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A.From cancer to Alzheimer's ( 早老性痴呆病 ) to diabetes, advances in genetic sciencemean that many of us are soon going to know--or at least have the option to know--more about our risks for a wide range of illnesses than we'd ever thought possible.On the surface, that sounds like a good thing, and it is in many respects. But whileknowledge may be power, genetic testing also brings with it tremendous physical andpsychological collapse.
B.In the past two decades, the number of genetic tests available has jumped from a fewhundred to nearly 3,000. Rebecca Nagy, president of the National Society of GeneticCounselors (NSGC), recalls that when she entered the field 15 years ago, it took ayear to get the results of a BRCA ( 乳癌) test. Today, you get them back in a week ortwo.
C.As the cost of testing declines, says Lawrence Brody, an investigator with the NationalInstitutes of Human Genome ( 基因组) Research Institute. Medicine is movingtoward "multiplex testing for lots of things at once". We're at the point, he explains,where sequencing a person's entire exome 外显子组) can be done for somewherein the neighborhood of $1,000." Whereas before it would have been really bizarre tohave someone's entire genome sequenced because it cost about the same as the GDPof several small countries. With exome sequencing, a patient may go in with questionsabout his prostate ( 前列腺 ) and come out with a report showing increased risks foreverything from bloodclots ( 凝块 ) to kidney disease.
D. Such data points are known as "incidental findings", and they are at the heart of thehottest ethical debate now prevailing in the field, says Nagy. "What results do youdisclose to someone and what results do you withhold? And do you give patients
that choice?" One commonly cited example: what happens when a toddler'sexome is sequenced to determine the cause of a developmental delay and the labdiscovers that the child has the BRCA1 mutation ( 变异 ) ? Should the lab withholdthat information?
E. Nagy explains that "a basic principle of genetics is that patients should haveautonomy"--meaning the right to choose what they do and do not want to know.But the American College of Medical Genetics and Genomics issued a statementcontending that, in the case of certain specific harmful and active genes, doctors havean ethical obligation to alert patients to the discovered risks. Balancing this "duty towarn" with an individual's right to autonomy is tricky enough on its own. But thereare other complicating factors to consider. What if disorders are likely to impact otherfamily members? And what about all the mutations that will pop up but that we don'tyet understand? "The menu is probably more vast in terms of what you can look atthan people are prepared for, and the results will contain more uncertainty than peopleare prepared for."
F.Social worker Katie Berry has a front-row view of all the issues that this new medicallandscape is raising. Through Columbia Presbyterian Hospital in New York, Berrycounsels men and women at high risk for Huntington's ( 亨廷顿症) , an inherited
neurodegenerative disorder ( 退行性神经紊乱 ) that typically appears in midlifewith some brutal combination of physical, cognitive, and psychiatric decline. A personwith the Huntington's gene can expect to get sick at some point down the road. Thereis no cure and, unlike with breast cancer, no preventive measures beyond maximizinggeneral health with the aim of delaying onset.
G. Berry works solely with individuals not yet experiencing symptoms. Some havealready been gene-tested. Others know that the disease runs in their family andare hesitating about whether to get tested--and when. With no preventive optionsavailable for Huntington's, the question of when to test is often dictated by loomingdecisions about marriage or parenthood. Most of the patients who come to Berry arein their 30s or early 40s. "People who are in their teens and early 20s tend not to bethinking about these things," she explains. "There's a level of denial in very youngadults."
H. But as people start pairing up and settling down, the stakes of not knowing get higher.(People with the Huntington's gene have a 50 percent chance of passing it to a child.)"They know there is this sword of Damocles hanging over their heads," says Berry.But until the test is done, they can cling to the hope that they escaped the geneticbullet. "They think, 'It's possible I'll never get it. It's possible I can continue to livethe life I'm living now,'" she says. "Knowing creates a whole other reality--a hugelydifferent reality."
I.Indeed, the news that one's genome contains a potential time bomb presentsnumerous, extremely painful psychological hurdles. Breaking the news to family canbe a particularly rough part of the process, and not simply because of the heartbreakit brings loved ones. Learning that a family member has a particular mutation can suddenly force brothers and sisters, children and parents to confront unsettling questions about their own genes--questions that many people would prefer not tohave raised at all.
J. To facilitate sharing, medical facilities are increasingly providing aid and guidance. Visvanathan's clinic invites patients to have family come in and talk with the staff. "Wetry to take some of that burden," she explains. Hospitals at places like GeorgetownUniversity and the University of Pennsylvania often provide patients with lettertemplates tailored specifically toward informing family.
K. Then there's the long-term challenge of living with a genetic ghost hiding in thebackground. At times, the anxiety can cause great damage, says Berry. "People talkfrequently about how they go through periods--and I suspect it's true of anyone whofaces a chronic illness or potentially fatal disease--periods that last days, weeks,months, or even years when there's a hyper-alertness about the body." Every twitch,twinge, or tickle spurs a raw terror that the illness has begun to take hold. "Peoplesay they're convinced they have the disease even though there's nothing obviouslysymptomatic about them," Berry says.
L. For the medical community, addressing these challenges will mean changing medical-school curricula and investing in continuing education. "It means us going out tophysicians' offices and helping them understand when it's appropriate to refer aperson to a genetic counselor," Nagy says. "It's making them feel comfortable that,once referred, their patients will come back to them for ongoing care."
M.Much more broadly, the general public is increasingly going to need a grasp ofgenetic basics to better manage their health, says Visvanathan. "Maybe the geneticaspects of health need to be brought into schools," she says. "Informing people at ayoung age would be helpful." Where and when this education should take place is,in fact, already under discussion. "I was at a conference last year in Boston wherepeople were talking about how to educate elementary school kids," Nagy recalls.
N. Equally important, there will be a need for more organizations to do the simple workof linking those facing similarly cloudy futures to one another. Having a supportnetwork of others who understand the fears, thoughts, medical peculiarities, andeven the language of your disorder makes a huge difference, says Berry. "You see apositive effect when people realize that they are not journeying alone." In some cases,just having a regular chance to vent provides a measure of relief. "We have heardfrom patients that they love the support group because it allows them to gather all thatnegative energy, worry, and anxiety and spew it out in a one- or two-hour period," shesays. "Then the rest of the month they don't have to think about it so much." But theanxiety never fades entirely, says Berry. "It's always present, always niggling."
O.Such is the burden of knowledge--and, more specifically, foreknowledge. It is aburden more and more of us are going to have to decide whether to assume and onethat our medical system is just beginning to learn how to help us shoulder. "Thisreally is a slightly different pattern for medicine," says Brody. "It's going to take a lotof work."

1.[选词填空]According to Lawrence Brody, people can do tests with various complicated items atonce in hospitals now since it costs much less to do them.
    • 解题思路:题干意为,根据劳伦斯·布罗迪的看法,由于现在做测试的花销大大降低,人们能够在医院里即刻完成对多项复杂内容的检测。根据题干中的关键词Lawrence Brody可定位到C段。该段首句提到,劳伦斯·布罗迪认为随着测试成本的下降,医学界正在朝着“即刻完成众多项目的复杂检测”的方向发展。由此可知,题干是对原文的同义转述,故选C。
    2.[选词填空]We have to be aware of the negative effect of genetic testing, which may do harm toour body and mind.
      • 解题思路:题干意为,加拿大时时彩技巧需要注意到基因测试的负面作用,这种测试可能会对加拿大时时彩技巧的身体和心理造成伤害。根据题干中的关键词body and mind可定位到A段。该段末句提到,虽然知识或许就是力量,但是基因测试也会给加拿大时时彩技巧的身心带来崩溃性的后果。由此可知,题干是对原文的同义转述,故选A。
      3.[选词填空]

      Visvanathan suggests educating students about the basic knowledge of genes in orderto better manage their health.

        • 解题思路:题干意为,维斯瓦纳坦建议教育学生掌握基因基础知识以便促进他们更好地管理自己的健康。根据题干中的关键词Visvanathan可定位到M段。该段第二、三句提到,维斯瓦纳坦认为也许基因方面的健康知识需要被引入学校,在人们年轻的时候就了解此事是有好处的。由此可知,题干是对原文的同义转述,故选M。
        4.[选词填空]People with potential threat of Huntington's often won't decide to have a gene testuntil a decision has to be made on whether to get married or have a baby.
          • 解题思路:题干意为,有亨廷顿症潜在危险的人经常是在不得不做出结婚或生子的决定时才会想去做基因检测。根据题干中的关键词Huntington’s可定位到G段。该段第四句提到,亨廷顿症没有预防性的措施,人们往往拖到必须决定是否结婚或生子时才会决定做基因检测。由此可知,题干是对原文的同义转述,故选G。
          5.[选词填空]It will be good for people with genetic problems to find ways to release their pressure.
            • 解题思路:题干意为,有基因问题的人寻找方法来减轻压力会对他们有好处。根据题干中的关键词pressure可定位到N段。该段第四句提到,在某些情况下,找个正常的渠道发泄也是一种缓解措施。由此可知,题干是对原文的同义转述,故选N。
            6.[选词填空]People need courage to live with the fact of having a genetic problem for a longperiod and sometimes they become anxious.
              • 解题思路:题干意为,人们需要勇气长久地面对有基因问题这个事实,有时他们会变得焦虑不安。根据题干中的关键词anxious可定位到K段。该段第一句和第二句提到,和潜伏在身边的遗传幽灵一起生活是个长期的挑战。有时这种焦虑会带来巨大的伤害。由此可知,题干是对原文的同义转述,故选K。
              7.[选词填空]Usually when a family member is diagnosed with gene problem, other members notonly feel sad but also worry about themselves.
                • 解题思路:题干意为,通常当某个家庭成员被诊断出有基因问题时,其他成员不仅感到难过,而且也担心自己。根据题干中的关键词family和member可定位到I段。该段第二、三句提到,向家人告知某个家庭成员有基因问题的过程尤为困难。家人不仅为该成员感到伤心,而且该家庭成员的兄弟姐妹、子女及父母都得面对对自身基因产生某种特定突变的质疑。由此可知,题干是对原文的同义转述,故选I。
                8.[选词填空]The American College of Medical Genetics and Genomics advocates informingpatients with certain gene problems of potential risks.
                  • 解题思路:题干意为,美国医学遗传学和基因组学研究院主张告知基因有某些问题的病人他们面临的潜在危险。根据题干中的关键词American College of Medical Genetics andGenomics可定位到E段。该段第二句提到,美国医学遗传学和基因组学研究院声明称若病人具有某些特定的有害并活跃的基因,医生有道德上的义务警示病人患病的风险。由此可知,题干是对原文的同义转述,故选E。
                  9.[选词填空]People are optimistic about their chances of being caught by an inherited diseasebefore the genetic test is done.
                    • 解题思路:题干意为,人们在做基因检测前对自己得某种遗传病的可能性持乐观态度。根据题干中的关键词genetic test可定位到H段。该段第四句提到,人们会守着这样一种希望:他们可能会侥幸躲过基因的“子弹”,直到做了测试为止。由此可知,题于是对原文的同义转述,故选H。
                    10.[选词填空]It's difficult for us to accept the bad result of a genetic test but doctors and experts aretrying to find ways to help us.learn how to bear it.
                      • 解题思路:题干意为,加拿大时时彩技巧难以接受基因检测出的不良结果,但是医生及专家们正努力寻找帮加拿大时时彩技巧学会承受的方法。根据题干中的关键词doctors and experts可定位到O段。该段第一、二句提到,这是知情——更确切地说,是预知——的负担。加拿大时时彩技巧越来越多的人将不得不决定是否要承受这一负担,加拿大时时彩技巧的医疗体系也才刚刚开始学会如何帮助加拿大时时彩技巧承受。由此可知,题干是对原文的同义转述,故选O。
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                      • 参考答案:C,A,M,G,N,K,I,E,H,O