大学英语精读第四册 Unit Five:To Lie or Not to Lie--The Docto
时间：2018-12-04 作者：英语课 分类：大学英语精读第四册
Text
Is 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 TOLIE—
THE DOCTOR'S DILEMMA
Sissela Bok
Should doctors ever lie to benefit their patients -- to speed recovery or to conceal 1 the approach of death? In medicine as in law, government, and other lines of work, the requirements of honesty often seem dwarfed 2 by greater needs: the need to shelter from brutal 3 news or to uphold a promise of secrecy 4; to expose corruption 5 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 form 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 urgently. At times, they see important reasons to lie for the patient's 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 destroying their hope, so that they may recover more slowly, or deteriorate 6 faster, perhaps even commit suicide. As one physician wrote: "Ours is a profession which traditionally has been guided by a precept 7 that transcends 8 the virtue 9 of uttering the truth for truth's sake, and that is 'as far as possible do no harm.'"
Armed with such a precept, a number of doctors may slip into deceptive 10 practices that they assume will "do no harm" and may well help their patients. They may prescribe innumerable placebos 11, sound more encouraging than the facts warrant, and distort grave news, especially to the incurably 12 ill and the dying.
But the illusory nature of the benefits such deception 13 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 when they learn that they have been misled. We are also learning that truthful 14 information, humanely 15 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 of benevolent 16 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 illness 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 remaining 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 scrupulously 17 hones with their patients; it contributes to the spiral of lawsuits 18 and of "defensive 19 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 informed 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 20 bill of rights, believers in benevolent deception continue their age-old practices. Colleagues may disapprove 21 but refrain from objecting. 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 22 may find themselves repeatedly in difficulty where serious consequences seem avoidable only through deception. Yet the public has every reason to be wary 23 of professional deception, for such practices are peculiarly likely to become deeply rooted, to spread, and to erode 24 trust. Neither in medicine, nor in law, government, or the social sciences can there be comfort in the old saying, "What you don't know can't hurt you."
New Words
dilemma
n. a situation in which one has to make a choice between two equally unsatisfactory things; a difficult choice 窘境，进退两难
benefit
vt. do good to 有益于
recovery
n. the process or fact of getting back to a former state of good health; the state of recovering or being recoverd 痊愈；复得
conceal
vt. hide, keep from being seen or known 隐瞒
line
n. a business, profession, trade, etc. 行业
dwarf
vt. 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
shelter
vi. take shelter; find protection 躲避
vt. provide shelter for; protect 掩蔽；庇护
brutal
a. cruel, severe
uphold
vt. support 支撑；维护
secrecy
n. the practice of keeping secrets; the state of being secret
expose
vt. disclose; leave uncovered or unprotected 揭露；暴露
corruption
n. dishonesty; immoral 26 behaviour 腐化，道德败坏
promote
vt. help to grow or develop; raise in rank, condition, or importance 促进，推进；提升
checkup
n. a general medical examination
minimize
vt. reduce to the smallest possible amount or degree
gravity
n. the quality of being serious critical 严重性
confront
vt. meet face to face; oppose （勇敢地）面对；对抗
urgently
ad. in an urgent manner 紧急地，急迫地
urgent a.
self-serving
a. serving one's own interests; seeking advantage for oneself 利已的
recover
vi. get well; get back to a normal condition
deteriorate
v. (cause to ) become worse （使）恶化
suicide
n. the act of killing 27 oneself
physician
n. a doctor of medicine 内科医生
traditionally
ad. by tradition; in a traditional manner
precept
n. a rule of moral conduct; maxim 28 戒律；格言
precept
vt. rise above or go beyond the limits of; surpass 超越
virtue
n. goodness or moral excellence 29; a good quality 美德；优点
utter
vt. speak; give out
deceptive
a. deceiving or misleading; meant to deceive
innumerable
a. too many to be counted
placebo
n. substance given instead of real medicine to a patient for psychological effect 安慰剂
warrant
vt. justify 30; authorize 31; guarantee 使有（正当）理由；授权（给）；担保
distort
vt. give a false account of; twist out of the usual shape 歪曲；弄歪
grave
a. serious; requiring careful consideration 严重的；严肃的
incurably
ad. beyond cure
illusory
a. deceptive and unreal; based on an illusion 虚幻的
deception
n. 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
contrary
a. completely different or wholly opposed 相反的；对抗的
overwhelming
a. too many, too great, or too much to be resisted 势不可挡的；压倒之势的
betray
vt. be unfaithful to; deceive 背叛
truthful
a. true
humanely
ad. tenderly, kind-heartedly 仁爱地；人道地
tolerate
vt. allow or endure with protest 容忍
advocate
n. person who speaks for an idea, way of life, etc. 拥护者，倡导者
benevolent
a. intending or showing good will, kindly 32, friendly 仁慈的
invade
vt. enter (a country) with armed forces in order to attack; violate, interfere 33 with 侵犯
autonomy
n. (the right of) self-government; freedom to determine one's own actions, behavior, etc. 自治（权）；自主
render
vt. cause to be
informed
a. having knowledge or information; having and using suitable knowledge 了解情况的；有见识的
concerning
prep. about, with regard to
increasingly
ad. more and more all time
befall( befell, befallen)
vt. (use. sth. bad ) happen to (sb.) 降临到……头上
integrity
n. honesty or sincerity 34; wholeness 诚实，正直；完整
credibility
n. the quality of being believable; trustworthiness 可靠性；可信
colleague
n. an associate; fellow worker or member of a profession or organization 同事
suspicion
n. doubt; mistrust 怀疑
deceit
n. deception; a dishonest trick 欺骗
undercut
vt. undermine; weaken 暗中破坏；削弱
scrupulously
ad. carefully; conscientiously 35 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）
lawsuit
n. a noncriminal case in a court of law 诉讼（案件）
injure
vt. cause physical harm to; damage
arise (arose)
vi. move or go upward; come into existence 上升；出现
bill
n. 法案；议案；账单
alternative
n. a choice between two or more things; any of the things to be chosen 抉择；可供选择的东西
treatment
n. a substance or method used in treating someone medically 治疗；疗法
eloquent
a. having the power of expressing one's feeling or thoughts with grace and force 雄辩的
disapprove
vt. consider not good or not suitable; have or express an opinion against 不赞成
refrain
vi. hold oneself back; keep oneself (from doing sth.) 忍住；戒除
object
vi. be against sth. or sb. 反对
objection n.
bitterly
ad. sharply severely 36
deceive
vt. cause (sb.) to believe sth. that is false 欺骗
debate
vt. argue about (sth.) in an effort to persuade other people 辨论
issue
n. a question that arises for discussion 问题；争端
practitioner
n. a professional man, esp. in medicine or in law 开业者（尤指医生、律师等）
consequence
n. result; importance 后果；重要性
avoidable
a. that can be prevented from happening
wary
a. cautious; in the habit of looking out for possible danger or trouble 谨慎的；谨防的
erode
vt. wear away; eat into 腐蚀
saying
n. a well-known wise statement; proverb 格言；谚语
Phrases & Expressions
go on (a trip, vacation)
depart for the purpose of
at times
occasionally; now and then 间或；有时
in one's eyes
in one's opinion
for one's (own) sake
for one's 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; despite
in the first place
firstly
in the course of during
during
in the dark
uninformed; ignorant 不知情，蒙在鼓里
bring to a close
end 结束，终止
take leave (of)
say goodbye (to)
in the long run
in the end; ultimately 从长远的观点看；最终
go to great lengths
do anything possible, however dangerous, unpleasant, wicked, etc. 不遗余力
refrain from
not do , stop
day after day
each day
take a/ one's stand
declare one's position, loyalty 37, opinions, etc., and be prepared to fight (for these opinions, etc.)表明立场、意见等
- He had to conceal his identity to escape the police.为了躲避警方，他只好隐瞒身份。
- He could hardly conceal his joy at his departure.他几乎掩饰不住临行时的喜悦。
- The old houses were dwarfed by the huge new tower blocks. 这些旧房子在新建的高楼大厦的映衬下显得十分矮小。
- The elephant dwarfed the tortoise. 那只乌龟跟那头象相比就显得很小。 来自《简明英汉词典》
- She has to face the brutal reality.她不得不去面对冷酷的现实。
- They're brutal people behind their civilised veneer.他们表面上温文有礼，骨子里却是野蛮残忍。
- All the researchers on the project are sworn to secrecy.该项目的所有研究人员都按要求起誓保守秘密。
- Complete secrecy surrounded the meeting.会议在绝对机密的环境中进行。
- The people asked the government to hit out against corruption and theft.人民要求政府严惩贪污盗窃。
- The old man reviled against corruption.那老人痛斥了贪污舞弊。
- Do you think relations between China and Japan will continue to deteriorate?你认为中日关系会继续恶化吗？
- He held that this would only cause the situation to deteriorate further.他认为，这只会使局势更加恶化。
- It occurs to me that example is always more efficacious than precept.我想到身教重于言教。
- The son had well profited by the precept and example of the father.老太爷的言传身教早已使他儿子获益无穷。
- The chemical dilution technique transcends most of the difficulties. 化学稀释法能克服大部分困难。
- The genius of Shakespeare transcends that of all other English poets. 莎士比亚的才华胜过所有的其他英国诗人。
- He was considered to be a paragon of virtue.他被认为是品德尽善尽美的典范。
- You need to decorate your mind with virtue.你应该用德行美化心灵。
- His appearance was deceptive.他的外表带有欺骗性。
- The storyline is deceptively simple.故事情节看似简单，其实不然。
- But, eventually, I think they were just kind of like placebos. 但是后来，我想它们只是安慰剂（安慰剂：没有任何药效的药） 来自电影对白
- But comparable numbers of those who received placebos also improved. 但是吃安慰剂的人的病情也改善了。 来自互联网
- But young people are incurably optimistic and women have a special knack of forgetting their troubles. 可是青年人，永远朝着愉快的事情想，女人们尤其容易忘记那些不痛快。
- For herself she wanted nothing. For father and myself she was incurably ambitious. 她为她自己并无所求，可为父亲和我，却有着无法遏制的野心。
- He admitted conspiring to obtain property by deception.他承认曾与人合谋骗取财产。
- He was jailed for two years for fraud and deception.他因为诈骗和欺诈入狱服刑两年。
- You can count on him for a truthful report of the accident.你放心，他会对事故作出如实的报告的。
- I don't think you are being entirely truthful.我认为你并没全讲真话。
- Is the primary persona being treated humanely by the product? 该产品对待首要人物角色时是否有人情味？ 来自About Face 3交互设计精髓
- In any event, China's interest in treating criminals more humanely has limits. 无论如何，中国对更人道地对待罪犯的兴趣有限。 来自互联网
- His benevolent nature prevented him from refusing any beggar who accosted him.他乐善好施的本性使他不会拒绝走上前向他行乞的任何一个乞丐。
- He was a benevolent old man and he wouldn't hurt a fly.他是一个仁慈的老人，连只苍蝇都不愿伤害。
- She toed scrupulously into the room. 她小心翼翼地踮着脚走进房间。 来自辞典例句
- To others he would be scrupulously fair. 对待别人，他力求公正。 来自英汉非文学 - 文明史
- Lawsuits involving property rights and farming and grazing rights increased markedly. 涉及财产权，耕作与放牧权的诉讼案件显著地增加。 来自辞典例句
- I've lost and won more lawsuits than any man in England. 全英国的人算我官司打得最多，赢的也多，输的也多。 来自辞典例句
- Their questions about the money put her on the defensive.他们问到钱的问题，使她警觉起来。
- The Government hastily organized defensive measures against the raids.政府急忙布置了防卫措施抵御空袭。
- He was so eloquent that he cut down the finest orator.他能言善辩，胜过最好的演说家。
- These ruins are an eloquent reminder of the horrors of war.这些废墟形象地提醒人们不要忘记战争的恐怖。
- I quite disapprove of his behaviour.我很不赞同他的行为。
- She wants to train for the theatre but her parents disapprove.她想训练自己做戏剧演员，但她的父母不赞成。
- one of the greatest practitioners of science fiction 最了不起的科幻小说家之一
- The technique is experimental, but the list of its practitioners is growing. 这种技术是试验性的，但是采用它的人正在增加。 来自辞典例句
- He is wary of telling secrets to others.他谨防向他人泄露秘密。
- Paula frowned,suddenly wary.宝拉皱了皱眉头，突然警惕起来。
- Once exposed,soil is quickly eroded by wind and rain.一旦暴露在外，土壤很快就会被风雨侵蚀。
- Competition in the financial marketplace has eroded profits.金融市场的竞争降低了利润。
- The worker is starching the linen.这名工人正在给亚麻布上浆。
- Fine linen and cotton fabrics were known as well as wool.精细的亚麻织品和棉织品像羊毛一样闻名遐迩。
- She was questioned about his immoral conduct toward her.她被询问过有关他对她的不道德行为的情况。
- It is my belief that nuclear weapons are immoral.我相信使核武器是不邪恶的。
- Investors are set to make a killing from the sell-off.投资者准备清仓以便大赚一笔。
- Last week my brother made a killing on Wall Street.上个周我兄弟在华尔街赚了一大笔。
- Please lay the maxim to your heart.请把此格言记在心里。
- "Waste not,want not" is her favourite maxim.“不浪费则不匮乏”是她喜爱的格言。
- His art has reached a high degree of excellence.他的艺术已达到炉火纯青的地步。
- My performance is far below excellence.我的表演离优秀还差得远呢。
- He tried to justify his absence with lame excuses.他想用站不住脚的借口为自己的缺席辩解。
- Can you justify your rude behavior to me?你能向我证明你的粗野行为是有道理的吗？
- He said that he needed to get his supervisor to authorize my refund.他说必须让主管人员批准我的退款。
- Only the President could authorize the use of the atomic bomb.只有总统才能授权使用原子弹。
- Her neighbours spoke of her as kindly and hospitable.她的邻居都说她和蔼可亲、热情好客。
- A shadow passed over the kindly face of the old woman.一道阴影掠过老太太慈祥的面孔。
- If we interfere, it may do more harm than good.如果我们干预的话，可能弊多利少。
- When others interfere in the affair,it always makes troubles. 别人一卷入这一事件，棘手的事情就来了。
- His sincerity added much more authority to the story.他的真诚更增加了故事的说服力。
- He tried hard to satisfy me of his sincerity.他竭力让我了解他的诚意。
- He kept silent,eating just as conscientiously but as though everything tasted alike. 他一声不吭，闷头吃着，仿佛桌上的饭菜都一个味儿。 来自《简明英汉词典》
- She discharged all the responsibilities of a minister conscientiously. 她自觉地履行部长的一切职责。 来自《简明英汉词典》