Physician-assistedSuicide

The SupremeCourt's decisions on physician-assisted suicide carry important implicationsforhow medicine seeks to relieve dying patients of pain and suffering.

2.Although it ruledthat there is no constitutional right to physician-assisted suicide,the Courtin effect supported the medical principle of"double effect,"acenturies-old moral

principle holdingthat an action having two effects一a good one that is intended and a harmful one that is foreseen一is permissible if the actor intends only the good effect.

3.Doctors have usedthat principle in recent years to justify using high dose of morphine tocontrol terminally ill patients' pain,even though increasing dosages willeventually

kill the patient.

4.NancyDubler,director of Montefiore Medical Center,contendsthat the principle will shield doctors who until now have very,very stronglyinsisted that they could not give

patients sufficientmedication to control their pain if that might hasten death.

5.George Annas,chairof the health law department at Boston University,maintainsthat, as long as a doctor prescribes a drug for a legitimate medicalpurpose,the doctor has

done nothingillegaleven if the patient uses the drug to hasten death."It's likesurgery,"he says."We don't callthose deaths homicides because thedoctors didn't intend to kill

theirpatients,although they risked their death.If you're a physician,you can riskyour patient's suicide as long as you don't intend theirsuicide."Onanother level,many in the

medical communityacknowledge that the assisted-suicide debate has been fueled in part by thedespair of patients for whom modern medicine has prolonged the physical

agony of dying.

6.Just three weeksbefore the Court's ruling on physician-assisted suicide,the National Academy ofScience(NAS)released a two-volume report,Approaching Death:Improving

Care atthe End ofLife.It identifies the under-treatment of pain and the aggressive useof"ineffectual and forced medical procedures that may prolong and evendishonor the

period ofdying" as the twin problems of end-of-life care.

7. The profession istaking steps to require young doctors to train in hospices（临终关怀医院）, to test knowledge ofaggressive pain management therapies,to develop a

Medicare billingcode for hospital-based care,and to develop new standards for assessing andtreating pain at the end of life. Annas says lawyers can play a key role in

insisting that thesewell-meaning medical initiatives trans-late into better care.George Annas wouldprobably agree that doctors should be punished if they prolong________.

A.help the dying endtheir lives

B.can be prescribed

C.the needlesssuffering of the patients

D.the helplessnessof the patients

E.inadequatetreatment of pain