三個學術型超複雜文法結構長難句 癌症治療困境與突破 生命倫理學争議下的代理孕母 安寧療護的建立與意義

例句一(醫學史:癌症治療的困境與突破)

原句

Historians of medicine who study cancer therapy, noting that from the Second World War onward researchers who had noticed that nitrogen mustard destroyed white blood cells developed chemotherapy, and that in 1948 Sidney Farber, treating children with leukemia, induced brief remissions with a folate antagonist, argue that the field, which expanded under the American government's war on cancer launched in 1971 and which has recently turned to immunotherapies that mobilize the body's own defenses, has advanced not by a single cure but by uneven gains, since drugs that kill tumor cells also injure healthy tissue, while patients, whose lives treatment may lengthen, must weigh those added months against pain, cost, and the toll of side effects.

斷行排列

Historians of medicine

 who study cancer therapy,

 noting that from the Second World War onward

  researchers

   who had noticed that nitrogen mustard destroyed white blood cells

  developed chemotherapy,

 and that in 1948

  Sidney Farber,

   treating children with leukemia,

  induced brief remissions with a folate antagonist,

argue

 that the field,

  which expanded under the American government's war on cancer launched in 1971

  and which has recently turned to immunotherapies

   that mobilize the body's own defenses,

 has advanced not by a single cure but by uneven gains,

  since drugs that kill tumor cells also injure healthy tissue,

  while patients,

   whose lives treatment may lengthen,

  must weigh those added months against pain, cost, and the toll of side effects.

主句

Historians argue that the field has advanced not by a single cure but by uneven gains.(主詞之後接 who 子句與 noting 片語,動詞 argue 要等到很後面才出現)

拆成短句

醫學史學者提出主張。(主句)

這些學者研究癌症治療。(who 關係子句)

他們注意到兩件事。(noting,現在分詞片語)

第二次世界大戰以後,研究者發展出化學治療。(第一個 that 子句)

這些研究者曾注意到氮芥會破壞白血球。(who 關係子句,內含 noticed that 子句)

1948年,法伯治療白血病兒童。(第二個 that 子句,與前者並列,現在分詞片語 treating 插在主詞與動詞之間)

他用一種葉酸拮抗劑誘發短暫緩解。(induced,with 片語)

這個領域在1971年美國政府發起的「抗癌戰爭」下擴張。(which 非限定關係子句,過去分詞片語 launched)

它最近轉向動員人體自身防禦的免疫療法。(第二個 which 子句,與前者並列,that 關係子句)

這個領域的進展不是靠單一療法,而是靠不均衡的收穫。(argue 的受詞 that 子句主結構,not...but... 對比結構)

因為殺死腫瘤細胞的藥物也傷害健康組織。(since 子句)

而病人的生命雖可能因治療而延長。(while 子句,whose 關係子句)

病人必須權衡多出來的這幾個月與痛苦、費用及副作用的代價。(while 子句的主結構,三個並列受詞)

中譯

研究醫學史的學者注意到,第二次世界大戰以後,曾注意到氮芥會破壞白血球的研究者發展出化學治療,而且1948年法伯在治療白血病兒童時,用一種葉酸拮抗劑誘發了短暫的緩解,因而主張,這個在1971年美國政府發起的「抗癌戰爭」下擴張、最近又轉向動員人體自身防禦的免疫療法的領域,其進展不是靠單一療法,而是靠不均衡的收穫,因為殺死腫瘤細胞的藥物也傷害健康組織,而病人的生命雖可能因治療而延長,卻必須權衡多出來的這幾個月與痛苦、費用及副作用的代價。

補充說明

氮芥的研究始於戰時,與戰後的發展一脈相承。免疫檢查點抑制劑是近年重要突破,艾利森與本庶佑因此獲2018年諾貝爾生理醫學獎。各種癌症的療效差異很大,原句只作概括性陳述,療效與存活數字宜另查專書。

例句二(生命倫理學:代理孕母爭議)

原句

Bioethicists who study surrogate motherhood, noting that in the Baby M case, in which a woman who had agreed to be inseminated with a man's sperm and to give up the resulting child to him and his wife refused after the birth to do so, the New Jersey Supreme Court in 1988 voided the contract while granting custody to the biological father, and that later arrangements, in which an embryo created elsewhere is carried by a woman genetically unrelated to the child, have shifted the dispute from a mother's claim to the question of payment, contend that the practice, which supporters defend as a gift between consenting adults and which critics condemn as the sale of a woman's body and a child, cannot be judged by consent alone, since a poor woman who accepts payment may be pressed by need, while the child, who cannot consent to anything, becomes the object of a contract that the law may refuse to enforce.

斷行排列

Bioethicists

 who study surrogate motherhood,

 noting that in the Baby M case,

  in which a woman

   who had agreed to be inseminated with a man's sperm

   and to give up the resulting child to him and his wife

  refused after the birth to do so,

  the New Jersey Supreme Court in 1988

  voided the contract

   while granting custody to the biological father,

 and that later arrangements,

  in which an embryo

   created elsewhere

   is carried by a woman genetically unrelated to the child,

  have shifted the dispute

   from a mother's claim to the question of payment,

contend

 that the practice,

  which supporters defend as a gift between consenting adults

  and which critics condemn as the sale of a woman's body and a child,

 cannot be judged by consent alone,

  since a poor woman

   who accepts payment

  may be pressed by need,

  while the child,

   who cannot consent to anything,

  becomes the object of a contract

   that the law may refuse to enforce.

主句

Bioethicists contend that the practice cannot be judged by consent alone.(主詞之後接 who 子句與 noting 片語,動詞 contend 要等到很後面才出現)

拆成短句

生命倫理學者提出主張。(主句)

這些學者研究代理孕母。(who 關係子句)

他們注意到兩件事。(noting,現在分詞片語)

在「Baby M」案中,紐澤西州最高法院於1988年判定契約無效。(第一個 that 子句,主詞與動詞之間被 in which 子句隔開)

該案中,一名女子曾同意以某男子的精子受孕,並把生下的孩子交給他與他的妻子。(in which 關係子句,who 子句內兩個以 and 並列的不定詞片語)

她生產後卻拒絕這麼做。(refused...to do so,do so 代替前述兩項約定)

法院同時把監護權判給生父。(while 子句,現在分詞片語 granting)

後來的安排改由與孩子沒有基因關係的女子懷在外受精的胚胎。(第二個 that 子句,與前者並列,in which 關係子句,過去分詞 created)

這些安排把爭議從母親的主張轉向報酬問題。(have shifted...from...to...)

這種做法不能只用同意來評斷。(contend 的受詞 that 子句主結構,被動語態)

支持者把它辯護為成年人之間同意的贈與。(which 非限定關係子句)

批評者斥之為出賣女人的身體與孩子。(第二個 which 子句,與前者並列)

因為接受報酬的貧窮女子可能受需要所迫。(since 子句,who 關係子句)

而無法同意任何事的孩子,成為契約的標的。(while 子句,who 關係子句)

這份契約,法律可能拒絕執行。(that 關係子句)

中譯

研究代理孕母的生命倫理學者注意到,在「Baby M」案中,一名女子曾同意以某男子的精子受孕,並把生下的孩子交給他與他的妻子,生產後卻拒絕這麼做,紐澤西州最高法院於1988年判定契約無效,同時把監護權判給生父,而且後來的安排,改由與孩子沒有基因關係的女子懷在外受精的胚胎,把爭議從母親的主張轉向報酬問題,因而主張,這種被支持者辯護為成年人之間同意的贈與、被批評者斥為出賣女人的身體與孩子的做法,不能只用同意來評斷,因為接受報酬的貧窮女子可能受需要所迫,而無法同意任何事的孩子,卻成為法律可能拒絕執行的契約的標的。

補充說明

Baby M 案是「傳統代孕」:代理母 Mary Beth Whitehead 以自己的卵子受精,與孩子有基因關係;委託方是 William Stern 與其妻。法院判定契約無效,Whitehead 仍是法律上的母親並保有探視權,但監護權依孩子的最佳利益判給生父。第二個 that 子句所指的是「妊娠代孕」,代理母與孩子沒有基因關係,兩者在倫理與法律上的處理不同。各國立場分歧很大,有禁止、僅允許無償,也有開放商業代孕,原句不替任何一方下結論,法律細節宜另查專書。

例句三(安寧療護:安寧病房的建立與意義)

原句

Scholars of palliative care who study the hospice movement, noting that in 1967 Cicely Saunders, a nurse and physician who had listened to dying patients, opened St Christopher's Hospice in London, where she treated suffering as "total pain," physical, emotional, social, and spiritual, and that the idea, which spread to the United States in the 1970s and to Taiwan in 1990, was later written into law and insurance coverage in many places, argue that the hospice, which does not seek to hasten death and which does not treat dying as a failure of medicine, matters less as a building than as a change in what care is for, since a ward that offers pain relief, family support, and honest talk lets patients, who once died amid futile treatments, spend their last weeks as persons rather than as cases.

斷行排列

Scholars of palliative care

 who study the hospice movement,

 noting that in 1967

  Cicely Saunders,

   a nurse and physician

    who had listened to dying patients,

  opened St Christopher's Hospice in London,

   where she treated suffering as "total pain,"

    physical, emotional, social, and spiritual,

 and that the idea,

  which spread to the United States in the 1970s

  and to Taiwan in 1990,

  was later written into law and insurance coverage in many places,

argue

 that the hospice,

  which does not seek to hasten death

  and which does not treat dying as a failure of medicine,

 matters less as a building

 than as a change in what care is for,

  since a ward

   that offers pain relief, family support, and honest talk

  lets patients,

   who once died amid futile treatments,

  spend their last weeks as persons rather than as cases.

主句

Scholars argue that the hospice matters less as a building than as a change in what care is for.(主詞之後接 who 子句與 noting 片語,動詞 argue 要等到很後面才出現)

拆成短句

安寧療護學者提出主張。(主句)

這些學者研究安寧運動。(who 關係子句)

他們注意到兩件事。(noting,現在分詞片語)

1967年,桑德斯在倫敦開設聖克里斯多福安寧院。(第一個 that 子句,主詞與動詞之間被同位語隔開)

她是護理師兼醫師,曾傾聽臨終病人。(同位語 a nurse and physician,who 關係子句)

她在那裡把痛苦視為「全人痛苦」。(where 非限定關係子句)

這種痛苦包括身體、情緒、社會與靈性層面。(四個並列形容詞)

這個理念在1970年代傳到美國,1990年傳到臺灣。(第二個 that 子句,與前者並列,which 非限定關係子句)

它後來在許多地方被寫入法律與保險給付。(被動語態)

安寧病房的意義不在於它是一棟建築。(argue 的受詞 that 子句主結構,less...than... 比較結構)

而在於它改變了照護的目的。(than as a change in what care is for,what 名詞子句)

安寧病房不求加速死亡。(which 非限定關係子句)

它也不把臨終視為醫學的失敗。(第二個 which 子句,與前者並列)

因為提供止痛、家屬支持與誠實對話的病房,讓病人度過餘生。(since 子句,that 關係子句)

這些病人過去常在無效的治療中死去。(who 關係子句)

他們現在能以「人」而非「病例」的身分度過最後幾週。(lets...spend,rather than 對比結構)

中譯

研究安寧療護的學者注意到,1967年,曾傾聽臨終病人的護理師兼醫師桑德斯,在倫敦開設了聖克里斯多福安寧院,她在那裡把痛苦視為包括身體、情緒、社會與靈性層面的「全人痛苦」,而且這個理念在1970年代傳到美國、1990年傳到臺灣,後來在許多地方被寫入法律與保險給付,因而主張,這個不求加速死亡、也不把臨終視為醫學失敗的安寧病房,其意義與其說在於一棟建築,不如說在於改變了照護的目的,因為提供止痛、家屬支持與誠實對話的病房,讓過去常在無效治療中死去的病人,能以「人」而非「病例」的身分度過最後幾週。

補充說明

「total pain」是桑德斯提出的概念。美國第一家安寧院於1974年成立,聯邦醫療保險的安寧給付始於1982年;臺灣的第一個安寧病房設於馬偕醫院,法規方面有2000年的《安寧緩和醫療條例》。年份宜另查專書確認。

三句的共同提醒

例句一的主詞 Historians of medicine 後面連著 who 子句與 noting 片語。片語內第一個 that 子句,主詞 researchers 與動詞 developed 之間,插入 who 子句,內含 noticed that 子句;第二個 that 子句,主詞 Sidney Farber 與動詞 induced 之間,插入現在分詞片語 treating。動詞 argue 要等到很後面才出現。argue 之後,the field 與動詞 has advanced 之間,被兩個以 and 並列的 which 子句隔開,第二個內含 that 關係子句;not...but... 對比之後,since 與 while 子句還各帶出 whose 子句。

例句二的主詞 Bioethicists 後面連著 who 子句與 noting 片語。片語內第一個 that 子句,主詞 the New Jersey Supreme Court 與動詞 voided 之間,被 in which 子句隔開,這個子句裡的 who 子句又含兩個以 and 並列的不定詞片語(to be inseminated、to give up),而動詞 refused 要等到最後才出現,句尾的 to do so 回指前面兩項約定;第二個 that 子句,主詞 later arrangements 之後也帶出 in which 子句,內有過去分詞 created。動詞 contend 要等到很後面才出現。contend 之後,the practice 與動詞 cannot be judged 之間,被兩個並列的 which 子句隔開,句尾 since 子句帶出 who 子句,while 子句帶出 who 子句,最後再接 that 關係子句。

例句三的主詞 Scholars of palliative care 後面連著 who 子句與 noting 片語。片語內第一個 that 子句,主詞 Cicely Saunders 與動詞 opened 之間,插入同位語 a nurse and physician 與 who 子句,之後又接 where 子句,內含四個並列形容詞。第二個 that 子句,主詞 the idea 與動詞 was written 之間,插入 which 子句,內有兩個並列地點。動詞 argue 要等到很後面才出現。argue 之後,the hospice 與動詞 matters 之間,被兩個並列的 which 子句隔開;less...than... 比較結構之中,than 後面是 what care is for 名詞子句,句尾 since 子句裡 patients 與 spend 之間,插入 who 子句。

另外,三句主題都涉及生命倫理,但性質並不相同:例句一談治療的得與失,例句二談契約、同意與弱勢者保護的爭議,例句三談照護目的的轉變。三句只是陳述學界的一般論述,並不對任何病人、代理母或家庭作價值判斷,各國法規與數字宜另查專書。

這次修正只在例句二:把「bear a child for a couple」改為「be inseminated with a man's sperm and to give up the resulting child to him and his wife」,並同步更新斷行排列、拆成短句第5、6點、中譯、補充說明與共同提醒。需要的話,我也可以把整篇存成 Word 或 PDF 檔。

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