It identifies the under treatment of pain and the aggressive use of “ineffectual and forced medical procedures that may prolong and even dishonor the period of dying” as the twin problems of end-of-life care.
Which of the following best defines the word “aggressive” (line 4, paragraph 7)? [A] Bold. [B] Harmful. [C] Careless. [D] Desperate 简析： aggressive：adj
好侵略的（偏贬义）例句：We will not allow a reunited Germany to become an aggressive force again
莽撞的（贬义）：an aggressive driver 一个莽撞的司机。
咄咄逼人（中性）：US business today finds itself challenged by aggressive overseas competitors. 美国的工商业今天面临着咄咄逼人的海外竞争者的挑战。
进取，有闯劲（褒义）：He is not aggressive enough to succeed in business.
莽撞的（不顾可能不好的后果 temerarious; reckless; rash）；冒失的（not shy or embarrassed ）
desperate : adj
(of an act和一种行动搭配时) 表示孤注一掷(tried in despair or when everything else has failed) If you are desperate, you are in such a bad situation that you are willing to try anything to change it.
在文中其实aggressive use 是和前文under treatment 对应的，下文还有aggressive pain management therapies这一表达。
通过原文可以知道造成prolong and even dishonor the period of dying的原因一个是“治疗不足”，对应的另一个就是“过分的大胆”使用”，另外ineffectual and forced也说明在这里aggressive是“莽撞的”这个偏贬义的含义。