The good news made headlines nationwide: Deaths from several kinds of cancer have declined significantly in recent years. But the news has to be bittersweet for many cancer patients and their families. Every year, more than 500,000 people in the United States still die of cancer. In fact, more than half of all patients diagnosed with cancer will die of their disease within a few years. And while it is true that survival is longer today than in the past, the quality of life for these patients is often greatly diminished. Cancer – and many of the treatments used to fight it – causes pain, nausea, fatigue, and anxiety that routinely go undertreated or untreated.

In the nation’s single-minded focus on curing cancer, we have unintentionally devalued the critical need for palliative care, which focuses on alleviating physical and psychological symptoms over the course of the disease. Nothing would have a greater impact on the daily lives of cancer patients and their families than good symptom control and supportive therapy. Yet the National Cancer Institute (NCI), the federal government’s leader in cancer research and training, spent less than 1 percent of its 1999 budget on any aspect of research or training in palliative care.

The nation needs to get serious about reducing needless suffering. NCI should commit itself to and fund research aimed at improving symptom control and palliative care. NCI also could designate “centers of excellence” among the cancer centers it recognizes. To get that designation, centers would deliver innovative, top-quality palliative care to all segments of the populations the centers serve; train professionals in medicine, nursing, psychology, social work, and other disciplines to provide palliative care; and conduct research.

Insurance coverage for palliative and hospice care also contributes to the problem by forcing people to choose between active treatment or hospice care. This “either/or” approach does not readily allow these two types of essential care to be integrated. The Medicare hospice benefit is designed specially for people in the final stages of illness and allows enrollment only if patients are expected to survive six months or less. The benefit excludes patients from seeking both palliative care and potentially life-extending treatment.

That makes hospice enrollment an obvious deterrent for many patients. And hospices, which may have the most skilled practitioners and the most experience in administering palliative care, cannot offer their services to people who could really benefit but still are pursuing active treatment.

Death is inevitable, but severe suffering is not. To offer hope for a long life of the highest possible quality and to deliver the best quality cancer care from diagnosis to death, our public institutions need to move towards policies that value and promote palliative care. (449 words)

Notes: nausea 恶心；single-minded 一心一意的；palliative 减轻的，缓解的；palliative care 姑息治疗；commit oneself to 承担去做…；insurance coverage保险复盖范围； hospice (晚期病人)收容所，收容计划；Medicare [美] 老年医疗保健制度 （指政府为65岁以上老人设置的医疗费减免制度）；benefit保险金；deterrent 威慑力量；制止因素；administer给予；实施，执行。

考考译文

一条好消息成了全国各大报刊的头条新闻：近年来，几种癌症的死亡人数已经大大降低了。但是这条新闻对于许多癌症患者及其家庭来说仍是忧喜参半。每年，美国仍有50多万人死于癌症。事实上，诊断为癌症的所有病人中一半以上将在今后几年内死于这种疾病。虽然确实现在的存活时间比过去长，但是这些病人的生活质量往往大大下降了。癌症 － 以及用来与癌症作斗争的许多治疗 － 会引起疼痛、恶心、疲劳和焦虑，所有这些反应通常没有得到很好的治疗或者根本没有治疗。

在国家专心集中精力治疗癌症时，我们却无意间忽视了对姑息治疗的需要；这种治疗注重缓解疾病过程中的生理和心理症状。有效的症状控制和支持性治疗对于癌症病人和他们家人的日常生活来说比什么都重要。然而国家癌症研究所（NCI），作为联邦政府在癌症研究和培训方面的领导者，在姑息治疗的研究和培训方面所花的钱只占它1999年预算的1%弱。

国家需要严肃认真地考虑如何减轻病人不必要的痛苦。国家癌症研究所也可以在它所承认的癌症中心中树立一些“优秀中心”。为了获得这样的命名，癌症中心将向它们服务的各种病人提供有创新的、高质量的姑息治疗，培训医药、获理、心理咨询、社会工作和其它学科方面的专业人员并进行研究。

姑息治疗和晚期病人收容治疗的保险覆盖范围迫使人们在积极治疗和晚期病人收容治疗两者之间做出选择，这也是问题产生的部分原因。这种“二选一”的做法不允许把两种必需的治疗合二而一。医疗保险的晚期病人收容治疗的保险金专门是为晚期病人设立的，只有预期病人只能存活六个月或不到六个月才允许登记收容。这种保险金把既寻求姑息治疗又寻求可能延长寿命治疗的病人排除在外。

这就使得晚期病人收容登记对许多病人来说起到明显限止的作用。晚期病人收容所，虽然在实施姑息治疗方面可能拥有技术水平最高的开业医生和最丰富的治疗经验，但是不能向真正受益但又在寻求积极治疗的病人提供它们的各种服务。

死亡是不可避免的，但痛苦的折磨是可以避免的。为了给予癌症患者从被确诊到死亡之前尽可能优质的长期生活的希望以及最好的癌症治疗，我们的公共机构需要提出新的政策，重视并推进姑息治疗。

Americans today don’t place a very high value on intellect. Our heroes are athletes, entertainers, and entrepreneurs, not scholars. Even our schools are where we send our children to get a practical education – not to pursue knowledge for the sake of knowledge. Symptoms of pervasive anti-intellectualism in our schools aren’t difficult to find.

“Schools have always been in a society where practical is more important than intellectual,” says education writer Diane Ravitch. “Schools could be a counterbalance.” Ravitch’s latest book, Left Back: A Century of Failed School Reforms, traces the roots of anti-intellectualism in our schools, concluding they are anything but a counterbalance to the American distaste for intellectual pursuits.

But they could and should be. Encouraging kids to reject the life of the mind leaves them vulnerable to exploitation and control. Without the ability to think critically, to defend their ideas and understand the ideas of others, they cannot fully participate in our democracy. Continuing along this path, says writer Earl Shorris, “We will become a second-rate country. We will have a less civil society.”

“Intellect is resented as a form of power or privilege,” writes historian and professor Richard Hofstadter in Anti-Intellectualism in American Life, a Pulitzer Prize winning book on the roots of anti-intellectualism in US politics, religion, and education. From the beginning of our history, says Hofstadter, our democratic and populist urges have driven us to reject anything that smells of elitism. Practicality, common sense, and native intelligence have been considered more noble qualities than anything you could learn from a book.

Ralph Waldo Emerson and other transcendentalist philosophers thought schooling and rigorous book learning put unnatural restraints on children:” We are shut up in schools and college recitation rooms for 10 or 15 years and come out at last with a bellyful of words and do not know a thing.” Mark Twain’s Huckleberry Finn exemplified American anti-intellectualism. Its hero avoids being civilized – going to school and learning to read – so he can preserve his innate goodness.

Intellect, according to Hofstadter, is different from native intelligence, a quality we reluctantly admire. Intellect is the critical, creative, and contemplative side of the mind. Intelligence seeks to grasp, manipulate, re-order, and adjust, while intellect examines, ponders, wonders, theorizes, criticizes and imagines.

School remains a place where intellect is mistrusted. Hofstadter says our country’s educational system is in the grips of people who “joyfully and militantly proclaim their hostility to intellect and their eagerness to identify with children who show the least intellectual promise.” (414 words)

Notes：intellect 才智，智能。entertainers 表演家。entrepreneurs 企业家。pervasive 弥漫的，渗透的，遍布的。intellectualism （哲）主知主义（主张知识为纯理性的产物）。counterbalance 平衡力，起平衡作用的因素。anything but 根本不。distaste (for) n. 厌恶，不喜欢。populist adj.平民主义的。elitism 杰出人物统治论，高人一等的优越感。complementary 补充的，互补的。civil 公民的；文明的。transcendentalist 先验论的。rigorous 严格的，严厉的。a bellyful of 满腹的。innate 天生的，先天的。contemplative 沉思的。

考考译文

美国人今天并不十分重视理性才智(与感情和本能相对)。我们的英雄是运动员、表演家和企业家，而不是学者。甚至我们的学校是我们送孩子去接受实用教育的地方 -- 而不是为了知识而去探索知识的地方。在我们学校中不难找到普遍存在的反主知主义的迹象。

“学校一直是处在更重视实用性而不是理性知识的社会中，”教育作家Diane Ravitch说。“学校可以成为一个起平衡弥补作用的力量。” Ravitch的近著 <落后了：学校改革失败的100年>，探索了我们学校中反主知主义的根源，结论是，现在的学校根本就不是对美国人厌恶知识追求的起平衡弥补作用的力量。

但是学校可以而且应该成为一种平衡力。鼓励孩子摒弃理性思维的生活，使孩子很容易受到别人的利用和控制。如果没有批判思维的能力，没有维护自己思想和理解别人思想的能力，孩子们就无法充分参与我们的民主生活。沿着这条道路走下去，作家Earl Shorris说，“我们将变成一个二流国家。我们将成为一个缺乏文明的社会。”

“理性才智作为权力或特权的一种形式而受到憎恶，”历史学家Richard Hofstadter教授在其 <美国生活中的反主知主义> 一书中写道。该书在论述美国政治、宗教和教育中的反主知主义根源方面荣获了美国普利策奖金。从我们的历史开端起，Hofstadter说，我们的民主的和平民主义的要求一直驱使我们摒弃任何带有精英主义的思想。实用性、常识和天智一直被认为是比从书本上学到的任何知识更高尚的品质。

Ralph Waldo Emerson和其他先验论哲学家认为，上学和严格的书本学习人为地限制了孩子：“从10岁到15岁，我们被关在中学里和大学的背诵教室里，最终等我们出来时，知识满腹，但什么事也不懂。“马克 吐温的 <Huckleberry Finn> 一书就是美国反主知主义的一个事例。该书的主人公逃避接受文明的熏陶 – 上学和学习读书 – 因此他能保持他天生的美德。

按照Hofstadter的看法，理性才智与天智截然不同。天智是一种我们不愿意崇尚的品质。理性才智是思维中长于批判的、有创造性的和善于思考的一面。天智是要去理解、支配、重组和调整，而理性才智是考察、沉思、质疑、理论化、批判和想像。

学校仍然是理性才智受到怀疑的地方。Hofstadter说，我们国家的教育制度是掌握在这样一些人的手里，他们“高兴地、好斗地

宣称他们对理性才智的敌视，宣称渴望认同理性才智前景最差的