问题 单项选择题

知情同意原则是指临床医师在为病人作出诊断和治疗方案后,必须向病人提供包括诊断方案的性质、作用、一句、损伤、风险、不可预测的意外及其他可供选择的诊疗方案及其利弊等信息,是病人或家属经深思熟虑自主作出选择,并以相应方式表达其接受或拒绝此种诊疗方案的意愿和承诺;在得到患方明确承诺后,才可最终确定和实施由其确认的诊治方案。 根据上述定义,下列违反了知情同意原则的是:

A.医生向白血病患儿的家属交代了骨髓移植手术的作用、风险、预后及花费等情况,家属在讨论后,决定在手术同意书上签字 

B.医生向患者交代了目前患者可以选择的两种治疗方案,但患者和家属由于文化水平低,并未听懂,因此让医生替他们做决定 

C.医生向患者进行检查前,医生将检查的用处以及可能存在的风险向患者告知,患者表示清楚,但非常关心检查的费用是否报销,在得知是自费检查时,拒绝了该项检查 

D.某患者在化疗前,医生提供了两种可供选择的方案,一种为效果较好但昂贵的进口药,一种是效果稍差但便宜的国产药,家属和患者的意见不一致,请医生帮他们拿主意,在医生的耐心解释下,患者与家属终于达成了共识

答案

参考答案:B

解析:解析 第一步:抓住定义中的关键词,“使病人或家属经深思熟虑自主作出选择”。 第二步:逐一判断选项: B项:患者和家属因文化水平低未能听懂医生的交代而让医生替他们做决定不符合题干中医生在为病人诊断和治疗方案后必须向病人讲解清楚后病人或家属做出选择。 A项:符合定义中病人了解详情后自己做出选择。 C项:符合定义中病人了解详情后自己做出选择。 D项:医生并没有帮患者拿主意,而是在医生的耐心解释下,或者与家属终于达成了共识。 因此,正确答案是B。 考点:单定义判断

单项选择题

It is no longer just dirty blue-collar jobs in manufacturing that are being sucked offshore but also white-collar service jobs, which used to be considered safe from foreign competition. Telecoms charges have tumbled, allowing workers in far-flung locations to be connected cheaply to customers in the developed world. This has made it possible to offshore services that were once non-tradable. Morgan Stanley’s Mr. Roach has been drawing attention to the fact that the "global labour arbitrage" is moving rapidly to the better kinds of jobs. It is no longer just basic data processing and call centres that are being outsourced to low-wage countries, but also software programming, medical diagnostics, engineering design, law, accounting, finance and business consulting. These can now be delivered electronically from anywhere in the world, exposing skilled white-collar workers to greater competition.
The standard retort to such arguments is that outsourcing abroad is too small to matter much. So far fewer than lm American service-sector jobs have been lost to off-shoring. Forrester Research forecasts that by 2015 a total of 3.4m jobs in services will have moved abroad, but that is tiny compared with the 30m jobs destroyed and created in America every year. The trouble is that such studies allow only for the sorts of jobs that are already being off-shored, when in reality the proportion of jobs that can be moved will rise as IT advances and education improves in emerging economies.

Which of the following could be the best title for the text
[A] Business consulting.
[B] Blue-collar jobs.
[C] Non-tradable services.
[D] White-collar blues.


Alan Blinder, an economist at Princeton University, believes that most economists are underestimating the disruptive effects of off-shoring, and that in future two to three times as many service jobs will be susceptible to off-shoring as in manufacturing. This would imply that at least 30% of all jobs might be at risk. In practice the number of jobs off-shored to China or India is likely to remain fairly modest. Even so, the mere threat that they could be shifted will depress wages.
Moreover, says Mr. Blinder, education offers no protection. Highly skilled accountants, radiologists or computer programmers now have to compete with electronically delivered competition from abroad, whereas humble taxi drivers, janitors and crane operators remain safe from off-shoring. This may help to explain why the real median wage of American graduates has fallen by 6% since 9000, a bigger decline than in average wages.
In the 1980s and early 1990s, the pay gap between low-paid, low-skilled workers and high-paid, high-skilled Workers widened significantly. But since then, according to a study by David Autor, Lawrence Katz and Melissa Kearney, in America, Britain and Germany workers at the bottom as well as at the top have done better than those in the middle-income group. Office cleaning cannot be done by workers in India. It is the easily standardised skilled jobs in the middle, such as accounting, that are now being squeezed hardest. A study by Bradford Jensen and Lori Kletzer, at the Institute for International Economics in Washington D. C., confirms that workers in tradable services that are exposed to foreign competition tend to be more skilled than workers in non-tradable services and tradable manufacturing industries.

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