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Assisted dying
A medical student has made some language notes on a journal article.
| A 53-year old woman with incurable muscular dystrophy flew to Switzerland to end her life. Assisted dying is legal in Switzerland, but illegal in the UK. Opponents of euthanasia, or “mercy killing”, argue that legalization would lead to abuse and call for doctors who participate to be struck off. What Britain needs, they claim, is better palliative care and morehospices for the terminally ill to allow such patients to die with dignity. This follows a recent US case where the husband of a woman who had been in a persistent vegetative state for 16 years was successful in having artificial feeding withdrawn in spite of opposition from his wife's parents. | struck off =removed from the GMC registerand banned from practicing medicine in the UK palliative care =treatmentto relieverather than cure symptoms hospice =facility providing care for terminally ill patients terminally ill =not expected life persistent vegetative state =unable to speak or follow simple commands; does not respond in any psychologically meaningful way palliative –паллиативный,уменьшающий тяжесть симптомов без излечения основного заболевания |
Exercises:
1. Which GM guidelines in A breached in each these cases?
a.A GP falls asleep regularly during consultations. His colleagues do not nothing.
b.A doctor knows that a patient has a mental disease. She informs a friend whose daughter has just become engaged to this man.
c.A doctor attempts to dissuade a patient from having an abortion as this procedure is against his religious beliefs.
d.A doctor refers a patient to a medical textbook for an explanation of his pancreatic cancer.
e.A doctor fails to complete the number of days of professional development training advised annually.
f.A doctor tells a seriously overweight patient who has ignored his advice to diet that she deserves any ill effects that might result from her obecity.
2. Match each headline an opening line from a newspaper report.
| 1. 66-year-od becomes oldest mother |
| 2. Frozen embryo case to go to Europe |
| 3. Surrogate mother sued by couple |
| 4. Embryo cloning – where will it take us? |
| 5. Using body parts without consent |
| 6. Designer baby's rules are relaxed |
| 7. Doctors back infant mercy killing |
a.A woman of 30 who agreed to bear a child for a childless couple then refused to part with the child has been…
b.A surgeon has been accused of removing organs from patients without their knowledge…
c.Three-quarters of Belgian doctors are willing to assist in the death of critically ill babies to end their suffering.
d.A woman hoping to stop the destruction of six embryos. Launched a case at the European Court of Human Rights….
e.A woman has given birth in Romania following IVF treatment.
f.If your favorite pet dies, is it technically possible to produce exact replicas – but what about humans?
g.It is now legal to select embryos to provide blood cell transplants for sick siblings.
attempt –попытка
to dissuade –разубедить
obesity -полнота
to refuse –отказаться
to refer –отсылать
explanation -объяснение
annually –ежегодно
to deserve –заслуживать
to accuse –обвинять
to launch a case –подать в суд
exact replica -точная копия
siblings –братья и сестры
Unit 21 Research Studies 
Case-control studies
Here are some extracts from a medical textbook.
In a case-control study,a group of people suffering from a disease (the cases)is compared with a group whodo not have thedisease, but are similar in other ways (the controls). The two groups, theparticipants in thestudy, are compared to see if they were exposedto a possible risk factoror not. A risk factoris something which may contribute to the cause of disease. This type of study is often used as a first stepin identifying the cause of a disease.
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Cohort studies
In a cohort study, a group (cohort) of people (subjects) who are similar is studied over a period of years (a longitudinal study) to determine if there is a relationship between exposure to a risk factor and development of a disease. At the beginning of a prospective study, none of the subjects has the disease. They are followed up for a number of years, and at the end of the period, those who have developed the disease are compared with those who have not. In a retrospectivestudy, the researchers look back, by studying hospital records for example, at what has happened in the past, comparing subjects who have developed the disease with those who have not. In a cohort study and in a case-control study the subjects are only observed and there is no intervention such as drug treatment or surgery. A cohort study is a more reliable method of identifying the cause of disease than a case-control study. But for proof of cause, a trial is needed.
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Trials
In atrial, a group of people who are suffering from a disease are given a particular treatment. To determine the effectiveness of the treatment, a controlled trial is performed. Two groups are studied: one group (the study group) is given the treatment and the other (the control group) is not. The controls may be given a placebo - something which seems to be identical to the treatment but which has no effect. If there is an equal possibility that patients may be selected for the study group or for the controls, the trial is said to be randomized. A randomized controlled trial makes bias - error in a study which influences the results - less likely. An additional way of removing bias is blinding: patients do not know if they are receiving the treatment or the placebo. If, in addition, the researchers do not know who is receiving the treatment, the trial is a double blind trial. Randomized controlled trials are used to test treatments or preventive measures.
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Variables
If the subjects in a study are all aged 50, then age is a constant in the study. If their ages range from 20 to 70, then age is a variable. A confounding variable is any variable which is associated with both the disease and the risk factor being studied (for example, smoking in the case of cooks and lung cancer). If such variables exist there is no way for the researcher to know whether the difference in the risk factor or the confounding variable is the one that is truly causing the disease.
trial (перен.) –эксперимент
bias – отклонение, пристрастие, предубеждение
confounding – смешанный
cohort – когорта – группа людей, являющаяся объектом эпидемиологического исследования
Exercises:
1. Complete the table.
| Noun | Verb |
| bias | |
| control | |
| exposure | |
| (person) | participate |
| intervene | |
| study |
2. Complete the sentences.
1. People who are not receiving the experimental treatment, but who are otherwise the same as those receiving it are ……………
2. A trial in which neither the subjects nor the researchers know who is receiving the treatment is a ……………-…………… trial.
3. A study that follows the participants over many years is a …………… study.
4. A …………… is a group of people with similar characteristics.
5. Allocation to groups is …………… if all participants have equal chance of being in either group.
6. A harmless substance given to some participants to test the effect of a trial substance is a ……………
7. Something that might be a part of the cause of a disease is a ………… factor.
8. Something that might cause confusion about the cause of a disease is a ……………. variable.
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