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Unit 10
Medical Ethics
After-Class Reading
PASSAGE I Required Course: Bedside Manner 101[1]
Connie Cronin is the kind of nurse who loves to work the overnight shift on Christmas Eve to usher in the holiday with her patients. That's why she was so troubled one morning when she realized on her way home from work that she had all but ignored a patient ravaged with infections and confined to isolation.[2] Cronin was the only person the patient would see all night, but because she was also the only nurse on duty, she avoided his gaze in her rush to finish her tasks. The next evening she headed straight to his room only to learn that he had died. "I abandoned that man during his last hours on Earth," she says.
Virtually every health worker has a story of regret over care not given to a needy patient. Such events were once the exception, but today, caregivers say, they are becoming the rule.[3] One CEO of a large health and hospital system in Dallas, Texas, believes that doctors get pressure from all sides to reduce costs and it takes their focus off the patient. His opinion was echoed by other doctors, nurses and administrators, who attended the first national conference on "relationship-centered" care[4] in December 1998.
As the conference title suggests, most health professionals agree on the need for doctors and nurses alike to practice better bedside manners during increasingly short sessions with patients. Studies show that the more comfortable patients feel with a caregiver, the more likely they are to reveal key medical facts and to follow medical instructions. Yet, 6 out of 10 doctors surveyed said that medical school had poorly prepared them to talk with patients. Also 7 out of 10 doctors surveyed said that insufficient time with patients was a serious problem.
Still, health care workers can take a number of steps to improve their talks with patients, according to Aaron Lazare, Dean of the University of Massachusetts Medical School. For example, after asking, "What brings you here today? "a doctor; should try not to interrupt the patient's reply. A recent study showed that a doctor usually breaks in after just 18 seconds, but a patient who is allowed to speak freely will finish in two and a half minutes. A second key question, the Dean says, is, "What were you hoping I could do for you?" Doctors and nurses are often amazed by the answer. Patients want to be told that they don't have cancer. Other times they say, "Tell my wife not to leave me" or "Tell my boss I can't work."
A doctor's biggest mistake, researchers say, is intimidating patients into silence by tapping a pencil impatiently or keeping one hand on the exam room door handle. Dean Lazare says, "No visit should end without a doctor asking, 'Is there anything else you'd like to tell me?'" For their part, patients must speak up.[5] Many people suffer from what medical professionals call the "good-patient syndrome", a reluctance to take up a nurse's time or a fear that a complaint isn't worth mentioning. One thing that frustrates doctors is that a number of patients wait until they are halfway out the door to bring up their most urgent concern.
To prevent these problems, Dean Lazare and others are helping medical and nursing schools create a list of communication "competencies", such as helping a patient discuss worries and delivering bad news gently. A few schools now require future health professionals to take a course each year to practice with actors simulating difficult cases. Students are videotaped so that they can see themselves backing away from a prostitute, sighing as an elderly man talks on and on, or glaring angrily when challenged.[6] Soon students may conduct mock physicals[7] and be graded on bedside manner as part of medical licensing exams.
No matter what formal training is offered, nurses and doctors will always find their own ways of meeting a patient's needs. Connie Cronin set up a network of nurses who were willing to cover for one another when the need arose. Thanks to that system, she was able to spend 45 minutes with a dying cancer patient while the woman waited for her husband in the middle of the night. He didn't arrive in time, but the patient had Cronin there to hold her hand through her final breath[8].
Dr. Bernie Siegel, a surgeon at Yale Medical School, has developed his own way for relating to[9] his patients more effectively. He recently wrote a book called Love, Medicine, and Miracles, which tells of his life and experience in healing. In the 1970s he was a surgeon at Yale, had a wonderful wife and five beautiful children, but he was terribly unhappy. Like most doctors of his generation, he had been trained to keep an emotional distance from sick people and their families. He treated people's diseases and kept himself apart from their lives, but he was miserable behind the wall he had built between his patients and himself. He considered leaving medicine.
Then he decided that before he quit he would try a different way of doctoring. He would allow himself to care about the patients he was treating. Once he did this, he began to see that it was very strange to think of medicine as a profession where doctors stand apart from their patients. He knew that he had to deal with cancer but that cancers were growing inside of people. So he shaved his head, moved his desk against the wall, sat down by his patients, and asked them to call him by his first name, Bernie.
As Bernie, he now talks with his patients and tries to help them with their fears. One thing he tells everyone is that it is important to show appreciation to others. He often tells people to give a reminder of their love to their family that day-a note, flowers, a card, a hug, or just say it out loud because everyone in the family needs reminders. He recommends that his patient say "I love you" to someone that day, starting with the one to whom it is the hardest to say, and who often needs it" the most. He strongly believes that this "prescription" works well and has no side effects. It is helpful to the person who is ill as well as to those people who are not. Bernie is convinced that if people are to heal physically they must also heal emotionally.[10] When his cancer patients are undergoing unpleasant treatments such as chemotherapy, expressions of love help both them and those who are close to them. His patients believe him because he takes the time to show his love and concern to them. Not all doctors can become Bernie Siegel, but all can learn to become more caring. (1130 words)
Proper Names
Aaron Lazare
(男子名)艾伦.拉扎尔
Bernie Siegel
(男子名)伯尼.西格尔
Connie Cronin
(女子名)康妮.克罗宁
University of Massachusetts Medical School
马萨诸塞大学医学院
Yale Medical School
耶鲁大学医学院
New Words
bedside *
n. the area beside a bed 床边
e.g. I) She sat by her son's bedside all night, watching for signs of recovery.
II) I keep a bedside lamp on all night.
caregiver
n. someone who is responsible for looking after another person, especially one who is disabled, ill, or very young 照顾者
e.g. The role of caregiver in this society is often taken on by women.
CEO
n. chief executive officer 首席执行官
doctoring
n. treating someone who is sick 医治，治疗
mock
adj. not real or genuine, but similar to the real thing 非真实的，模拟的
e.g. I) The general wanted to conduct a mock battle to train the soldiers.
II) The film set is made from mock facades (门面) with no real buildings behind them.
prostitute
n. someone, usually a woman, who has sex with men for money 娼妓，妓女
ravage
v. destroy, ruin, or damage very badly 毁坏，使遭蹂躏
e.g. An incurable (不能治愈的) skin disease has ravaged his once-handsome face.
Phrases and Expressions
all but
almost 几乎，差不多
e.g. The game was all but over by the time we arrived.
back away from
move backwards away from someone in fear or dislike （由于恐惧或厌恶等）后退，躲开
e.g. I) James got to his feet and started to come over, but the girls hastily backed away.
II) The little boy backed away from the fierce dog.
break in
interrupt someone's conversation or activity 插嘴，打断
e.g. I) Please don't break in on our conversation.
II) As she was talking, he suddenly broke in, saying, "That's a lie."
bring up
introduce a particular subject into a discussion or conversation 谈到，提出
e.g. I) Don't bring up that old subject again.
II) I want to bring this matter up for a vote.
cover for
do the work that someone else usually does because they are ill or not present 代替，代......工作
e.g. She did not have enough nurses to cover for those who went ill or took holiday.
intimidate someone into (doing) something
frighten or threaten someone in order to make them do something against their wishes 恐吓某人做......，威胁某人做......
e.g. The shooter intimidated a witness into silence by pointing at him with a gun.
keep someone apart/away from
cause someone not to go near 使某人不靠近
e.g. Police warned bystanders to keep apart/away from the blazing buildings.
side effect
an unwanted effect which happens in addition to an intended effect 副作用
e.g. Reported side effects of this drug are heightened blood pressure and headaches.
speak up
state clearly and freely what one thinks 明确而坦率地说出想法
e.g. Those who are suffering from distress should speak up.
take up
fill or occupy the specified space or time 填满，占据（空间或时间）
e.g. I) Her time is fully taken up with writing.
II) The entire memo (备忘录) took up all of two pages.
thanks to
because of 由于，因为
e.g. Thanks to fine acting by all the cast (演员阵容), the play succeeded.
usher in
bring something into existence, introduce something new 迎接，宣告，开创
e.g. I) Children ushered in the First of June.
II) The new government ushered in a period of prosperity.
PASSAGE II Human Cloning, Don't just Say No!
That scientists have cloned a sheep sends academics[1] and the public into a panic at the prospect that humans might be next. That's an understandable reaction. Cloning is a radical challenge to the most fundamental laws of biology, so it's not unreasonable to be concerned that it might threaten human society and dignity. Yet much of the ethical opposition seems also to grow out of an unthinking disgust.[2] And that makes it hard for even trained scientists and ethicists to see the matter clearly. While human cloning might not offer great benefits to humanity[3], no one has yet made a persuasive case[4] that it would do any real harm, either.
Theologians contend that to clone a human would violate human dignity. That would surely be true if a cloned individual were treated as a lesser being,[5] with fewer rights or lower stature[6]. But why suppose that cloned persons wouldn't share the same rights and dignity as the rest of us? A leading ethicist has suggested that cloning would violate the "right to genetic identity"[7]. Where did he come up with such a right? It makes perfect sense to say that adult persons have a right not to be cloned without their voluntary, informed consent[8]. But if such consent is given, whose "right" to genetic identity would be violated?
Many of the science-fiction scenarios prompted by the prospect of human cloning turn out, upon reflection, to be absurdly improbable. There's the fear, for instance, that parents might clone a child to have "spare parts"[9] in case the original child needs an organ transplant. But parents of identical twins don't view one child as an organ farm[10] for the other. Why should cloned children's parents be any different?
Another disturbing thought is that cloning will lead to efforts to breed individuals with genetic qualities perceived as exceptional (math geniuses, basketball players). Such ideas are repulsive because of the atrocities committed by the Nazis in the name of eugenics. But there's a vast difference between "selective breeding" as practiced by totalitarian regimes (where the urge to produce certain types of people leads to efforts to eradicate other types) and the immeasurably more benign forms already practiced in democratic societies (where, say, lawyers freely choose to marry other lawyers).[11] Banks stocked with the frozen sperm of geniuses already exist. They haven't created a master race[12] because only a tiny number of women have wanted to impregnate themselves this way. Why would it be different if human cloning became available?
So who will likely take advantage of cloning? Perhaps a grieving couple whose child is dying. This might seem psychologically twisted. But a cloned child born to such dubious parents stands no greater or lesser chance of being loved, or rejected, or warped than a child normally conceived.[13] Infertile couples are also likely to seek out cloning. That such couples have other options (in vitro fertilization or adoption) is not an argument for denying them the right to clone.[14] Or consider an example raised by Judge Richard Posner: a couple in which the husband has some tragic genetic defect. Currently, if this couple wants a genetically related child, they have four not altogether pleasant[15] options. They can reproduce naturally and risk passing on the disease to the child. They can go to a sperm bank and take a chance on unknown genes. They can try in vitro fertilization and dispose of any afflicted embryo-though that might be objectionable, too. Or they can get a male relative of the father to donate sperm, if such a relative exists. This is one case where even people unnerved by cloning might see it[16] as not the worst option.
Even if human cloning offers no obvious benefits to humanity, why ban it? In a democratic society we don't usually pass laws outlawing something before there is actual or probable evidence of harm.[17] A moratorium on further research into human cloning might make sense, in order to consider calmly the grave questions it raises, If the moratorium is then lifted, human cloning should remain a research activity for an extended period[18]. And if it is ever attempted, it should-and no doubt will-take place only with careful scrutiny and layers of legal oversight. Most important, human cloning should be governed by the same laws that now protect human rights. A world not safe for cloned humans would be a world not safe for the rest of us. (740 words)
Proper Name
Richard Posner
(男子名)理查德.鲍斯奈
New Words
adoption *
n. the legal process where non-biological parents or a non-biological parent becomes the legal guardian of a child 收养，领养
e.g. I) The dying mother had to offer her child for adoption.
II) Adoption can provide homes for many children without parents.
atrocity
n. a very cruel, shocking action 暴行
e.g. The killing was cold-blooded, and those who committed this atrocity should be tried and punished.
breeding *
n. producing of young by animals 繁殖
e.g. April is the breeding season for this kind of deer.
clone
v. make an exact copy of a plant or animal by taking a cell from it and developing it artificially 无性繁殖，克隆
e.g. The idea of cloning extinct (灭绝的) life forms still belongs to science fiction.
cloning *
n. the act or process of producing an animal or plant from the cells of another animal or plant artificially 无性繁殖，克隆
disgust
1) n. a feeling of very strong dislike or disapproval 厌恶
e.g. The execution of political opponents aroused widespread disgust.
2) v. make someone feel a strong sense of dislike and disapproval 使厌恶
e.g. The candidate's dirty joke disgusted many voters.
eradicate
v. get rid of something completely 摆脱，消灭
e.g. We should take positive efforts to eradicate every trace of discrimination.
ethicist
n. someone who studies questions about what is morally right and wrong 伦理学家，道德学家
eugenics
n. the study of methods to improve the human race by carefully selecting parents who will produce the strongest children 优生学
extended *
adj. continued or prolonged 延长的，延续的
e.g. What I need is an extended vacation on a tropical island.
fertilization *
n. an act, process, or instance of making sperm join an egg so that a young baby or animal develops or joining particles of pollen so that a new plant develops 受精
immeasurably *
adv. infinitely, limitlessly 无法计量地，无限地
impregnate
v. make a woman or animal pregnant 使怀孕
infertile
adj.
1) unable to breed or reproduce, barren 不孕的
2) (of soil) of poor quality so that plants cannot grow in it 不肥沃的，贫瘠的
e.g. The polluted waste is often dumped, making the surrounding land infertile.
layer
n.
1) different levels or parts of something, such as a system or an idea, and the way they are added together or hide each other 层次，层面
e.g. The study looked at ways to eliminate the present layers of bureaucracy.
2) a thickness of some material laid on or spread over a surface 一层
e.g. I) A fine layer of dust covers everything in the room.
II) There was a thin layer of oil on the surface of the water.
moratorium
n. a stopping of an activity for a period of time 暂停（活动）
e.g. The House (议院) voted to impose a one-year moratorium on nuclear testing.
outlaw
v. make something illegal or unacceptable 禁止，取缔
e.g. Last week the government warned that it would consider legislation to outlaw smoking in public places.
oversight
n. the act of overseeing, supervision 监督，看管
e.g. The president entrusted (委托) him with the oversight of agricultural reform.
reproduce
v.
1) (of living things) produce offspring by natural means 生育，繁殖
e.g. I) Most plants reproduce by seeds.
II) Some creatures were better at surviving and reproducing themselves than others, so they thrived at the others' expense.
2) produce a copy of something or show or do something again 复制，重做
e.g. I) This copier (复印机) can reproduce color photographs.
II) The car design unfortunately reproduced some of the problems of the earlier model.
repulsive
adj. very unpleasant 令人厌恶的
e.g. I think rats and snakes are repulsive and disgusting.
scenario
n. a description of the characters, place, and things that will happen in a film, play, etc. 脚本，剧情说明
scrutiny
n. careful and thorough examination 详尽的查验
e.g. His work looks good, but it will not bear close scrutiny.
theologian
n. someone who studies the nature of God, religion, and religious beliefs 神学家，神学研究者
twisted *
adj. warped, strange in an unpleasant way 扭曲的
e.g. The letter showed horribly clearly the workings of a twisted mind.
unnerve *
v. worry or trouble someone 使紧张不安，使心慌意乱
e.g. His encounter with the guard dog had completely unnerved him.
vitro
used in "in vitro", meaning "happening outside the body in artificial conditions, often in a test tube" 在体外，在试管内
warp
v. have a bad effect on someone so that they think strangely about things 使（性格等）不正常，使乖戾
Phrases and Expressions
dispose of
1) get rid of 去除，舍弃
e.g. I) All the old furniture has been disposed of.
II) Engine oil cannot be disposed of down the drain.
2) deal with 处理，处置
e.g. You did us a great favor by the manner in which you disposed of that problem.
make sense
1) be sensible, be reasonable 合情合理，有道理，很明智
e.g. It doesn't make sense to buy that expensive coat when these cheaper ones are just as good.
2) have an understandable meaning 有意义，讲得通
e.g. What you say makes no sense.
pass on...to...
hand or give something to someone else 将......传递给另一人
e.g. Pass the book on to me when you have finished with it.
seek out
look for someone or something until you find them 搜寻，找出
e.g. Now is the time for local companies to seek out business opportunities in Europe.
stand a chance of doing...
be likely to do... 有可能
e.g. She didn't stand a chance of winning.
take a chance (on something)
attempt to do something in spite of the possibility of failure, take a risk 冒险，投机，碰运气
e.g. After a sleepless night, he decided to take a chance on opening his own company selling computer components.
PASSAGE III How the Gene Test Can Affect Your Insurance
Jamie Stephenson has seen first-hand what modern genetic science can do for a family. When her son David was 2 years old, a pediatrician noticed signs of mental retardation and developmental delays[1]. A lab test confirmed the diagnosis, and the Stephensons spent several years learning to live with it. When David was 6, he visited a neurologist, who scribbled "hereditary mental retardation" on an insurance-company claim form[2]. The company responded promptly-by canceling coverage[3] for the entire family of six. There is no medical treatment for his mental retardation, and none of David's siblings had been diagnosed with the condition. "The company didn't care," Stephenson says. "They just saw a positive[4] genetic test and said, 'You're out[5]'".
No one would argue that genetic tests are worthless. Used properly, they can give people unprecedented power over their lives. Prospective parents who discover they're silent carriers[6] of the gene for a disease like Tay-Sachs, which causes death by the age of 3, can make better-informed decisions about whether and how to have kids. Some genetic maladies can be managed through medication and lifestyle changes once they're identified. And while knowing that you're at special risk for cancer may be an emotional burden, it can also alert you to the need for intensive monitoring.
The catch[7] is that no one can guarantee the privacy of genetic information. Outside of large group plans[8], insurance companies often scour people's medical records before extending coverage. And though employers face some restrictions, virtually any company with a benefits program can get access to workers' health data. So can schools, adoption agencies and the military.
How often is genetic information used against people? No one knows, but there are signs that discrimination is fairly common. In one recent study, more than 200 instances were documented in which people experienced genetic discrimination. Many participants told of losing their health and life insurance. But that wasn't their only problem. One respondent was denied a job selling insurance after he disclosed that he had a hereditary disease that can be treated for about $ 1,200 a year. A social worker who had excelled during her first year at a Wisconsin healthcare company was quickly forced out after mentioning that her uncle had Huntington's, a brain disease that victims' offspring have a 50 percent chance of developing. A woman in the early stages of Huntington's disease was unable to place her child with a private adoption agency.[9] A public agency took the child, eventually matching her with a couple who had previously been rejected themselves[10]-because one partner carried the Huntington's gene. "It's a stark commentary on how society regards people at risk," they said.
Not surprisingly, people from high-risk families have come to fear tests almost as much as the disease. It is estimated that only 15 percent of the people with a Huntington's afflicted parent choose to learn their own status[11]. Discrimination isn't their only concern; virtually everyone testing positive for the Huntington's gene develops symptoms during middle age, and doctors can do nothing to help. But people who might benefit from genetic tests are almost as leery.[12] When researchers surveyed 279 people from families plagued by[13] lung cancer, only 43 percent wanted to have gene tests that might gauge their own susceptibility. Many said the prospect of discrimination scared them off.
Besides depriving people of potentially useful information, the fear of discrimination can hamper scientific progress. Barbara Weber, a geneticist, often asks those who learn they carry the Huntington's gene to take part in confidential follow-up studies[14]. She wants to know which strategies are most effective for preserving their health. "We have the tools to answer these questions," she says. "All they have to do s is tell us how they're doing every six months." Yet 75 percent of the people she approaches say no.
The federal government is now taking steps to make genetic information less threatening. A recently enacted health insurance act bars insurers from treating genetic mutations as "pre-existing conditions" unless they are causing illness. The act also guarantees coverage to anyone leaving one group plan for another, whatever his pre-existing conditions. That will make switching jobs easier for many people, but ethicists say the act is only a first step. Because it covers only group plans and doesn't deal with disability insurance, the act won't do much for people like Theresa Morelli, who applied for independent coverage several years ago. Morelli was 28 and in perfect health when she met with an insurance agent and paid her first premium[15]. A month later, she got her check back, along with a letter saying her application had been denied because her father had Huntington's disease. Morelli's father had in fact received that diagnosis-erroneously, it turned out-and her doctor had made a note of it in her chart.
The restrictions on employers are also full of holes[16]. A disabilities act bars companies from discrimination against people with disabilities-and it defines that term broadly enough to include genetic mutations that have yet to cause symptoms[17]. But the act does nothing to prevent employers from gathering medical information. As long as employers have access to genetic information, they'll have an irresistible incentive to use it.
Lawmakers are now racing to strengthen the protections. At least 15 states in the U. S. have recently placed restrictions on insurers or employers, and Congress will consider several bills in the new session[18]. The insurance industry argues that it should be free to charge people rates that reflect their risks, at least when dealing with individuals and small companies. But most ethicists contend that where health coverage is concerned, people shouldn't be penalized for risks they can't modify.
Discrimination isn't the only potential downside to genetic testing. Some of the new susceptibility tests can only vaguely predict illness-and no one forces the companies that offer them[19] to counsel patients about what the results actually mean. Even when the tests are sound and the results secure, the knowledge they create can dash hopes[20] and divide families. (1001 words)
Proper Names
Barbara Weber
(女子名)芭芭拉.韦伯
Jamie Stephenson
(女子名)杰米.斯蒂芬森
Theresa Morelli
(女子名)特里萨.莫雷里
New Words
alert
1) v. cause to be on guard, warn 使警觉，使警惕
e.g. The general manager alerted the staff to the crisis facing the company.
2) adj. paying full attention to things around you and able to deal with anything that might happen 警惕的，警觉的
e.g. We are very alert to the dangers of operating a nuclear power station.
carrier
n.
1) the bearer of a defective gene 带有缺陷基因的人
e.g. His mother must be a carrier of color-blindness.
2) a vehicle that is used for carrying people, especially soldiers, or things 运输工具
e.g. There were armored personnel carrier and tanks on the streets.
commentary
n.
1) anything serving to illustrate a point, prompt a realization, or exemplify 说明，写照
e.g. I) The dropout rate is a sad commentary on our school system.
II) His life was a fitting commentary on his teaching. 他的一生恰当地说明了他的教诲
2) a description of an event on radio or television while the event is taking place 实况报道
e.g. That program will include live commentary on the England-Ireland game.
developmental *
adj. relating to the development of someone or something 发育的，发展的
e.g. The first year is a vital period of developmental growth.
diagnosis
n. the discovery and identification of what is wrong with someone who is ill or with something that is not working properly 诊断
e.g. Symptoms may not appear for some weeks, so diagnosis can be difficult.
disclose
v. make something known 透露
e.g. I) Neither side would disclose details of the transaction.
II) The government disclosed that another diplomat has been arrested for spying.
downside
n. the negative aspect of something 消极面，负面
e.g. The downside of this approach is a lack of clear leadership.
enact
v. make a proposal into a law 制定（法律等），通过（法案等）
e.g. The authorities have failed so far to enact a law allowing unrestricted (无限制的) emigration.
gauge
v. appraise, estimate, or judge 估计，判定
e.g. I) It was difficult to gauge how people would respond to this policy.
II) His mood can be gauged by his reaction to the most trivial of incidents.
geneticist
n. a person who studies or specializes in genetics 遗传学家
healthcare
n. any field or enterprise concerned with supplying services, equipment, information, etc., for the maintenance or restoration of health 保健，保健事业
hereditary
adj. passed on to a child from its parents before it is born 遗传的
e.g. Cystic fibrosis (囊肿性纤维化) is the most common fatal hereditary disease.
high-risk
adj. involving a risk of death, injury, failure, etc. 高风险的
Huntington
n. (used in Huntington's chorea) a hereditary chorea, appearing in middle age, characterized by gradual deterioration of the brain and gradual loss of voluntary movement 遗传性慢性舞蹈病
insurer
n. a company that sells insurance 保险公司，承保方
lawmaker
n. a person who makes or enacts laws, legislator 立法者
leery
adj. cautious and suspicious about something and tending to avoid it 猜疑的，有戒心的
e.g. They were leery about investing in a company controlled by a single individual.
lung
n. either of the two organs in the chest with which people and some animals breathe 肺
e.g. I) She breathed deeply to fill her lungs with the fresh sea air.
II) Smoking causes lung cancer.
malady
n. an illness or disease 病，疾病（通常做比喻）
e.g. I) All the rose bushes seem to be suffering from the same mysterious malady.
II) Violent crime is only one of the maladies afflicting modern society.
mutation
n. a change in the genetic structure of an animal or plant that makes it different from others of the same type 基因突变
e.g. It is well-known that radiation can cause mutations.
offspring
n. (both singular and plural) someone's child or children 子女，后代
e.g. How do parents pass genes on to their offspring?
penalize
v. treat someone unfairly or make them have a disadvantage 对待......不公平，使处于不利地位
e.g. They thought it was unfair that some people who served on juries were penalized by not being paid by the employer.
pre-existing
adj. that exists beforehand 先存在的，先发生的
retardation
n. slowness or limitation in intellectual understanding and awareness, emotional development, academic progress, etc. 智力迟钝，精神发育迟缓
e.g. The principles of care for people with mental retardation have undergone radical changes over the past 20 years.
scour
v. search very carefully and thoroughly through an area, a document, etc. 仔细搜索
e.g. We scoured the room for clues regarding the identity of the burglar.
stark
adj. unpleasantly clear, harsh 严酷的，赤裸裸的
e.g. The stark reality is that we are operating at a huge loss.
Tay-Sachs
n. (used in Tay-Sachs disease) a degenerative brain disorder caused by lack of or deficiency in an essential enzyme, usually resulting in mental and physical deterioration and death in early childhood 家族性黑蒙性白痴症
unprecedented
adj. never before known or experienced, unparalleled 前所未有的，绝无仅有的
e.g. This century has witnessed environmental destruction on an unprecedented scale.
worthless
adj. having no value or usefulness 无价值的，没用的
e.g. The goods are often worthless by the time they arrive.
Phrases and Expressions
alert someone to something
make someone aware of something, especially a dangerous or unpleasant situation 使......警觉，使......警惕
e.g. An anonymous letter alerted police to the possibility of a terrorist attack at the airport.
at risk
threatened by the possibility of loss, failure, etc., in danger 有危险的，危机四伏的
e.g. I) A young woman out alone at night is at risk.
II) His job is at risk, that is, he may be made redundant (被解雇的).
bar someone from (doing) something
prevent someone from doing or using something 阻止......做......,排斥......
e.g. I) She was barred from (entering) the competition because of her age.
II) The incident led to him being barred from playing for England.
deprive someone of something
take something away from someone, prevent someone from enjoying or using something 剥夺某人某物
e.g. As a punishment, the naughty boy was temporarily deprived of his friends' company.
live with...
accept or tolerate something 接受，容忍
e.g. I'm sorry your tooth is hurting but you'll just have to live with it until we get you to the dentist.
outside of
except for, apart from 除了......之外
e.g. I) Outside of us three, no one knows anything about the problem.
II) Outside of strawberries (草莓), I have no allergies (强烈反感).
scare someone off
make someone leave, stay away, etc. by frightening or alarming them 将......吓跑
e.g. I) He scared people off by being so rude.
II) The high price is scaring off possible buyers.
take steps to do something
take a series of actions in order to achieve a desired result 采取行动以达到某目的
e.g. I) The government is taking steps to control the rising crime rate.
II) She is not content with her present lot (命运) and wishes to take steps to improve it.
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