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Loneliness, despair, chronic illness, and depression are all prevalent in the geriatric population.
在老年群体中，孤独、绝望、慢性病以及抑郁症非常常见。
Our effort must be to treat individual symptoms and organ system failure as they appear,but most important,to help aging individuals develop an overall lifestyle that gives them a sense of well-being，of being useful, of being appreciated, and of having meaning in their lives.
当个体出现症状，或是器官系统衰竭时，我们必须采取措施，但是最重要的是让老年人得到幸福感，让他们感觉自己还有用武之地，能够得到人们的肯定，让他们的生活更有意义。
The internist must devote increasing time and effort to aging patients and must be particularly sensitive to subtle changes in their environments,
内科医生要增加他们对待老年病患的时间和精力，并对周围环境中的细微变化特别敏感，
including the loss of a loved one, shrinking income relative to cost of living, dislocation from their homes, and the despair that comes from being unable to adjust to new surroundings such as a retirement center or nursing home.
包括失去至亲的痛苦，生活收入减少，远走他乡，以及因无法适应新环境而带来的绝望感，例如在退休疗养中心或是养老院。
Each of these profoundly affects the way a patient reacts to physical diseases.
这些都将对病人对抗疾病造成深远的影响。
The responsibility of the internist extends beyond the usual in this situation and requires a very special integration of medical knowledge and knowledge of how people adjust to their changing needs.
内科医生的责任范围超过了他通常遇到的情况，这就需要他们将医疗知识与如何让病人适应需求的认识结合起来。
HELP WITH DYING
帮助临终患者
Rarely does an individual really wish to die, but when the time does come patients want to die with dignity.
很少有人想要终结生命，但是当这一天来临的时候，病人希望能够有尊严的死去。
What most of us desire above all is not just life, but a satisfactory quality of life, and we may sometimes quite rationally risk death to escape an unacceptable life.
最重要的是，绝大多数人不仅仅需要生活，他们需要的是一个令他们满意的生活质量，但是有时，我们会为了逃避那不可接受的生活而走向死亡。
Issues surrounding dying patients and even the realistic definition of death are topics frequently encountered by today's internist.
如今，围绕着临终病患，甚至是关于死亡的真正定义等问题一直围绕着内科医生。
It is an often, if sometimes faintly, praised triumph for modern medicine that we now have the technologic skills and instrumentation to keep essential body functions such as circulation and respiration operating almost indefinitely.
我们现在已经拥有这样的技术和设备来维持重要的机体功能如循环、呼吸，使它们几乎无限期地运转，这一点是人们经常称颂的现代医学成就。
The ability to continue these functions regardless of the expected outcome for the patient has produced considerable ethical conflict for many who deal with patients in critical life support areas and intensive care units.
无论这样做会给病患带来什么样的后果，对于那些工作在重症监护室治疗病患的医生来说，继续维持机体功能引发了诸多道德冲突。
译文属可可英语原创，未经允许，不得转载。
