资源描述
学术英语医学,AcademicEnglishforMedicine,Unit7,Physician-PatientRelationshipLifecanbehard.Relationshipsareoftendifficult.Inaneraoffastadvancingmedicaltechnology,rapidlychangingmedicalethics,andinincreasinglylitigioussociety,goodphysician-patientrelationshipiscriticallyimportantforeffectivehealthcaredelivery.Thisunitshedssomelightonhowtobuildsucharelationshiptohelpusthroughtheunpredictabilityinlife.,Unit7LifeandMedicine,UnitContents,Lead-in,TextA,TextB,TextC,Listening,Speaking,Writing,GetreadingforUnit8,Lead-in,IssuestobecoveredTask,Unit7LifeandMedicine,Lead-in,Issuestobecovered,Theshiftfrompaternalisticparadigmtopatient-centerparadigminmedicaldecisionmakingTheimportanceofgoodphysician-patientrelationshipinboththemedicalpracticeandthepatientsrecoveryThingsthatcountsinmaintainingaamiablephysician-patientrelationshipThewaytocommunicateproperlyandeffectivelywiththepatients,Unit7LifeandMedicine,Lead-in,Decidewhetherlife-supportsystemshouldbecontinuedorwithdrawn;Decidewhethereuthanasiashouldbeconsidered;Decidewhetheranewtherapyshouldbetried;Decidewhethersurgeryshouldbethefirstchoiceorthelastresort;Decidewhethertransferorreferralisneeded.,Task:ReadthetitleofTextAandimaginethreedifferentsituationsinwhichdoctorsmaybeaskedtomake“toughdecisions”fortheirpatients.Thenwritethemdown.,Unit7LifeandMedicine,TextA,CriticalreadingandthinkingTopicsforpresentationUsefulexpressionsDifficultsentencesLanguagebuilding-upSignpostlanguageVocabularytestSuggestedanswers,Unit7LifeandMedicine,TextACriticalreadingandthinking,Topicsforpresentation,1Whatdifficultsituationistheyoungdoctorfacing?,AdyingpatientDecisionwhethertowithdrawlife-supportmachinesandmedicationandstartcomfortmeasuresThefamilysrefusaltomakeanydecisionorwithdrawanytreatments,Unit7LifeandMedicine,TextA,Usefulexpressions,护士站nursingstation停止使用呼吸机并停药/停止治疗withdrawlife-supportmachinesandmedications/treatmentwhowasimpressivenotonlyforhisclinicalskillsbutalsoforhisdevotiontopatientswhowasimpressivenotonlyforhisclinicalskillsbutalsoforhisdevotiontopatientsItoldthemsufferingorcomfortitwastheirdecision.Butintheend,theymadenodecisionandjustwalkedrightoutoftheroom,Criticalreadingandthinking,Unit7LifeandMedicine,2Whatispaternalisticdecision-makinginmedicine?,Topicsforpresentation,TextACriticalreadingandthinking,DoctorsasexclusivedecisionmakerPatientsasparticipantswithoutlittlesayinthefinalchoice,Unit7LifeandMedicine,TextA,Usefulexpressions,Thewaydoctorsandpatientsapproachmedicaldecisionshaschangedsharplyoverthelast50years.andpatients,iftheyparticipated,oftenhadlittlesayinthefinalchoice.,Criticalreadingandthinking,Unit7LifeandMedicine,TextA,Topicsforpresentation,3Inwhatwaycanpatientempowermentbegoodforthepatient?,Criticalreadingandthinking,Respectforthepatient,especiallythepatientsautonomyPatient-centercareThePatientsasdecisionmakerbasedontheinformationprovidedbythedoctor,Unit7LifeandMedicine,TextA,Topicsforpresentation,3Inwhatwaycanpatientempowermentbegoodforthepatient?,Criticalreadingandthinking,Twoprinciples/tenets/notionsinvolvedinthedecision-makingprocessrespectforthepersonanewclinicalideal:patient-centeredcareinwards,clinicsandoperatingroomsrespectforapersonsautonomylettingpatientsmaketheirowndecisions,Unit7LifeandMedicine,TextA,Topicsforpresentation,4Whydoestheauthorsaytoomuchphysicianrestraintmaynotbethatgoodforthepatient?,Criticalreadingandthinking,Thepatientsareforcedtomakedecisionstheyneverwantto.Patients,atleastalargemajority,prefertheirdoctorstomakefinaldecisions.Shiftingresponsibilityofdecisionmakingtothepatientswillbringaboutmorestresstothepatientsandtheirfamilies,especiallywhenthebestoptionforthepatientisuncertain,Unit7LifeandMedicine,TextA,Usefulexpressions,amajorityofpatientsarebeinglefttomakedecisionsthattheyneverwantedtointhefirstplace.Whenitcametomedicaldecisions,almostalltherespondentswantedtheirdoctorstoofferchoicesandconsidertheiropinions.Butamajorityofpatientstwooutofthreealsopreferredthattheirdoctorsmakethefinaldecisionsregardingtheirmedicalcare.notwhenthemedicalchoicesareobvious,butwhenthebestoptionforapatientisuncertainwhendoctorspasstheburdenofdecision-makingtoapatientorfamily,itcanexacerbateanalreadystressfulsituation.,Criticalreadingandthinking,Unit7LifeandMedicine,TextA,Topicsforpresentation,5.Whatkindofconsiderationsmayhavepreventeddoctorsfrommakingdecisionsfortheirpatients?,Criticalreadingandthinking,Doctorsareverymuchcautiousaboutcommittingsomekindofethicaltransgression.WhoamItopresumetoknowwhatmypatientsneed?,Unit7LifeandMedicine,TextA,ACaseinPoint:LanguageMakesaDifference,Tellrelativesthatitistheirchoicetowithdrawlifesupportfromadyingpatient.Butthatdoctormayalsousevalue-ladenlanguagetodescribetheoptions.Onealternativemaybedescribedtothefamilyas“reasonable”or“comforting,”whiletheotherisdepictedas“invasive,”“aggressive”or“painful”.,Criticalreadingandthinking,Unit7LifeandMedicine,TextA,ACaseinPoint:LanguageMakesaDifference,Dr.CurlinsWisdomIBizarredishonestofcommunicationPatientsendupfeelingmanipulatedandwillresistmakinganydecisionatall.,Criticalreadingandthinking,Unit7LifeandMedicine,TextA,ACaseinPoint:LanguageMakesaDifference,Dr.CurlinsWisdomII“Wehavetostopdrawingacirclearoundpatientsandtheirfamilies,”“Wehavetostopsubjectingthemtothelonelinessandburdenofautonomyandinsteadbeginstandinginthatcirclewiththem.”,Criticalreadingandthinking,Unit7LifeandMedicine,6Doyouagreethatdoctorsshouldbepreparedtomakeanydecisionstogetherwiththeirpatients?,TextA,Topicsforpresentation,Criticalreadingandthinking,Shoulderingresponsibilitytogetherwiththepatientmaybebetterthanhavingthepatientmakedecisionontheirownalone.Balancingbetweenpaternalismandrespectforpatientsautonomyconstitutesalargepartofmedicalpractice.,Unit7LifeandMedicine,TextA,Usefulexpressions,thekeytopreservingpatientautonomyandpatient-centeredcareliesnotinlettingpatientsmakethefinaldecisionsalonebutinrespectingtheiropinionsandshoulderingtheresponsibilitytogether.Iadmit,myself,willneedtobemoremindfulofwhetherpatientswantthemtoshareinformation,bedirectiveorhandovertheresponsibilityofthedecision.,Criticalreadingandthinking,Unit7LifeandMedicine,TextA,AdditionalActivity,WatchtheVideoandseewhataretipsgivenbyDr.ThaddeusBelltobuildaAmiablePPRelationshipDoctor-PatientRelationship,Criticalreadingandthinking,Unit7LifeandMedicine,TextA,Difficultsentences,Hewaslargeandpowerfullybuiltbutneverseemedtoloomoverhispatients,Criticalreadingandthinking,他身材高大伟岸，但是从来不让病人有咄咄逼人的感觉,Unit7LifeandMedicine,TextA,Difficultsentences,asmovementscallingforpatientempowermentgrewandmedicalethicistsbeganarticulatingprinciplesregardingtheethicalcareofpatients.,Criticalreadingandthinking,要求病人授权的呼声越来越高，而且医学伦理学家也开始阐述病人伦理关怀的相关原则。,Unit7LifeandMedicine,TextA,Difficultsentences,Onetenetthatgainedparticulartractionamongclinicians,Criticalreadingandthinking,临床医生们尤为拥护的一条宗旨,thisethicalprincipleledtoanewclinicalideal:patient-centeredcare,这条伦理原则导致了一种新的临床理念的出现：以病人为中心的医护。,Unit7LifeandMedicine,TextA,Difficultsentences,youngdoctors,myselfincluded,wouldbetrainedtorestrainourselvesfrommakinganythingbutemergencyormundanedecisionsforpatients.,Criticalreadingandthinking,包括我在内，年轻医生将接受培训，学会除了一些紧急状况或日常琐事，不为病人作其他任何决定。,Unit7LifeandMedicine,TextA,Difficultsentences,andthatinterpretationwouldworkitswayintotheteachingprogramsofmedicalschoolsandintostatelawsthatmandateddiscussionoftreatmentoptionswithpatients.,Criticalreadingandthinking,而且，对病人自主性的解释逐渐进入了医学院校的课程，也被写进各州的法律，规定医生必须与病人讨论治疗方案的选择。,Unit7LifeandMedicine,TextA,Difficultsentences,Whiledoctorsmightequatelettingpatientsmaketheirowndecisionswithrespect,Criticalreadingandthinking,虽然医生也许认为让病人自己作决定就是尊重病人,Unit7LifeandMedicine,TextA,Difficultsentences,Somewillresorttoveilingtheirownopinionsinahalfheartedattempttodirectthedecision.,Criticalreadingandthinking,有些医生采取的做法是隐藏自己的观点，用隐隐约约的方式引导病人作决定。,Unit7LifeandMedicine,TextA,Difficultsentences,Whilethedoctorsmightbeconvincedthattheyarebeingobjectiveanddispassionate,moreoftenthannottheyaresendingmixedmessages.,Criticalreadingandthinking,虽然医生坚信自己的态度客观冷静，但往往他们在向病人发出莫衷一是的信息。,Unit7LifeandMedicine,anursing_(护士站)_machines(生命维持系统)comfort_(舒适护理措施)to_treatment(停止治疗)_decision-makingprocess(家长式决策程序)patient_(给病人授权)medical_(医学伦理学家)ethical_(伦理准则)clinical_(临床理念)_care(以病人为中心的护理),TextALanguageBuilding-up,VocabularyTest,station,life-support,measures,withdraw,paternalistic,empowerment,ethicists,principles,ideal,Unit7LifeandMedicine,patient-centered,patient_(病人自主权)treatment_(治疗选择)_purview(专属领域)_decisions(紧急情况下做的决定)physician_(对医生的限制)_andconfusion(焦虑与困惑)ethical_(违背伦理)family_(家庭医疗),TextALanguageBuilding-up,VocabularyTest,autonomy,options,exclusive,emergency,restraint,anxiety,transgression,practice,Unit7LifeandMedicine,TextA,Suggestedanswers,Task1OverviewThistextcanbebrieflydividedintothreeparts:introductionofthetopicandthetheme,argumentationforthetheme,andconclusion.Readthetextcarefullyandfillinthemissinginformationforeachpartinthefollowingdiagram.,Criticalreadingandthinking,Unit7LifeandMedicine,TextA,Suggestedanswers,Task1Overview,Criticalreadingandthinking,Unit7LifeandMedicine,TextA,Task1/MedicalterminologyMatcheachdefinitionwithitscorrespondingEnglishtermandChineseequivalent.,medication,药物，药物治疗,自主性,autonomy,临床医生,clinician,surgical,外科的,painful,疼痛的,Suggestedanswers,Languagebuilding-up,2,Unit7LifeandMedicine,TextA,physician,医生，内科医生,clinical,临床的,ethicist,伦理学家,unethical,不道德的,hospitalize,住院,Task1/MedicalterminologyMatcheachdefinitionwithitscorrespondingEnglishtermandChineseequivalent.,Suggestedanswers,2,Languagebuilding-up,Unit7LifeandMedicine,TextA,Task2/Signpostlanguage,Underlinethefirstsentencesofparagraphs4,5,6,8,11and12,analyzehowtheauthormanagestobringanewtopicandmaintaincoherence,andcompletethefollowingtable.,Languagebuilding-up,Suggestedanswers,Unit7LifeandMedicine,TextA,Task3/FormalEnglish,ThefollowingsentencesaretakenfromTextA.Replacetheunderlinedformalwordswithlessformalones.,Forgenerations,thesedecisionsweretheexclusivepurviewofdoctors(para.4)Onetenetthatgainedparticulartractionamongclinicianswasrespectfortheperson.(para.5)andthatinterpretationwouldworkitswayintotheteachingprogramsofmedicalschoolsandintostatelawsthatmandateddiscussionoftreatmentoptionswithpatients.(para.6),Languagebuilding-up,Suggestedanswers,belief/idea,area/field,ordered,Unit7LifeandMedicine,TextA,Task3/FormalEnglish,ThefollowingsentencesaretakenfromTextA.Replacetheunderlinedformalwordswithlessformalones.,Whenitcametomedicaldecisions,almostalltherespondentswantedtheirdoctorstoofferchoicesandconsidertheiroptions.(para.9)Butamajorityofpatientstwooutofthreealsopreferredthattheirdoctorsmakethefinaldecisionsregardingtheirmedicalcare.(para.9)6doctors,likemyyoungcolleaguesand,Iadmit,myself,willneedtobemoremindfulofwhetherpatientswantthemtoshareinformation(para.15),Languagebuilding-up,Suggestedanswers,conscious/aware,relatingto/about,answerers,Unit7LifeandMedicine,TextA,Additionalactivity,GrouppresentationHospicemovementhasbeenapopularconceptinrecentdecadesinthefieldofhealthcare.Workinasmallgroupandexplorerelevantinformationaboutthissubjectinthefollowingaspects:1.definition2.history3.advantages4.developmentinChina,Unit7LifeandMedicine,TextB,CriticalreadingandthinkingLanguagebuilding-upSuggestedanswers,Unit7LifeandMedicine,TextB,CriticalReadingandThinking,1.PatsPersonalStatus(P181),A78-year-oldwomansufferingfromlungcancerwithwidespreadmetastasesandreceivingpalliativecarefromhospiceAdairyfarmerMotherofsixInteriordesignerOneofthebestpiebakersinthecounty,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,Unit7LifeandMedicine,TextB,CriticalReadingandThinking,KnowledgeofSubjectMatter,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,lungcancerReportsfromthehospitalandoncologistconfirmedwidespreadmetastases.Pathaddeclinedaggressivetreatment.Shewasreceivingpalliativecarefromhospiceunderthesupervisionofanoncologist.,1.PatsPersonalStatus(P181),Unit7LifeandMedicine,TextB,CriticalReadingandThinking,2.Patselectronicrecord(P181),Thecomputerizedtomography(CT):extensivebilateralinfiltratesandapossiblesmallnoduleinthebaseoftheleftlungwithfollow-uprecommendedbutnotobtainedAchestX-raymorethanayearago:aleftlower-lobepneumoniawithfollow-upsuggestedbutnotobtained,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,Unit7LifeandMedicine,TextB,CriticalReadingandThinking,2.thereasonsforherhavingproblemswithdoctors(P154),KnowledgeofSubjectMatter,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,pulmonaryembolicomputerizedtomography(CT)extensivebilateralinfiltratesapossiblesmallnoduleinthebaseoftheleftlungAchestX-rayreportfromavisitmorethanayearagowithoneofmypartnersrevealedaleftlower-lobepneumoniaandsuggestedfollow-uptoensureresolution,Unit7LifeandMedicine,TextB,CriticalReadingandThinking,3.themedicalmistake(P181),Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,Theabnormalitynotnoted.Frequentvisitstodoctorsbutnotinformedofthefindings,Unit7LifeandMedicine,TextB,CriticalReadingandThinking,4.theauthorsself-reflection(P181),Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,Whotoblame?Noneofthehospitalteam,mypartners,ortheradiologiststotaketheblame.AsPatsfamilyphysician,theauthorsresponsibilitytofollowupabnormaltests;theauthormadetheseriousmistake.Allsortsofquestionsrunningthroughtheauthorsmind:patsresponse,possibilitiesofothermistakes,problemswithhealthcaresystem,causesofmedicalmistakesorerrors,what-ifs,andnextactions,Unit7LifeandMedicine,TextB,CriticalReadingandThinking,5.theauthorsthevisittoPat(P181),PatlyinginbedinadarkenedroomwithmildlylaboredbreathingTheauthorkneelingatthebedsidelisteningtoPatsstoriesTheauthorapologizingfortheseriousmistakePatsforgivenessfortheauthorsmistake,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,Unit7LifeandMedicine,TextB,CriticalReadingandThinking,6.thelessonthewriterlearnedfromPat(P181),AcceptingunexpectedForgivingCelebratingHopingLivinganddyingwithcourageanddignity,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,Unit7LifeandMedicine,TextB,Usefulexpressions,Criticalreadingandthinking,Theprimarylesionwasdetectedyearsago,buttherewasnofollow-up.Someonedroppedtheball.reportsfromahospitalstaymorethan3yearsagoPatpresentedinfrequentlyforcareandusuallyonlyifsomethingwaswrong.sortoutmythoughtsmildlylaboredbreathingdistraughtaboutconflictswithmanyfamilymemberswhowerenotonspeakingtermsnotfulfilledmyresponsibilitytomadeadifferenceintheoutcomeAtremendousloadwasliftedfrommyshoulders.,Unit7LifeandMedicine,widespread_(广泛转移)_treatment(积极治疗)_lesion(原发病灶)torecommend_(建议随访)electronic_(电子病历)pulmonary_(肺栓塞)computerized_(CT,计算机断层扫描)bilateral_(双侧浸润)a(n)_X-ray(X线胸片)left_pneumonia(左下叶肺炎)_breathing(呼吸困难)thehospice_(临终关怀团队),TextBLanguageBuilding-up,VocabularyTest,metastases,aggressive,primary,follow-up,record,emboli,tomography,infiltrates,chest,Unit7LifeandMedicine,lower-lobe,labored,team,TextB,Suggestedanswers,Criticalreadingandthinking,Task1Reflection,1.B2.B3.C4.D5.C6.A,Unit7LifeandMedicine,TextC,Languagebuilding-upSuggestedanswers,Unit7LifeandMedicine,_illness(慢性病)_aspects(社会心理学领域)evidence-based_(询证临床指南)to_aplanofcare(实施治疗方案),TextCLanguageBuilding-up,VocabularyTest,chronic,psychosocial,guidelines,implement,Unit7LifeandMedicine,TextC,Task:Completethefollowingbriefsummaryofthetextaftercarefulreading.,Suggestedanswers,答案有误,Unit7LifeandMedicine,Listening,RecognizingdigressionsSuggestedanswers,Unit7LifeandMedicine,Listening,Recognizingdigressions,Recognizingthestart:IrememberonceThatremindsmeBythewayRecognizingtheend:So,asIwassayingAnyway,wherewasI?Backtothepoint,Unit7LifeandMedicine,Listening,Suggestedanswers,Expressionforthestartofadigression:Expressionfortheendofadigression:,Task1Listentoalectureonceandnotedowntheexpressionsthespeakerusestosignaladigression.,AsIrememberonce,Sobacktothepoint,Task2Listentothelectureagainandcompleteeachofthefollowingsentenceswiththebestanswer.,1.B2.C3.A4.B5.C,Unit7LifeandMedicine,Speaking,Seminar&PresentationTask,Unit7LifeandMedicine,Speaking,DevelopinganEffectiveIntroduction,Attractyourlistenersinterest1)Relateyourtopictoyourlistenersconcerns,suchasgoals,experiencesandproblemstheyhave.2)Tellananecdotethatrelatestoyourtopic.3)Askyourlistenersquestionsthatwillkeeptheminterestedinyourpresentation.4)Useaquotationfromanexpert.5)Offeraninterestingorsurprisingfact,opinion,orstatistics.,Unit7LifeandMedicine,Speaking,DevelopinganEffectiveIntroduction,Previewingthecontent1)Stateyourtopicclearly.2)Previewthestructureofyourpresentationandtheorderofthemainideas.,Unit7LifeandMedicine,Speaking,Task,Workinpairstomakeapresentationonthefollowingtopics.Choosefromtheabovestrategiestostartyourpresentation.1.patientautonomy2.medicalchoices3.hospicecare4.doctorslanguage5.medicalmistakes,Unit7LifeandMedicine,Writing,WritingconclusionsTask,Unit7LifeandMedicine,WritingResearchPaperProject,1.Referbacktothetopicofyourpaper.2.Restatethethesis.3.Analyzeandevaluateyourownideastoexplaintheirsignificance.4.Offerrecommendationsforfutureaction.,Writingconclusions,Unit7LifeandMedicine,WritingResearchPaperProject,Task:Searchforaresearchpaperandmakeananalysisoftheconclusions.,Unit7LifeandMedicine,GetreadyforUnit8,PresentationsforUnit8,Unit7LifeandMedicine,GetreadyforUnit8,PresentationsforUnit8,1.Howareresearchandpracticerelatedtoeachother?(P195)2.Elaboratetheprincipleofrespectforpersons.3.Explaintheprincipleofbeneficence.(P195)4.HowistheprincipleofbeneficencerelatedtoHippocraticOath.(P195)5.Illustratetheprincipleofjusticewithconcreteexamples.(P195)6.Defineinformedconsentandexemplifyitsapplication.(P195)7.Whataretheconsiderationsinvolvedinselectionofhumansubjectsinresearch?(P195),Unit7LifeandMedicine,
展开阅读全文