| C．he/she has never thought about it |
| D．values are something often in their thought |
The author lists 13 values in his booklet to _____.
| A．invite foreigners to visit America |
| B．look at Americans through the eyes of foreign visitors |
| C．describe the confusing actions of most Americans |
| D．help international visitors understand Americans |
The underlined word "ingrained" in Line 2, Paragraph 3 most probably means _____.
| A．rooted in the minds | B．found in the grains |
| C．planted for food | D．prepared with grain |
Visitors sometimes find Americans behave in a strange, confusing or unbelievableway, probably because _____.
| A．Americans are hard to understand |
| B．Americans have values which are entirely different from their own |
| C．they view Americans according to the values in their own society |
| D．it is difficult to understand any people when you first encounter them |
We are not who we think we are.
The American self-image is spread with the golden glow of opportunity. We think of the United States as a land of unlimited possibility, not so much a classless society but as a place where class is mutable—a place where brains, energy and ambition are what counts, not the circumstances of one's birth.
The Economic Mobility Project, an ambitious research led by Pew Charitable Trusts, looked at the economic fortunes of a large group of families over time, comparing the income of parents in the late 1960s with the income of their children in the late 1990s and early 2000s. Here is the finding: "The 'rags to riches' story is much more common in Hollywood than on Main Street. Only 6 percent of children born to parents with family income at the very bottom move to the top.
That is right, just 6 percent of children born to parents who ranked in the bottom of the study sample, in terms of income, were able to bootstrap their way into the top. Meanwhile, an incredible 42 percent of children born into that lowest are still stuck at the bottom, having been unable to climb a single rung of the income ladder.
It is noted that even in Britain---a nation we think of as burdened with a hidebound class system-children who are born poor have a better chance of moving up. When the studies were released, most reporters focused on the finding that African-Americans born to middle-class or upper middle-class families are earning slightly less, in inflation-adjusted dollars, than did their parents.
One of the studies indicates, in fact, that most of the financial gains white families have made in the past three decades can be attributed to the entry of white women into the labor force. This is much less true for African-Americans.
The picture that emerges from all the quintiles, correlations and percentages is of a nation in which, overall, "the current generation of adults is better off than the previous one", as one of the studies notes.
The median income of the families in the sample group was $55,600 in the late 1960s; their children's median family income was measured at $71,900. However, this rising tide has not lifted all boats equally. The rich have seen far greater income gains than have the poor.
Even more troubling is that our nation of America as the land of opportunity gets little support from the data. Americans move fairly easily up and down the middle rungs of the ladder, but there is "stickiness at the ends" —four out of ten children who are born poor will remain poor, and four out of ten who are born rich will stay rich.What did the Economic Mobility Project find in its research?
| A．Children from low-income families are unable to bootstrap their way to the top. |
| B．Hollywood actors and actresses are upwardly mobile from rags to riches. |
| C．The rags to riches story is more fiction than reality. |
| D．The rags to riches story is only true for a small minority of whites. |
It can be inferred from the undertone of the writer that America, as a classless society, should ________.
| A．perfect its self-image as a land of opportunity |
| B．have a higher level of upward mobility than Britain |
| C．enable African-Americans to have exclusive access to well-paid employment |
| D．encourage the current generation to work as hard as the previous generation |
Which of the following statements is TRUE according to the passage?
| A．The US is a land where brains, energy and ambition are what counts. |
| B．Inequality persists between whites and blacks in financial gains. |
| C．Middle-class families earn slightly less with inflation considered. |
| D．Children in lowest-income families manage to climb a single rung of the ladder. |
What might be the best title for this passage?
| A．Social Upward Mobility. |
| B．Incredible Income Gains. |
| C．Inequality in Wealth. |
| D．America Not Land of Opportunity. |
By far the most common difficulty in study is simple failure to get down to regular concentrated work. This difficulty is much greater for those who do not work to a plan and have no regular routine of study. Many students muddle along, doing a bit of this subject or that, as the mood takes them, or letting their set work pile up until the last possible moment.
Few students work to a set timetable. They say that if they did work out a timetable for themselves they would not keep to it, or would have to change it frequently, since they can never predict from one day to the next what their activities will be.
No doubt some students take much more kindly to a regular routine than others. There are many who shy away from a self-controlled weekly timetable, and dislike being tied down to a fixed program of work. Many able students state that they work in cycles. When they become interested in a topic they work on it attentively for three or four days at a time. On other days they avoid work completely. It has to be admitted that we do not fully understand the motivation to work. Most people over 25 years of age have become used to a work routine, and the majority of really productive workers set aside regular hours for the more important areas of their work. The “tough-minded” school of workers doesn’t fully accept the idea that good work can only be done naturally, under the influence of inspiration.
Those who believe that they need only work and study as the fit takes them have a mistaken belief either in their own talent or in the value of “freedom”. Freedom from control and discipline leads to unhappiness rather than to “self-expression” or “personality development”. Our society insists on regular habits, timekeeping and punctuality (being on time), and whether we like it or not, if we mean to make our way in society, we have to meet its demands.The most widespread problem in applying oneself to study is __________ .
| A．changing from one subject to another |
| B．the failure to keep to a set timetable of work |
| C．the unwillingness to work out a systematic plan |
| D．working on a subject only when one feels like it |
Which of the following is TRUE?
| A．Many students are not interested in using a self-controlled timetable. |
| B．Many students don’t like being told to study to a fixed timetable. |
| C．Most people over 25 years of age don’t work to a set timetable. |
| D．Tough-minded people agree that good work is done naturally. |
The underlined part “as the fit takes them” means __________.
| A．when they have the energy |
| B．when they are in the mood |
| C．when they feel fit |
| D．when they find conditions suitable |
A suitable title for the passage might be __________.
| A．Attitudes to Study |
| B．A Study Plan |
| C．The Difficulties of Studying |
| D．Study and Self-discipline |