Disease is a fluid concept influenced by societal and cultural atti

游客2024-01-11 34

问题             Disease is a fluid concept influenced by societal and cultural attitudes that
   change diachronically in response to new scientific and medical discoveries.
   Historically, doctors defined a disease according to a cluster of symptoms, and
Line as their clinical descriptions became more sophisticated, they started to classify
(5)    diseases into separate groups, so that from this medical taxonomy came new
   insights into disease etiology. Before the 20th century, schizophrenia and
   syphilitic insanity were treated as the same disease, but by early 1900 it became
   evident that psychoses without associated dementia represented a separate
   disease for which the term schizophrenia was then coined. The definition of
(10) schizophrenia continues to evolve from the psychiatric disease of the 1960s to an
   illness with a suspected genetic etiology, though the existence of such an
   etiology remains uncertain. While an optimistic hunt is still on for the genes
   involved, we must continue to define schizophrenia in terms of the presence or
   absence of "positive" and "negative" symptoms.
(15)       Labeling someone as diseased, however, has enormous individual, social,
   financial, and physical implications, for irrespective of disease symptoms, the
   label itself may lead to significant distress. Individuals with asymptomatic
   conditions, including genetic variations, may be perceived by themselves or
   others as having a disease. It is not that labeling someone as diseased is always
(20) positive-it does have severe ramifications, affecting decisions to have children
   or resulting in unjust treatment by life, medical, and disability insurers-but it
   can be beneficial, legitimizing symptoms, clarifying issues of personal
   responsibility, and improving accessibility to health care.  Nevertheless,
   deviations from normal that are not associated with risk should not be
(25) considered synonymous with disease. Two schools—nominalist and essentialist
   or reductionist—have debated the clinical criteria used to label a patient as
   diseased. Nominalists label symptoms with a disease name, such as
   schizophrenia, and do not offer an explanation of the underlying etiology, while
   essentialists contend that for every disease there is an underlying pathological
(30) etiology, and now argue that the essential lesion defining the disease state is a
   genetic abnormality.
         It has been suggested that diseases defined according to the essentialist
   tradition may be precisely wrong, whereas those defined in the nominalist
   traditional may be roughly accurate. But in labeling a disease state, we must
(35) consider both  the  phenotype  (symptoms)  or  the  genotype  (genetic
   abnormality), for the former describes a state that places individuals at some
   definable risk of adverse consequences, while the latter helps suggest specific
   genetic or pharmacologic therapies. Thus, both clinical criteria and genetic
   abnormalities should be used to define a disease state, and the choice of a
(40) disease definition will vary according to what one wishes to achieve, the genetic
   counseling of family members or the effective treatment of the patient. [br] It can be inferred that the author considers the way schizophrenia has been classified by doctors after 1960 to be an example of which of the following?

选项 A、A disease which resisted traditional methods of classification, but has been served well by modern methods of classification
B、A disease which has resisted modern methods of classification, and continues to require a traditional method of classification
C、A disease which satisfies modern methods of classification best, but which scientists prefer to classify through a traditional method
D、A disease which satisfies traditional methods of classification best, but which scientists prefer to classify through a modern method
E、A disease which may be defined equally well by modern methods of classification as by traditional ones

答案 B

解析

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