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1、学术英语学术英语 医学医学Academic English for MedicineUnit 8Principles of Biomedical EthicsDoctors and biomedical researchers make tough decisions that have to be morally justifiable every day.Biomedical ethics provides moral principles and behavioral guidelines for the biomedical research and practice of medic

2、ine.It encompasses philosophy,sociology,theology,and practical applications in clinical settings.Unit 8 Principles of Biomedical EthicsUnit ContentsLead-inText AText BText CListeningSpeakingWritingGet reading for Unit 9Lead-inIssues to be coveredTaskUnit 8 Principles of Biomedical EthicsLead-inIssue

3、s to be covered the boundaries between medical research and practice the moral principles and behavioral guidelines for the biomedical research and medical practice the ethical justification of dilemmas in medical practiceUnit 8 Principles of Biomedical EthicsLead-inDifferences between medicine from

4、 other branches of natural science MedicineOther Branches of ScienceHealth as the ultimate goalKnowledge and truth as the ultimate goalMorality and ethics as priority factors Honesty as a prime virtue of scientistsA doctor as a teacher,counselor,friend,advocate,protector,and healer all at the same t

5、imeScientist as explorerGood doctors:empathetic,sympathetic,caring,patient,considerateGood scientists:inquisitive,persistent,perseverant,creative Unit 8 Principles of Biomedical EthicsLead-inCore terms to know in relation to medical ethics Autonomy Beneficence Non-Maleficence Euthanasia Informed con

6、sent Confidentiality Ethics committeesUnit 8 Principles of Biomedical EthicsLead-inTask:Watch a video clip and put down the issues mentioned by the host.Then share with a partner your perspectives about these issues.Issues mentionedYour perspectives1).life2).3).quality of life 4).deathpatient rights

7、Unit 8 Principles of Biomedical EthicsText A Critical reading and thinking Topics for presentation Useful expressions Difficult sentencesLanguage building-up Signpost language Vocabulary testSuggested answersUnit 8 Principles of Biomedical EthicsText A Critical reading and thinkingTopics for present

8、ation1.How are research and practice related to each other?(Pre.1)Blurred distinction Cooccurrence of research and practice like in research designed to evaluate a therapy Notable departures from standard practice as“experimental”with the terms“experimental”and“research”carelessly definedUnit 8 Prin

9、ciples of Biomedical EthicsText A Critical reading and thinkingTopics for presentation1.How are research and practice related to each other?(Pre.1)Practice:interventions solely to enhance the well-being of an individual patient or client and that have a reasonable expectation of success.to provide d

10、iagnosis,preventive treatment or therapy to particular individualsUnit 8 Principles of Biomedical EthicsText A Critical reading and thinkingTopics for presentation1.How are research and practice related to each other?(Pre.1)Research:an activity to test hypothesis,permit conclusions to be drawn,and t

11、hereby to develop or contribute to generalizable knowledge expressed in theories,principles,and statements of relationshipsUnit 8 Principles of Biomedical EthicsText A Useful expressions The distinction between research and practice is blurred partly because and partly because notable departures fro

12、m Critical reading and thinkingUnit 8 Principles of Biomedical Ethics2.What is the principle of respect for persons?(Pre.2)(In Diagram P194)Topics for presentationText A Critical reading and thinkingBasic Ethical Principlesprinciple of respect of persons_principle of justiceA dilemma:involvement of

13、prisoners as subjects of researchRequirement 1:acknowledgement of autonomyRequirement 2:protection of persons with diminished autonomyRule 1:_Rule 2:maximization of possible benefits and minimization of possible harmsConception 1:unjustifiable denial of benefit or unduly imposition of burdenConcepti

14、on 2:_an equal shareaccording to _according to _according to societal contributionaccording to meritUnit 8 Principles of Biomedical EthicsText A Critical reading and thinkingTopics for presentation2.What is the principle of respect for persons?(Pre.2)(In Diagram P194)(In text)Two Ethical Convictions

15、&Two Moral Requirements Autonomy:Individuals treated as autonomous agents -Voluntary involvement in the research -Adequate information Protection:Persons with diminished autonomy entitled to protectionUnit 8 Principles of Biomedical EthicsText A Critical reading and thinkingTopics for presentation2.

16、What is the principle of respect for persons?(Pre.2)(In Diagram P194)(In text)Two Ethical Convictions&Two Moral Requirements An Instructive Example:prisoners involved in research -Not be deprived of the opportunity to volunteer for research -Be subtly coerced or unduly influenced to engage in resear

17、ch activities for which they would not otherwise volunteerUnit 8 Principles of Biomedical EthicsText A Useful expressions be treated as autonomous agents persons with diminished autonomy are entitled to protection A provides an instructive example prisoners not be deprived of the opportunity to volu

18、nteer for research for which they would not otherwise volunteerCritical reading and thinkingUnit 8 Principles of Biomedical EthicsText A Topics for presentation3 What is the principle of beneficence?(Pre.3)(In Diagram P194)Critical reading and thinkingUnit 8 Principles of Biomedical EthicsText A Top

19、ics for presentation3 What is the principle of beneficence?(Pre.3)(In text)Critical reading and thinking Such treatment falls under the principle of beneficence.The term beneficence is often understood to cover acts of kindness or charity that go beyond strict obligation.Unit 8 Principles of Biomedi

20、cal EthicsText A Topics for presentation4 What is the principle of beneficence?(Pre.4)Critical reading and thinking“Do no harm”as a fundamental principle of medical ethicsExtension of it to the realm of research by Claude BernardBenefits and risks as a set“duet”in both medical practice and research-

21、Exposure to the risks in the processes of learning what is harmful or beneficialUnit 8 Principles of Biomedical EthicsText A Topics for presentation5.The principle of justice?(Pre.5)(In Diagram P194)Critical reading and thinkingUnit 8 Principles of Biomedical EthicsText A Topics for presentation5 Wh

22、at concrete examples can be given to illustrate the principle of justice?(Pre.5)Critical reading and thinking Unreasonable denial of entitled benefit and unduly imposed burden -Enrolment of patients in new drug trial:who should be enrolled and who should not?Equal treatment of equals -Determining fa

23、ctors of equality:age,sex,severity of the condition,financial status,social statusUnit 8 Principles of Biomedical Ethics6 What is informed consent and its application?(Pre.6)Text A Topics for presentationCritical reading and thinking Definition:the opportunity to choose what shall or shall not happe

24、n to them Application -A process rather than signing a written form -Adequate information as the premise -A well-informed decision as the expected resultUnit 8 Principles of Biomedical EthicsAssessment of Risks and Benefits Text A Topics for presentationCritical reading and thinking A careful arraya

25、l of relevant data Alternative ways of obtaining the benefits sought in the research -The assessment presents both an opportunity and a responsibility to gather systematic and comprehensive information about proposed research.Unit 8 Principles of Biomedical EthicsAssessment of Risks and Benefits Tex

26、t A Topics for presentationCritical reading and thinking For the investigator -A means to examine whether the proposed research is properly designed For a review committee -A method for determining whether the risks that will be presented to subjects are justified For prospective subjects -Assisting

27、 the determination whether or not to participate.Unit 8 Principles of Biomedical EthicsText A Topics for presentation7.What are the considerations involved in selection of human subjects in research?(Pre.7)Critical reading and thinking Requirement for consent as entailed by the principle of respect

28、for persons Risk/benefit assessment as entailed by the principle of beneficence More requirements of fairness as entailed by the principle of justice -At the individual level:fairness -At the social level:distinction between classesUnit 8 Principles of Biomedical EthicsText A Topics for presentation

29、7.What are the considerations involved in selection of human subjects in research?(Pre.7)Critical reading and thinkingMore requirements of fairness as entailed by the principle of justiceAt the individual level:fairness they should not offer potentially beneficial research only to some patients who

30、are in their favor or select only undesirable persons for risky research.At the social level:distinction between classes there is an order of preference in the selection of classes of subjects(e.g.,adults before children)and that some classes of potential subjects(e.g.,the institutionalized mentally

31、 infirm or prisoners)may be involved as research subjects,if at all,only on certain conditions.Unit 8 Principles of Biomedical EthicsText A Useful expressions Just as the principle of respect for persons finds expression in the requirements for consent,and the principle of beneficence in risk/benefi

32、t assessment,the principle of justice gives rise to moral requirements that there be fair procedures and outcomes in the selection of research subjects.Critical reading and thinkingUnit 8 Principles of Biomedical EthicsText A Difficult sentencesAlmost all commentators allow that distinctions based o

33、n experience,age,deprivation,competence,merit and position do sometimes constitute criteria justifying differential treatment for certain purposes.Critical reading and thinking几乎所有的评论员承认，出于特定目的，进行差异化对待的标准可以包括有无经验、年龄大小、是否贫困、有无能力、功过大小和地位高低等因素的差异。Unit 8 Principles of Biomedical Ethicshuman_(人体研究对象)_res

34、earch(生物医学研究)accepted _(公认的治疗)a formal _(正式方案)the principle of _(有利原则)the principle of _(公正原则)_ agents(有自主能力的行为者)_autonomy(自主性减弱)be _ risk of harm(使面临受害危险)Hippocratic_(希波克拉底誓言)fairness in _(分配的公正性)informed_(知情同意)fair _ and outcomes(公正的程序和结果）Text A Language Building-up Vocabulary Testsubject biomedic

35、al therapyprotocolbeneficencejusticeautonomousdiminishedexposed toUnit 8 Principles of Biomedical EthicsOathdistributionconsentproceduresText A Suggested answersTask 1 OverviewComplete the following diagram with the missing information about basic ethical principles.Critical reading and thinkingBasi

36、c Ethical Principlesprinciple of respect of personsprinciple of beneficenceprinciple of justiceA dilemma:involvement of prisoners as subjects of researchRequirement 1:acknowledgement of autonomyRequirement 2:protection of persons with diminished autonomy Rule 1:do no harmRule 2:maximization of possi

37、ble benefits&minimization of possible harmsConception 1:unjustifiable denial of benefit or unduly imposition of burdenConception 2:equal treatment of equalsan equal shareaccording to individual needaccording to individual effortaccording to societal contributionaccording to meritUnit 8 Principles of

38、 Biomedical EthicsText A Task 1/Medical terminology Match each definition with its corresponding English term and Chinese equivalent.EnglishChinese Definition1something established as a rule beforehand2of or relating to biology and medicine3tending to prevent disease4a person who performs or offers

39、to perform a service voluntarily5lack of justiceprescription处方，惯例生物医学的biomedical预防的preventivevolunteer志愿者injustice不公正Suggested answersLanguage building-up2Unit 8 Principles of Biomedical EthicsText A EnglishChinese Definition6weak in body,especially from old age or disease;feeble7of,characterized by

40、,based on,or constituting a system8a person who investigates9the act of doing good;kindness10independent in mind or judgment;self-directedbeneficence善意，仁慈，善行infirm虚弱的，体弱的systematic系统的investigator研究员autonomous自主的Task1/Medical terminologyMatch each definition with its corresponding English term and Ch

41、inese equivalent.Suggested answers2Language building-upUnit 8 Principles of Biomedical EthicsText A Task 2/Signpost language DefiningLanguage building-upSuggested answersDefinitions can serve different purposes:to introduce unfamiliar words,to coin new words,or to introduce a new meaning to a famili

42、ar word;to explain,illustrate,or disclose important aspects of difficult concepts;to reduce vagueness and eliminate ambiguity.Unit 8 Principles of Biomedical EthicsText A Task 2/Signpost language DefiningLanguage building-upSuggested answersThree most common forms of definition by example by synonym

43、,and analytical definition.Unit 8 Principles of Biomedical EthicsText A Task 2/Signpost language DefiningLanguage building-upSuggested answersSignals and clue words to indicate definitions By“”,I mean mean refer to describe be understood as designate be defined as be same asUnit 8 Principles of Biom

44、edical EthicsText A Task 2/Signpost language The following sentences are taken from Text A,and all the signpost languages indicating definition have been removed.Complete the sentences and then compare your answers with the original sentences in Text A.Language building-upSuggested answersFor the mo

45、st part,the term“practice”_ interventions that are designed to enhance the well-being of an individual patient or client and that have a reasonable expectation of success.(para.2)By contrast,the term“research”_ an activity designed to test a hypothesis,permit conclusions to be drawn,and thereby to d

46、evelop or contribute to generalizable knowledge.(para.2)The expression“basic ethical principles_ those general judgments that serve as a basic justification for the many particular ethical prescriptions and evaluations of human actions.(para.3)refers to refers todesignatesUnit 8 Principles of Biomed

47、ical EthicsText A Task 2/Signpost language The following sentences are taken from Text A,and all the signpost languages indicating definition have been removed.Complete the sentences and then compare your answers with the original sentences in Text A.Language building-upSuggested answersThe term“ben

48、eficence”_to cover acts of kindness or charity that go beyond strict obligation.(para.6)This is a question of justice,_ of“fairness in distribution”or“what is deserved”.(para.8)is often understoodin the senseUnit 8 Principles of Biomedical EthicsText A Task 3/Formal EnglishParaphrase the following s

49、entences from Text A with a less formal style.Language building-upSuggested answersThe distinction between research and practice is blurred partly because both often occur together.(para.1)2.Persons with diminished autonomy are entitled to protection.(para.4)People with reduced autonomy have the rig

50、ht for protection.Its hard to find the differences between research and practice partly because both often go along with each.Unit 8 Principles of Biomedical EthicsText A Task 3/Formal EnglishParaphrase the following sentences from Text A with a less formal style.Language building-upSuggested answer

51、s3.The involvement of prisoners as subjects of research provides an instructive example.(para.5)4.Whether to allow prisoners to“volunteer”or to“protect”them presents a dilemma.(para.5)It is a dilemma whether to allow prisoners to“volunteer”or to“protect”them.The use of prisoners as subjects of resea

52、rch is a good example.5.Another way of conceiving the principle of justice is that equals ought to be treated equally.(para.8)Another way to understand the principle of justice is that equal people ought to be treated equally.Unit 8 Principles of Biomedical Ethics Text A Additional activity Group pr

53、esentationMedical authority and patients autonomy have to be balanced in making medical decisions.Traditionally,doctors played a dominant role in decision making.However,in medical context today,respect for a patients autonomy is considered a fundamental ethical principle.Conduct a survey and find o

54、ut a case in which a patients autonomy is taken into consideration.The following prompts may be helpful to you.1.You may first briefly describe the case.2.Who made the medical decision?3.How did the doctor and the patient keep balance in medical decision making?4.Give your comments on the case.Unit

55、8 Principles of Biomedical EthicsText BCritical reading and thinkingLanguage building-upSuggested answersUnit 8 Principles of Biomedical EthicsText B Critical Reading and Thinking1.the case of Ladan and Laleh Bijani(P201)A Heartbreaking Story with Important Lessons to Learn From Laleh and Ladan -29-

56、year-old twin sisters joint at the head -Determined to be separated -Bleeding to death on the operating table -Buried in their home country,IranWrite down the information on the following topics.Then compare your answers with your partner.Unit 8 Principles of Biomedical EthicsText B Critical Reading

57、 and Thinking2.in defense of the decision to operate(P202)Separate lives over life itself Respect for the twins autonomy Individual identity:separate interest and career Successful precedents Write down the information on the following topics.Then compare your answers with your partner.Unit 8 Princi

58、ples of Biomedical EthicsText B Critical Reading and Thinking2.in defense of the decision to operate(P202)Knowledge of Subject Matter Write down the information on the following topics.Then compare your answers with your partner.doctors encountered unforeseen obstacles in rerouting blood flow in the

59、 heads of the sisters,who shared a major vein that drained blood from the brain.Unit 8 Principles of Biomedical EthicsText B Useful expressions opinion is divided as to whether to justify a risky and experimental procedure a pediatric neurosurgeon from Johns Hopkins At a press conference they were s

60、o determined to be separated that he felt compelled to try to help them adding,I was convinced they wouldCritical reading and thinkingUnit 8 Principles of Biomedical EthicsText B Useful expressions he had no regrets about at a later press conference back in the United States surgeons should have per

61、formed the operation differently in several stages over the course of weeks until the surgery was already under wayCritical reading and thinkingUnit 8 Principles of Biomedical EthicsText B Useful expressions the team considered halting the surgery They proposed this to the person the twins had chose

62、n to represent them,but the representative insisted that the sisters would want the separation to proceed no matter what,so the doctors pressed on.keeping the name confidential the womens adoptive and biological fathersCritical reading and thinkingUnit 8 Principles of Biomedical EthicsText B Critica

63、l Reading and Thinking3.in criticism of the decision to operate(P 202)Write down the information on the following topics.Then compare your answers with your partner.Advanced ageGreat risk with 50-50 odds of dyingTechnical uncertainty:joint at the headLack of justification of a risky and experimental

64、 procedure only out of a patients wishes Responsible judgment on the part of the surgeonUnit 8 Principles of Biomedical EthicsText B Useful expressions it violated ethical standards for experimental surgery and should not have been done.the 50 percent risk of death You need more than an autonomous c

65、hoice on the part of the patient.You need responsible judgment on the part of the surgeon.Critical reading and thinkingUnit 8 Principles of Biomedical EthicsText B Useful expressions to meet the psychological needs of the twins spoken about their desire to pursue separate interests and careers.on at

66、 least two occasions at the representatives request when their medical judgment seemed to suggest a different course.Critical reading and thinkingUnit 8 Principles of Biomedical EthicsText B Critical Reading and Thinking4.an alternative course suggested by Dr.Carson(P 202)Write down the information on the following topics.Then compare your answers with your partner.Rather than complete the operation all at once,the separation could have been tried in several stages over the course of weeksUnit 8