1、Unit Five:To Lie or Not to Lie-The Doctors DilemmaTextIs it ever proper for a medical doctor to lie to his patient? Should he tell a patient he is dying? These questions seem simple enough, but it is not so simple to give a satisfactory answer to them. Now a new light is shed on them.TO LIE OR NOT T
2、OLIETHE DOCTORS DILEMMASissela BokShould doctors ever lie to benefit their patients - to speed recovery or to conceal the approach of death? In medicine as in law, government, and other lines of work, the requirements of honesty often seem dwarfed by greater needs: the need to shelter from brutal ne
3、ws or to uphold a promise of secrecy; to expose corruption or to promote the public interest.What should doctors say, for example, to a 46-year-old man coming in for a routine physical checkup just before going on vacation with his family who, though he feels in perfect health, is found to have a fo
4、rm of cancer that will cause him to die within six months? Is it best to tell him the truth? If he asks, should the doctors deny that he is ill, or minimize the gravity of the illness? Should they at least conceal the truth until after the family vacation?Doctors confront such choices often and urge
5、ntly. At times, they see important reasons to lie for the patients own sake; in their eyes, such lies differ sharply from self-serving ones.Studies show that most doctors sincerely believe that the seriously ill do not want to know the truth about their condition, and that informing them risks destr
6、oying their hope, so that they may recover more slowly, or deteriorate faster, perhaps even commit suicide. As one physician wrote: “Ours is a profession which traditionally has been guided by a precept that transcends the virtue of uttering the truth for truths sake, and that is as far as possible
7、do no harm.“Armed with such a precept, a number of doctors may slip into deceptive practices that they assume will “do no harm“ and may well help their patients. They may prescribe innumerable placebos, sound more encouraging than the facts warrant, and distort grave news, especially to the incurabl
8、y ill and the dying.But the illusory nature of the benefits such deception is meant to produce is now coming to be documented. Studies show that, contrary to the belief of many physicians, an overwhelming majority of patients do want to be told the truth, even about grave illness, and feel betrayed
9、when they learn that they have been misled. We are also learning that truthful information, humanely conveyed, helps patients cope with illness: helps them tolerate pain better, need less medicine, and even recover faster after surgery.Not only do lies not provide the “help“ hoped for by advocates o
10、f benevolent deception; they invade the autonomy of patients and render them unable to make informed choices concerning their own health, including the choice of whether to be patient in the first place. We are becoming increasingly aware of all that can befall patients in the course of their illnes
11、s when information is denied or distorted.Dying patients especially - who are easies to mislead and most often kept in the dark - can then not make decisions about the end of life: about whether or not they should enter a hospital, or have surgery; about where and with whom they should spend their r
12、emaining time; about how they should bring their affairs to a close and take leave.Lies also do harm to those who tell them: harm to their integrity and, in the long run, to their credibility. Lies hurt their colleagues as well. The suspicion of deceit undercuts the work of the many doctors who are
13、scrupulously hones with their patients; it contributes to the spiral of lawsuits and of “defensive medicine,“ and thus it injures, in turn, the entire medical profession.Sharp conflicts are now arising. Patients are learning to press for answers. Patients bills of rights require that they be informe
14、d about their condition and about alternatives for treatment. Many doctors go to great lengths to provide such information. Yet even in hospitals with the most eloquent bill of rights, believers in benevolent deception continue their age-old practices. Colleagues may disapprove but refrain from obje
15、cting. Nurses may bitterly resent having to take part, day after day, in deceiving patients, but feel powerless to take a stand.There is urgent need to debate this issue openly. Not only in medicine, but in other professions as well, practitioners may find themselves repeatedly in difficulty where s
16、erious consequences seem avoidable only through deception. Yet the public has every reason to be wary of professional deception, for such practices are peculiarly likely to become deeply rooted, to spread, and to erode trust. Neither in medicine, nor in law, government, or the social sciences can th
17、ere be comfort in the old saying, “What you dont know cant hurt you.“New Wordsdilemman. a situation in which one has to make a choice between two equally unsatisfactory things; a difficult choice 窘境，进退两难benefitvt. do good to 有益于recovery n. the process or fact of getting back to a former state of goo
18、d health; the state of recovering or being recoverd 痊愈；复得conceal vt. hide, keep from being seen or known 隐瞒linen. a business, profession, trade, etc. 行业dwarfvt. cause to appear small by comparison 使矮小，使相形见绌n. a person, animal, or plant of much less than the usual size 矮小；矮小的动（植）物sheltervi. take shel
19、ter; find protection 躲避vt. provide shelter for; protect 掩蔽；庇护brutala. cruel, severeupholdvt. support 支撑；维护secrecyn. the practice of keeping secrets; the state of being secretexposevt. disclose; leave uncovered or unprotected 揭露；暴露corruptionn. dishonesty; immoral behaviour 腐化，道德败坏promotevt. help to g
20、row or develop; raise in rank, condition, or importance 促进，推进；提升checkupn. a general medical examinationminimizevt. reduce to the smallest possible amount or degreegravityn. the quality of being serious critical 严重性confrontvt. meet face to face; oppose （勇敢地）面对；对抗urgently ad. in an urgent manner 紧急地，急
21、迫地urgent a.self-servinga. serving ones own interests; seeking advantage for oneself 利已的recover vi. get well; get back to a normal conditiondeterioratev. (cause to ) become worse （使）恶化suiciden. the act of killing oneselfphysician n. a doctor of medicine 内科医生traditionally ad. by tradition; in a tradit
22、ional mannerpreceptn. a rule of moral conduct; maxim 戒律；格言preceptvt. rise above or go beyond the limits of; surpass 超越virtuen. goodness or moral excellence; a good quality 美德；优点uttervt. speak; give outdeceptivea. deceiving or misleading; meant to deceive innumerablea. too many to be countedplacebon.
23、 substance given instead of real medicine to a patient for psychological effect 安慰剂warrant vt. justify; authorize; guarantee 使有（正当）理由；授权（给）；担保distortvt. give a false account of; twist out of the usual shape 歪曲；弄歪gravea. serious; requiring careful consideration 严重的；严肃的incurably ad. beyond cureillusor
24、ya. deceptive and unreal; based on an illusion 虚幻的deceptionn. deceiving or being deceived; a trick intended ot deceive 欺骗；诡计document vt. prove or support with documents 用文件证明contrarya. completely different or wholly opposed 相反的；对抗的overwhelminga. too many, too great, or too much to be resisted 势不可挡的；
25、压倒之势的betray vt. be unfaithful to; deceive 背叛truthfula. truehumanely ad. tenderly, kind-heartedly 仁爱地；人道地toleratevt. allow or endure with protest 容忍advocaten. person who speaks for an idea, way of life, etc. 拥护者，倡导者benevolenta. intending or showing good will, kindly, friendly 仁慈的invade vt. enter (a c
26、ountry) with armed forces in order to attack; violate, interfere with 侵犯autonomyn. (the right of) self-government; freedom to determine ones own actions, behavior, etc. 自治（权）；自主rendervt. cause to beinformeda. having knowledge or information; having and using suitable knowledge 了解情况的；有见识的concerningpr
27、ep. about, with regard to increasinglyad. more and more all timebefall( befell, befallen)vt. (use. sth. bad ) happen to (sb.) 降临到头上integrityn. honesty or sincerity; wholeness 诚实，正直；完整credibilityn. the quality of being believable; trustworthiness 可靠性；可信colleaguen. an associate; fellow worker or membe
28、r of a profession or organization 同事suspicionn. doubt; mistrust 怀疑deceitn. deception; a dishonest trick 欺骗undercutvt. undermine; weaken 暗中破坏；削弱scrupulouslyad. carefully; conscientiously 一丝不苟地spiral n. a curved shape which winds round; a continuous and expanding increase or decrease 螺旋（形）；盘旋上升（或下降）la
29、wsuitn. a noncriminal case in a court of law 诉讼（案件）injurevt. cause physical harm to; damagearise (arose)vi. move or go upward; come into existence 上升；出现billn. 法案；议案；账单alternativen. a choice between two or more things; any of the things to be chosen 抉择；可供选择的东西treatmentn. a substance or method used in
30、 treating someone medically 治疗；疗法eloquenta. having the power of expressing ones feeling or thoughts with grace and force 雄辩的disapprovevt. consider not good or not suitable; have or express an opinion against 不赞成refrainvi. hold oneself back; keep oneself (from doing sth.) 忍住；戒除objectvi. be against st
31、h. or sb. 反对objection n.bitterly ad. sharply severelydeceivevt. cause (sb.) to believe sth. that is false 欺骗debatevt. argue about (sth.) in an effort to persuade other people 辨论issuen. a question that arises for discussion 问题；争端practitionern. a professional man, esp. in medicine or in law 开业者（尤指医生、律
32、师等）consequencen. result; importance 后果；重要性avoidable a. that can be prevented from happeningwarya. cautious; in the habit of looking out for possible danger or trouble 谨慎的；谨防的erodevt. wear away; eat into 腐蚀saying n. a well-known wise statement; proverb 格言；谚语Phrases now and then 间或；有时in ones eyesin on
33、es opinion for ones (own) sakefor ones own benefit 为了某人自己的利益slip into fall into; enter (esp. through carelessness) 陷入contrary to opposite to; despitein the first placefirstlyin the course of duringduringin the darkuninformed; ignorant 不知情，蒙在鼓里bring to a closeend 结束，终止take leave (of)say goodbye (to)i
34、n the long run in the end; ultimately 从长远的观点看；最终go to great lengthsdo anything possible, however dangerous, unpleasant, wicked, etc. 不遗余力refrain from not do , stopday after dayeach daytake a/ ones standdeclare ones position, loyalty, opinions, etc., and be prepared to fight (for these opinions, etc.)表明立场、意见等
