【正文】 t realize that familiar substances such as alcohol and tobacco are also drugs. This is why the more neutral term substance is now used by many physicians and psychologists. The phrase substance abuse is often used instead of drug abuse to make clear that substances such as alcohol and tobacco can be just as harmfully misused as heroin and cocaine. We live in a society in which the medicinal and social use of substances (drugs) is pervasive: an aspirin to quiet a headache, some wine to be sociable, coffee to get going in the morning, a cigarette for the nerves. When do these socially acceptable and apparently constructive uses of a substance bee misuses? First of all, most substances taken in excess will produce negative effects such as poisoning or intense perceptual distortions. Repeated use of a substance can also lead to physical addiction or substance dependence. Dependence is marked first by an increased tolerance, with more and more of the substance required to produce the desired effect, and then by the appearance of unpleasant withdrawal symptoms when the substance is discontinued. Drugs (substances) that affect the central nervous system and alter perception, mood, and behavior are known as psychoactive substances. Psychoactive substances are monly grouped according to whether they are stimulants, depressants, or hallucinogens. Stimulants initially speed up or activate the central nervous system, whereas depressants slow it down. Hallucinogens have their primary effect on perception, distorting and altering it in a variety of ways including producing, hallucinations. These are the substances often called psychedelic (from the Greek word meaning mindmanifesting) because they seemed to radically alter one39。s medication is no longer justified by his intentions. 58. According to the NAS39。t call those deaths homicides because the doctors didn39。ll be appropriate for you to make a passing remark about the inedible canteen food or the chairman39。s LG Electronics in July.) Foreign made cars and textiles were sweeping into the domestic market. America39。s LG Electronics in July.) Foreign made cars and textiles were sweeping into the domestic market. America39。 convention, of a story which works well because the audience all shared the same view of doctors. A man arrives in heaven and is being shown around by St. Peter. He sees wonderful acmodations, beautiful gardens, sunny weather, and so on.. Everyone is very peaceful, polite and friendly until, waiting in a line for lunch, the new arrival is suddenly pushed aside by a man in a white coat, who rushes to the head of the line, grabs his food and stomps over to a table by himself. Who is that? the new arrival asked St. Peter. Oh, that39。s decisions on physicianassisted suicide carry important implications for how medicine seeks to relieve dying patients of pain and suffering. Although it ruled that there is no constitutional right to physicianassisted suicide, the Court in effect supported the medical principle of double effect, a centuriesold moral principle holding that an action having two effects — a good one that is intended and a harmful one that is foreseen — is permissible if the actor intends only the good effect. Doctors have used that principle in recent years to justify using high doses of morphine to control terminally ill patients39。s ruling on physicianassisted suicide, the National Academy of Science (NAS) released a twovolume report, Approaching Death: Improving Care at the End of Life. It identifies the undertreatment of pain and the aggressive use of ineffectual and forced medical procedures that may prolong and even dishonor the period of dying as the twin problems of endoflife care. The profession is taking steps to require young doctors to train in hospitals, to test knowledge of aggressive pain management therapies, to develop a Medicare billing code for hospitalbased care, and to develop new standards for assessing and treating pain at the end of life. Annas says lawyers can play a key role in insisting that these wellmeaning medical initiatives translate into better care. Large numbers of physicians seem unconcerned with the pain their patients are needlessly and predictably suffering, to the extent that it constitutes systematic patient abuse. He says medical licensing boards must make it clear ... that painful deaths are presumptively ones that are inpetently managed and should result in license suspension. 56. From the first three paragraphs, we learn that 中國最大的管 理 資料下載中心 (收集 \整理 . 大量免費(fèi)資源共享 ) 第 5 頁 共 20 頁 [A] doctors used to increase drug dosages to control their patients39。s pipelines. A few have already appeared. The goal of all will be to try to explain to a confused and often unenlightened citizenry that there are not two equally valid scientific theories for the origin and evolution of universe and life. Cosmology, geology, and biology have provided a consistent, unified, and constantly improving account of what happened. Scientific creationism, which is being pushed by some for equal time in the classrooms whenever the scientific accounts of evolution are given, is based on religion, not science. Virtually all scientists and the majority of nonfunda mentalist religious leaders have e to regard scientific creationism as bad science and bad religion. The first four chapters of Kitcher39。 we are geically programmed to disintegrate and perish, even under ideal conditions. We all understand that at some level, yet as medical consumers we treat death as a problem to be solved. Shielded by thirdparty payers from the cost of our care, we demand everything that can possibly be done for us, even if it39。s Evolution