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  3. Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore t

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore t

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问题     Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’ t spend much on him.
    It’ s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’ s unusual about them is not how much treatment they get compared to most Americans, but how little. Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. Almost all medical professionals have seen what we call "futile care" being performed on people. That’ s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, "Promise me if you find me like this that you’ll kill me. "
    How has it come to this—that doctors administer so much care that they wouldn’ t want for themselves? The simple, or not-so-simple, answer is this: patients, doctors, and the system.
    To see how patients play a role, imagine a scenario in which someone has lost consciousness and been admitted to an emergency room, and shocked and scared family members find themselves caught up in a maze of choices. When doctors ask if they want "everything" done, they answer yes. Then the nightmare begins. Feeding into the problem are unrealistic expectations of what doctors can accomplish. For example, many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor.
    But of course it’ s not just patients making these things happen. Doctors play an enabling role, too. The trouble is that even doctors who hate to administer futile care must find a way to address the wishes of patients and families. Imagine, once again, the emergency room with those grieving family members. They do not know the doctor. Establishing trust and confidence under such circumstances is a very delicate thing. People are prepared to think the doctor is acting out of base motives, trying to save time, or money, or effort, especially if the doctor is advising against further treatment.
    It’ s easy to find fault with both doctors and patients in such stories, but in many ways all the parties are simply victims of a larger system that encourages excessive treatment. In some unfortunate cases, doctors use the fee-for-service model to do everything they can, no matter how pointless, to make money. More commonly, though, doctors are fearful of litigation and do whatever they’ re asked to avoid getting in trouble.
In the passages that follows the last paragraph in the excerpt, the author is most likely to
选项 A、discuss the way to overcome the problem of overtreating in medicare system
B、suggest the patients to adjust their expectation on medical treatment
C、appeal to doctors to adhere strictly to their moral grounds
D、urge relevant department to issues policies to reform American medicare system
答案A
解析 作者在开篇引入话题之后，从第三段到第六段都在分析过度医疗产生的原因，那么自然而然地，在下文中就应该探讨针对上面论述的原因应该采取哪些有针对性的手段来遏止过度医疗。[A]为正确答案。[B]、[C]、[D]实际上涉及了遏制过度医疗的某个方面，但不是内涵最完整的答案。
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