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 litgation and do whatever they’re asked to avoid getting in trouble. The real problem the author is concerned about in this article is ______.
A. the over treatment for dying patients
B. the different attitude of doctor and patients toward death
C. the disproportionately high medicare expenditure in America
D. the unequal and non-transparent doctor-patient relationship
Our daily existence is divided into two phases, as distinct as day and night. We call them work and play. We work many hours a day and we allow the necessary minimum for such activities as eating and shopping. 46) The rest we spend in various activities which are known as ecreations, an elegant word which disguises the fact that we usually do not even play in our hours of leisure, but spend them in various forms of passive enjoyment or entertainment.We need to make, therefore, a hard-and-fast distinction not only between work and play but, equally, between active play and passive entertainment. 47) It is, I suppose, the decline of active play--of amateur sport--and the enormous growth of purely receptive entertainment which have given rise to a sociological interest in the problem. If the greater part of the population, instead of indulging in sport, spend their hours of leisure "viewing" television programs, there will inevitably be a decline in health and physique. In addition, we have yet to trace the mental and moral consequences of prolonged diet of sentimental or sensational spectacles on the screen. 48) There is, if we are optimistic, the possibility that the diet is too thin and unnourishing to have much permanent effect on anybody. Nine films out of ten seem to leave absolutely no impression on the mind or imagination of those who have seen them.49) It is only when entertainment is active, participated in, practiced, that it can properly be called play, and as such it is a natural use of leisure. In that sense play stands in contrast to work, and is usually regarded as an activity that alternates with work.Work itself is not a single concept. We say quite generally that we work in order to make a living. Some of us work physically, tilling the land, minding the machines, digging the coal; others work mentally, keeping accounts, inventing machines, teaching and preaching, managing and governing. 50) There does not seem to be any factor common to all these diverse occupations, except that they consume our time, and leave us little leisure. 49) It is only when entertainment is active, participated in, practiced, that it can properly be called play, and as such it is a natural use of leisure.