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  3. [A]So what do we do to be safer? Many smart people have tackled this question. Peter Pronovost at Johns Hopkins developed a chec

[A]So what do we do to be safer? Many smart people have tackled this question. Peter Pronovost at Johns Hopkins developed a chec

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问题 [A]So what do we do to be safer? Many smart people have tackled this question. Peter Pronovost at Johns Hopkins developed a checklist shown to bring hospital-acquired infections down to close to zero. There are rules against disturbing nurses while they dispense medications and software that warns doctors when patients’ prescriptions will interact badly. There are policies designed to empower nurses to confront doctors if they see something wrong, even if a senior doctor is at fault.
[B]Here’s one theory. It is a given that American doctors perform a staggering number of tests and procedures, far more than in other industrialized nations, and far more than we used to. Since 1996, the percentage of doctor visits leading to at least five drugs being prescribed has nearly tripled, and the number of M. R. I. scans quadrupled.
[C]Doctors make mistakes. They may be mistakes of technique, judgment, ignorance or even, sometimes, recklessness. Regardless of the cause, each time a mistake happens, a patient may suffer. We fail to uphold our profession’ s basic oath: " First, do no harm. "
[D]Herein lies a stunning irony. Defensive medicine is rooted in the goal of avoiding mistakes. But each additional procedure or test, no matter how cautiously performed, injects a fresh possibility of error. CT and M. R. I. scans can lead to false positives and unnecessary operations, which carry the risk of complications like infections and bleeding. The more medications patients are prescribed, the more likely they are to accidentally overdose or suffer an allergic reaction.
[E]According to a 1999 report by the Institute of Medicine, as many as 98,000 Americans were dying every year because of medical mistakes. Today, exact figures are hard to come by because states don’ t abide by the same reporting guidelines, and few cases gain as much attention as that of Rory Staunton, the 12-year-old boy who died of septic shock this spring after being sent home from a New York hospital. But a reasonable estimate is that medical mistakes now kill around 200,000 Americans every year. That would make them one of the leading causes of death in the United States. Why have these mistakes been so hard to prevent?
[F]What may be even more important is remembering the limits of our power. More—more procedures, more testing, more treatment—is not always better. In 1979, Stephen Bergman, under the pen name Dr. Samuel Shem, published rules for hospitals in his caustically humorous novel, The House of God. Rule No. 13 reads: "The delivery of medical care is to do as much nothing as possible. " First, do no harm.
[G]Certainly many procedures, tests and prescriptions are based on legitimate need. But many are not. In a recent anonymous survey, orthopedic surgeons said 24 percent of the tests they ordered were medically unnecessary. This kind of treatment is a form of defensive medicine, meant less to protect the patient than to protect the doctor or hospital against potential lawsuits.
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【C4】
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答案D
解析 紧接着[G]段提到的“预防性医疗”这个概念，[D]段继续讨论。Herein lies astunning irony．Defensive medicine is rooted in the goal of avoiding mistakes．这两句话是明显的过渡性语句。预防性医疗的目的旨在避免错误的发生。但是每进行一项多余的检测或治疗，无论医疗过程是多么的小心谨慎，都无法避免错误发生的可能。
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