學(xué)術(shù)英語醫(yī)學(xué)Unit7

學(xué)術(shù)英語醫(yī)學(xué)AcademicEnglishforMedicine第一頁，共67頁。Unit7Physician-PatientRelationshipLifecanbehard.Relationshipsareoftendifficult.Inaneraoffastadvancingmedicaltechnology,rapidlychangingmedicalethics,andinincreasinglylitigioussociety,goodphysician-patientrelationshipiscriticallyimportantforeffectivehealthcaredelivery.Thisunitshedssomelightonhowtobuildsucharelationshiptohelpusthroughtheunpredictabilityinlife.第二頁，共67頁。Unit7LifeandMedicineUnitContentsLead-inTextATextBTextCListeningSpeakingWritingGet

readingforUnit8第三頁，共67頁。Lead-inIssuestobecoveredTaskUnit7LifeandMedicine第四頁，共67頁。Lead-inIssuestobecoveredTheshiftfrompaternalisticparadigmtopatient-centerparadigminmedicaldecisionmakingTheimportanceofgoodphysician-patientrelationshipinboththemedicalpracticeandthepatient’srecoveryThingsthatcountsinmaintainingaamiablephysician-patientrelationshipThewaytocommunicateproperlyandeffectivelywiththepatientsUnit7LifeandMedicine第五頁，共67頁。Lead-inDecidewhetherlife-supportsystemshouldbecontinuedorwithdrawn;Decidewhethereuthanasiashouldbeconsidered;Decidewhetheranewtherapyshouldbetried;Decidewhethersurgeryshouldbethefirstchoiceorthelastresort;Decidewhethertransferorreferralisneeded.Task:ReadthetitleofTextAandimaginethreedifferentsituationsinwhichdoctorsmaybeaskedtomake“toughdecisions〞fortheirpatients.Thenwritethemdown.Unit7LifeandMedicine第六頁，共67頁。TextACriticalreadingandthinking–Topicsforpresentation–Usefulexpressions–DifficultsentencesLanguagebuilding-up–Signpostlanguage–VocabularytestSuggestedanswersUnit7LifeandMedicine第七頁，共67頁。TextA

CriticalreadingandthinkingTopicsforpresentation1Whatdifficultsituationistheyoungdoctorfacing??AdyingpatientDecisionwhethertowithdrawlife-supportmachinesandmedicationandstartcomfortmeasuresThefamily’srefusaltomakeanydecisionorwithdrawanytreatmentsUnit7LifeandMedicine第八頁，共67頁。TextA

Usefulexpressions護(hù)士站nursingstation停頓使用呼吸機(jī)并停藥/停頓治療withdrawlife-supportmachinesandmedications/treatment…whowasimpressivenotonlyforhisclinicalskillsbutalsoforhisdevotiontopatients…whowasimpressivenotonlyforhisclinicalskillsbutalsoforhisdevotiontopatientsItoldthemsufferingorcomfort—itwastheirdecision.Butintheend,theymadenodecisionandjustwalkedrightoutoftheroom

CriticalreadingandthinkingUnit7LifeandMedicine第九頁，共67頁。2Whatispaternalisticdecision-makinginmedicine?TopicsforpresentationTextA

CriticalreadingandthinkingDoctorsasexclusivedecisionmakerPatientsasparticipantswithoutlittlesayinthefinalchoiceUnit7LifeandMedicine第十頁，共67頁。TextA

UsefulexpressionsThewaydoctorsandpatientsapproachmedicaldecisionshaschangedsharplyoverthelast50years.…andpatients,iftheyparticipated,oftenhadlittlesayinthefinalchoice.CriticalreadingandthinkingUnit7LifeandMedicine第十一頁，共67頁。TextA

Topicsforpresentation3Inwhatwaycanpatientempowermentbegoodforthepatient?CriticalreadingandthinkingRespectforthepatient,especiallythepatient’sautonomyPatient-centercareThePatientsasdecisionmakerbasedontheinformationprovidedbythedoctorUnit7LifeandMedicine第十二頁，共67頁。TextA

Topicsforpresentation3Inwhatwaycanpatientempowermentbegoodforthepatient?CriticalreadingandthinkingTwoprinciples/tenets/notionsinvolvedinthedecision-makingprocessrespectforthepersonanewclinicalideal:patient-centeredcareinwards,clinicsandoperatingroomsrespectforaperson’sautonomylettingpatientsmaketheirowndecisionsUnit7LifeandMedicine第十三頁，共67頁。TextA

Topicsforpresentation4Whydoestheauthorsaytoomuchphysicianrestraintmaynotbethatgoodforthepatient?CriticalreadingandthinkingThepatientsareforcedtomakedecisionstheyneverwantto.Patients,atleastalargemajority,prefertheirdoctorstomakefinaldecisions.Shiftingresponsibilityofdecisionmakingtothepatientswillbringaboutmorestresstothepatientsandtheirfamilies,especiallywhenthebestoptionforthepatientisuncertainUnit7LifeandMedicine第十四頁，共67頁。TextA

Usefulexpressions…amajorityofpatientsarebeinglefttomakedecisionsthattheyneverwantedtointhefirstplace.Whenitcametomedicaldecisions,almostalltherespondentswantedtheirdoctorstoofferchoicesandconsidertheiropinions.Butamajorityofpatients—twooutofthree—alsopreferredthattheirdoctorsmakethefinaldecisionsregardingtheirmedicalcare.…notwhenthemedicalchoicesareobvious,butwhenthebestoptionforapatientisuncertain…whendoctorspasstheburdenofdecision-makingtoapatientorfamily,itcanexacerbateanalreadystressfulsituation.CriticalreadingandthinkingUnit7LifeandMedicine第十五頁，共67頁。TextA

Topicsforpresentation5.Whatkindofconsiderationsmayhavepreventeddoctorsfrommakingdecisionsfortheirpatients?CriticalreadingandthinkingDoctorsareverymuchcautiousaboutcommittingsomekindofethicaltransgression.‘WhoamItopresumetoknowwhatmypatientsneed?’Unit7LifeandMedicine第十六頁，共67頁。TextA

ACaseinPoint:LanguageMakesaDifferenceTellrelativesthatitistheirchoicetowithdrawlifesupportfromadyingpatient.Butthatdoctormayalsousevalue-ladenlanguagetodescribetheoptions.Onealternativemaybedescribedtothefamilyas“reasonable〞or“comforting,〞whiletheotherisdepictedas“invasive,〞“aggressive〞or“painful〞.CriticalreadingandthinkingUnit7LifeandMedicine第十七頁，共67頁。TextA

ACaseinPoint:LanguageMakesaDifferenceDr.Curlin’sWisdomIBizarredishonestofcommunicationPatientsendupfeelingmanipulatedandwillresistmakinganydecisionatall.CriticalreadingandthinkingUnit7LifeandMedicine第十八頁，共67頁。TextA

ACaseinPoint:LanguageMakesaDifferenceDr.Curlin’sWisdomII“Wehavetostopdrawingacirclearoundpatientsandtheirfamilies,〞“Wehavetostopsubjectingthemtothelonelinessandburdenofautonomyandinsteadbeginstandinginthatcirclewiththem.〞CriticalreadingandthinkingUnit7LifeandMedicine第十九頁，共67頁。6Doyouagreethatdoctorsshouldbepreparedtomakeanydecisionstogetherwiththeirpatients?TextA

TopicsforpresentationCriticalreadingandthinkingShoulderingresponsibilitytogetherwiththepatientmaybebetterthanhavingthepatientmakedecisionontheirownalone.Balancingbetweenpaternalismandrespectforpatient’sautonomyconstitutesalargepartofmedicalpractice.Unit7LifeandMedicine第二十頁，共67頁。TextA

Usefulexpressionsthekeytopreservingpatientautonomy—andpatient-centeredcare—liesnotinlettingpatientsmakethefinaldecisionsalonebutinrespectingtheiropinionsandshoulderingtheresponsibilitytogether.Iadmit,myself,willneedtobemoremindfulofwhetherpatientswantthemtoshareinformation,bedirectiveorhandovertheresponsibilityofthedecision.CriticalreadingandthinkingUnit7LifeandMedicine第二十一頁，共67頁。TextA

AdditionalActivityWatchtheVideoandseewhataretipsgivenbyDr.ThaddeusBelltobuildaAmiablePPRelationshipDoctor-PatientRelationshipCriticalreadingandthinkingUnit7LifeandMedicine第二十二頁，共67頁。TextA

DifficultsentencesHewaslargeandpowerfullybuiltbutneverseemedtoloomoverhispatients…Criticalreadingandthinking他身材高大偉岸，但是從來不讓病人有咄咄逼人的感覺Unit7LifeandMedicine第二十三頁，共67頁。TextA

Difficultsentences…asmovementscallingforpatientempowermentgrewandmedicalethicistsbeganarticulatingprinciplesregardingtheethicalcareofpatients.Criticalreadingandthinking…要求病人受權(quán)的呼聲越來越高，而且醫(yī)學(xué)倫理學(xué)家也開場(chǎng)闡述病人倫理關(guān)心的相關(guān)原那么。Unit7LifeandMedicine第二十四頁，共67頁。TextA

DifficultsentencesOnetenetthatgainedparticulartractionamongclinicians…Criticalreadingandthinking臨床醫(yī)生們尤為擁護(hù)的一條宗旨…thisethicalprincipleledtoanewclinicalideal:patient-centeredcare…這條倫理原那么導(dǎo)致了一種新的臨床理念的出現(xiàn)：以病人為中心的醫(yī)護(hù)。Unit7LifeandMedicine第二十五頁，共67頁。TextA

Difficultsentences…youngdoctors,myselfincluded,wouldbetrainedtorestrainourselvesfrommakinganythingbutemergencyormundanedecisionsforpatients.Criticalreadingandthinking…包括我在內(nèi)，年輕醫(yī)生將承受培訓(xùn)，學(xué)會(huì)除了一些緊急狀況或日?，嵤拢粸椴∪俗髌渌魏螞Q定。Unit7LifeandMedicine第二十六頁，共67頁。TextA

Difficultsentences…andthatinterpretationwouldworkitswayintotheteachingprogramsofmedicalschoolsandintostatelawsthatmandateddiscussionoftreatmentoptionswithpatients.Criticalreadingandthinking…而且，對(duì)病人自主性的解釋逐漸進(jìn)入了醫(yī)學(xué)院校的課程，也被寫進(jìn)各州的法律，規(guī)定醫(yī)生必須與病人討論治療方案的選擇。Unit7LifeandMedicine第二十七頁，共67頁。TextA

DifficultsentencesWhiledoctorsmightequatelettingpatientsmaketheirowndecisionswithrespect…Criticalreadingandthinking雖然醫(yī)生也許認(rèn)為讓病人自己作決定就是尊重病人…Unit7LifeandMedicine第二十八頁，共67頁。TextA

DifficultsentencesSomewillresorttoveilingtheirownopinionsinahalfheartedattempttodirectthedecision.Criticalreadingandthinking有些醫(yī)生采取的做法是隱藏自己的觀點(diǎn)，用隱隱約約的方式引導(dǎo)病人作決定。Unit7LifeandMedicine第二十九頁，共67頁。TextA

DifficultsentencesWhilethedoctorsmightbeconvincedthattheyarebeingobjectiveanddispassionate,moreoftenthannottheyaresendingmixedmessages.Criticalreadingandthinking雖然醫(yī)生堅(jiān)信自己的態(tài)度客觀冷靜，但往往他們?cè)谙虿∪税l(fā)出莫衷一是的信息。Unit7LifeandMedicine第三十頁，共67頁。anursing________(護(hù)士站)___________machines(生命維持系統(tǒng))comfort_________(舒適護(hù)理措施)to_________treatment(停頓治療)___________decision-makingprocess(家長(zhǎng)式?jīng)Q策程序)patient______________(給病人受權(quán))medical___________(醫(yī)學(xué)倫理學(xué)家)ethical__________(倫理準(zhǔn)那么)clinical_________(臨床理念)________________care(以病人為中心的護(hù)理)

TextA

LanguageBuilding-up

VocabularyTeststationlife-supportmeasureswithdrawpaternalisticempowermentethicistsprinciplesidealUnit7LifeandMedicinepatient-centered第三十一頁，共67頁。patient_________(病人自主權(quán))treatment___________(治療選擇)__________purview(專屬領(lǐng)域)__________decisions(緊急情況下做的決定)physician__________(對(duì)醫(yī)生的限制)_________andconfusion(焦慮與困惑)ethical_____________(違犯?jìng)惱?family________(家庭醫(yī)療)

TextA

LanguageBuilding-up

VocabularyTestautonomyoptionsexclusiveemergencyrestraintanxietytransgressionpracticeUnit7LifeandMedicine第三十二頁，共67頁。TextASuggestedanswersTask1OverviewThistextcanbebrieflydividedintothreeparts:introductionofthetopicandthetheme,argumentationforthetheme,andconclusion.Readthetextcarefullyandfillinthemissinginformationforeachpartinthefollowingdiagram.CriticalreadingandthinkingUnit7LifeandMedicine第三十三頁，共67頁。TextASuggestedanswersTask1OverviewCriticalreadingandthinkingBackgroundinformation:Changefromthepaternalisticcaretothepatient-centered

careTwounderlyingethicalprinciples:respectfortheperson

andrespectfortheperson’sautonomy

Conclusion:Thekeyforpreservingpatientautonomyliesinrespectingtheiropinionsandshoulderingtheresponsibilitytogether.Theme:Toomuchphysicianrestraintisharmfulorunethical.

LettingDoctorsMaketheToughDecisionsAnecdote:ayoungdoctor’sexperienceMainSupports:Studyfindings:mostpatients’positionTwoarguments:ExacerbatingthestressfulsituationCreatingdishonestyincommunicationPartI(P1-P8)PartII(P9-P14)PartIII(P15-P16)Unit7LifeandMedicine第三十四頁，共67頁。TextATask1/MedicalterminologyMatcheachdefinitionwithitscorrespondingEnglishtermandChineseequivalent.EnglishChineseDefinition1medicineordrugsgiventopeoplewhoareill2theconditionorqualityofbeingautonomous;independence3anexpertclinicalphysician4of,pertainingto,orcorrectablebysurgery5causingpain,fullofpainmedication藥物，藥物治療自主性

autonomy臨床醫(yī)生cliniciansurgical外科的painful疼痛的SuggestedanswersLanguagebuilding-up2Unit7LifeandMedicine第三十五頁，共67頁。TextAEnglishChineseDefinition6of,relatingto,orconnectedwithaclinic7aspecialistinethics8notethical9apersonlicensedtopracticemedicine;amedicaldoctor10admitorsend(aperson)intoahospitalfortreatmentphysician醫(yī)生，內(nèi)科醫(yī)生clinical臨床的ethicist倫理學(xué)家unethical不道德的hospitalize住院Task1/MedicalterminologyMatcheachdefinitionwithitscorrespondingEnglishtermandChineseequivalent.Suggestedanswers2Languagebuilding-upUnit7LifeandMedicine第三十六頁，共67頁。TextATask2/SignpostlanguageUnderlinethefirstsentencesofparagraphs4,5,6,8,11and12,analyzehowtheauthormanagestobringanewtopicandmaintaincoherence,andcompletethefollowingtable.Languagebuilding-upSuggestedanswersKeywordsrepeatedtoachievesmoothtransitionKeywordsusedtointroduceanewtopic1stsentenceofPara.4decisionschanged1stsentenceof.5tenetrespectfortheperson1stsentenceof.6ethicalprinciplerespectforaperson’sautonomy1stsentenceof.8physicianrestraintnotbeallthatgood,unethical1stsentenceof.11medicalchoices,optionchallenge,uncertain1stsentenceof.12patientsandtheirfamilies(doctors’)ownsetofworriesUnit7LifeandMedicine第三十七頁，共67頁。TextATask3/FormalEnglishThefollowingsentencesaretakenfromTextA.Replacetheunderlinedformalwordswithlessformalones.Forgenerations,thesedecisionsweretheexclusive

purviewofdoctors…(para.4)Onetenetthatgainedparticulartractionamongclinicianswasrespectfortheperson.(para.5)…andthatinterpretationwouldworkitswayintotheteachingprogramsofmedicalschoolsandintostatelawsthatmandateddiscussionoftreatmentoptionswithpatients.(para.6)Languagebuilding-upSuggestedanswersbelief/ideaarea/fieldorderedUnit7LifeandMedicine第三十八頁，共67頁。TextATask3/FormalEnglishThefollowingsentencesaretakenfromTextA.Replacetheunderlinedformalwordswithlessformalones.Whenitcametomedicaldecisions,almostalltherespondentswantedtheirdoctorstoofferchoicesandconsidertheiroptions.(para.9)Butamajorityofpatients—twooutofthree—alsopreferredthattheirdoctorsmakethefinaldecisionsregardingtheirmedicalcare.(para.9)6…doctors,likemyyoungcolleaguesand,Iadmit,myself,willneedtobemoremindfulofwhetherpatientswantthemtoshareinformation…(para.15)

Languagebuilding-upSuggestedanswersconscious/awarerelatingto/aboutanswerersUnit7LifeandMedicine第三十九頁，共67頁。

TextA

Additionalactivity

GrouppresentationHospicemovementhasbeenapopularconceptinrecentdecadesinthefieldofhealthcare.Workinasmallgroupandexplorerelevantinformationaboutthissubjectinthefollowingaspects:

1.definition2.history3.advantages4.developmentinChinaUnit7LifeandMedicine第四十頁，共67頁。TextBCriticalreadingandthinkingLanguagebuilding-upSuggestedanswersUnit7LifeandMedicine第四十一頁，共67頁。TextB

CriticalReadingandThinking1.Pat’sPersonalStatus(P181)A78-year-oldwomansufferingfromlungcancerwithwidespreadmetastasesandreceivingpalliativecarefromhospiceAdairyfarmerMotherofsixInteriordesignerOneofthebestpiebakersinthecountyWritedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine第四十二頁，共67頁。TextB

CriticalReadingandThinkingKnowledgeofSubjectMatter

Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.lungcancerReportsfromthehospitalandoncologistconfirmedwidespreadmetastases.Pathaddeclinedaggressivetreatment.Shewasreceivingpalliativecarefromhospiceunderthesupervisionofanoncologist.1.Pat’sPersonalStatus(P181)Unit7LifeandMedicine第四十三頁，共67頁。TextB

CriticalReadingandThinking2.Pat’selectronicrecord(P181)Thecomputerizedtomography(CT):extensivebilateralinfiltratesandapossiblesmallnoduleinthebaseoftheleftlungwithfollow-uprecommendedbutnotobtainedAchestX-raymorethanayearago:aleftlower-lobepneumoniawithfollow-upsuggestedbutnotobtained

Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine第四十四頁，共67頁。TextB

CriticalReadingandThinking2.thereasonsforherhavingproblemswithdoctors(P154)KnowledgeofSubjectMatter

Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.pulmonaryembolicomputerizedtomography(CT)extensivebilateralinfiltratesapossiblesmallnoduleinthebaseoftheleftlungAchestX-rayreportfromavisitmorethanayearagowithoneofmypartnersrevealedaleftlower-lobepneumoniaandsuggestedfollow-uptoensureresolutionUnit7LifeandMedicine第四十五頁，共67頁。TextB

CriticalReadingandThinking3.themedicalmistake(P181)Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Theabnormalitynotnoted.FrequentvisitstodoctorsbutnotinformedofthefindingsUnit7LifeandMedicine第四十六頁，共67頁。TextB

CriticalReadingandThinking4.theauthor’sself-reflection(P181)Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Whotoblame?Noneofthehospitalteam,mypartners,ortheradiologiststotaketheblame.AsPat’sfamilyphysician,theauthor’sresponsibilitytofollowupabnormaltests;theauthormadetheseriousmistake.Allsortsofquestionsrunningthroughtheauthor’smind:pat’sresponse,possibilitiesofothermistakes,problemswithhealthcaresystem,causesofmedicalmistakesorerrors,what-ifs,andnextactionsUnit7LifeandMedicine第四十七頁，共67頁。TextB

CriticalReadingandThinking5.theauthor’sthevisittoPat(P181)PatlyinginbedinadarkenedroomwithmildlylaboredbreathingTheauthorkneelingatthebedsidelisteningtoPat’sstoriesTheauthorapologizingfortheseriousmistakePat’sforgivenessfortheauthor’smistakeWritedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine第四十八頁，共67頁。TextB

CriticalReadingandThinking6.thelessonthewriterlearnedfromPat(P181)AcceptingunexpectedForgivingCelebratingHopingLivinganddyingwithcourageanddignityWritedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.Unit7LifeandMedicine第四十九頁，共67頁。TextB

UsefulexpressionsCriticalreadingandthinkingTheprimarylesionwasdetectedyearsago,buttherewasnofollow-up.Someonedroppedtheball.reportsfromahospitalstaymorethan3yearsagoPatpresentedinfrequentlyforcareandusuallyonlyifsomethingwaswrong.sortoutmythoughtsmildlylaboredbreathingdistraughtaboutconflictswithmanyfamilymemberswhowerenotonspeakingtermsnotfulfilledmyresponsibilityto…madeadifferenceintheoutcomeAtremendousloadwasliftedfrommyshoulders.Unit7LifeandMedicine第五十頁，共67頁。widespread___________(廣泛轉(zhuǎn)移)___________treatment(積極治療)_________lesion(原發(fā)病灶)torecommend_________(建議隨訪)electronic_________(電子病歷)pulmonary__________(肺栓塞)computerized___________(CT,計(jì)算機(jī)斷層掃描)bilateral__________(雙側(cè)浸潤(rùn))a(n)_________X-ray(X線胸片)left__________pneumonia(左下葉肺炎)__________breathing(呼吸困難)thehospice_______(臨終關(guān)心團(tuán)隊(duì))

TextB

LanguageBuilding-up

VocabularyTestmetastasesaggressiveprimaryfollow-uprecordembolitomographyinfiltrateschestUnit7LifeandMedicinelower-lobelaboredteam第五十一頁，共67頁。TextB

SuggestedanswersCriticalreadingandthinkingTask1Reflection1.B2.B3.C4.D5.C6.AUnit7LifeandMedicine第五十二頁，共67頁。TextCLanguagebuilding-upSuggestedanswersUnit7LifeandMedicine第五十三頁，共67頁。________illness(慢性病)____________aspects(社會(huì)心理學(xué)領(lǐng)域)evidence-based__________(詢證臨床指南)to___________aplanofcare(施行治療方案)TextC

LanguageBuilding-up

VocabularyTestchronicpsychosocialguidelinesimplementUnit7LifeandMedicine第五十四頁，共67頁。TextC

Task:Completethefollowingbriefsummaryofthetextaftercarefulreading.Suggestedanswers答案有誤Unit7LifeandMedicine第五十五頁，共67頁。ListeningRecognizingdigressionsSuggestedanswersUnit7LifeandMedicine第五十六頁，共67頁。Listening

RecognizingdigressionsRecognizingthestart:Irememberonce…Thatremindsme…Bytheway…Recognizingtheend:So,asIwassaying…Anyway,wherewasI?Backtothepoint…Unit7LifeandMedicine第五十七頁，共67頁。Listening

SuggestedanswersExpressionforthestartofadigression:Expressionfortheendofadigression:Task1Listentoalectureonceandnotedowntheexpressionsthespeakerusestosignaladigression.AsI