告知还是不告知？中国医生在向绝症病人披露癌症诊断时的两难处境
正文翻译
To Tell or Not: The Chinese Doctors’ Dilemma on Disclosure of a Cancer Diagnosis to the Patient
原标题《告知还是不告知：中国医生在向病人披露癌症诊断时的两难处境》
（本文发表于NIH网（美国国家医学图书馆））
To Tell or Not: The Chinese Doctors’ Dilemma on Disclosure of a Cancer Diagnosis to the Patient
原标题《告知还是不告知：中国医生在向病人披露癌症诊断时的两难处境》
（本文发表于NIH网（美国国家医学图书馆））
How to tell cancer patients about their diagnosis is approached in different ways across various countries and cultures. For example, in European and North American societies, physicians prefer direct truth telling (1), while in Asian countries, indirect truth telling is more culturally accepted (2). Families usually have major influence over clinicians’ disclosure of diagnosis to patients (3).
在不同的国家和文化中，在将其诊断告知癌症患者时，处理的方式各有不同。比如，在欧洲和北美社会，医生更愿意直接告知病人实情，而在亚洲国家，以间接的方式告知病人实情在文化上更容易被接受。临床医生向病人披露诊断时，家属的影响力往往是很大的。
在不同的国家和文化中，在将其诊断告知癌症患者时，处理的方式各有不同。比如，在欧洲和北美社会，医生更愿意直接告知病人实情，而在亚洲国家，以间接的方式告知病人实情在文化上更容易被接受。临床医生向病人披露诊断时，家属的影响力往往是很大的。
To investigate the opinions of clinicians in China regarding the disclosure of a cancer diagnosis and the underlying reasons for those opinions, a survey was administered to 180 physicians in Shandong Province in China to obtain the attitudes and relevant reasons regarding the disclosure of a cancer diagnosis to a patient.
为了调查中国临床医生对披露癌症诊断的看法，以及形成这些看法的根本原因，我们对中国山东省的180名医生进行了调查，以获知他们对向病人披露癌症诊断的态度以及相关原因。
为了调查中国临床医生对披露癌症诊断的看法，以及形成这些看法的根本原因，我们对中国山东省的180名医生进行了调查，以获知他们对向病人披露癌症诊断的态度以及相关原因。
We found that it remains difficult for clinicians in China to disclose diagnosis of a cancer, although autonomy has been recognized as an important ethical principle in medical practice. Our study shows that the diagnosis of cancers is often concealed from the patients, but disclosed to the families in China, for most physicians choose to inform the family first, but not the patients, generally based on the intention and desire of the family members, who prefer to conceal the diagnosis to the patients, considering the diagnosis would be a hard blow to the patients psychologically.
我们发现，尽管自主权被认为是医疗实践中的重要伦理原则，但在中国，临床医生仍然很难去披露癌症诊断。我们的研究表明，在中国，癌症诊断往往都是瞒着病人的，但会披露给家属，因为大部分医生会选择先知会家属而不是病人，一般来说，都是根据家属的意图和愿望来操作的，而家属更愿意对病人隐瞒诊断，个中考虑是：诊断会对病人造成沉重的心理打击。
我们发现，尽管自主权被认为是医疗实践中的重要伦理原则，但在中国，临床医生仍然很难去披露癌症诊断。我们的研究表明，在中国，癌症诊断往往都是瞒着病人的，但会披露给家属，因为大部分医生会选择先知会家属而不是病人，一般来说，都是根据家属的意图和愿望来操作的，而家属更愿意对病人隐瞒诊断，个中考虑是：诊断会对病人造成沉重的心理打击。
This study shows majority (98%) of the physicians would discuss the cancer diagnosis with family members before discussing it with the patient, and 82% of them will not tell the patient if the family requests “not to tell”. This phenomenon has been deeply rooted in the traditional Chinese culture -- Confucianism.
这项研究显示，大多数（98%）医生会在和病人讨论癌症诊断前先和家属讨论，如果家属要求“不要告诉”，82%的医生是不会告诉病人的。这种现象已经在中国传统文化（也即儒家思想）中扎根了。
这项研究显示，大多数（98%）医生会在和病人讨论癌症诊断前先和家属讨论，如果家属要求“不要告诉”，82%的医生是不会告诉病人的。这种现象已经在中国传统文化（也即儒家思想）中扎根了。
Confucianism regards human relations, rather than individual rights, as the basis of morality. The notion of the family (Jiā in Chinese) has a central position in Confucian classics, and the family is the basic autonomous unit. According to the Confucianism, when a patient was diagnosed with a cancer, his/her family members would deem it as their responsibility and even their natural right to make medical decision. If they think that it is harmful to inform the diagnosis to the patient, they usually request the doctor to dilute the severity of the disease, delay to tell, and even completely hide the diagnosis from the patient (4).
儒家思想认为，人与人之间的关系（而不是个体权利）是道德的基础。家的概念在儒家经典中居于核心地位，家庭是基本的自主性单位。根据儒家思想，当一个病人被诊断出癌症时，他/她的家庭成员会认为作出医疗决策是他们的责任，甚至会将其看作他们的自然权利。如果他们认为将诊断结果告知病人会造成伤害，他们通常会要求医生淡化病情的严重性，推迟告知，甚至是完全隐瞒诊断结果。
儒家思想认为，人与人之间的关系（而不是个体权利）是道德的基础。家的概念在儒家经典中居于核心地位，家庭是基本的自主性单位。根据儒家思想，当一个病人被诊断出癌症时，他/她的家庭成员会认为作出医疗决策是他们的责任，甚至会将其看作他们的自然权利。如果他们认为将诊断结果告知病人会造成伤害，他们通常会要求医生淡化病情的严重性，推迟告知，甚至是完全隐瞒诊断结果。
Our data shows that if the patients happened to be members of the physicians’ own families, nearly half of physicians would want to withhold the diagnosis. Modern Asian societies including China has been experiencing a transition, mainly due to the influence of the Western culture. Contemporary Chinese culture is a mixture of many values and beliefs from the ancient to the modern, and from the Western to the Eastern. Since the second half of the 1990s, more Japanese patients have received disclosure of a diagnosis of cancer than before (5). Most of the patients in China today hope their doctor to tell them the truth even if they have been diagnosed with cancer. Our study shows that if physicians themselves were diagnosed with cancer, 81% of them would want to know the diagnosis. There have been arguments whether the “Chinese family-based model” should be replaced by the Western model in order to respect the “autonomy” of Chinese patients. On the other hand, some argue that Asian bioethicists must develop a bioethics responding to their own cultural context (6).
我们的数据显示，如果病人恰好是医生自己的家庭成员，则有近一半的医生希望能隐瞒诊断。包括中国在内的现代亚洲社会一直在经历某种转型，主要是因为受到西方文化的影响。当代中国文化融合了从古至今，从西方到东方的诸多价值观和信仰。自九十年代后半页以来，被披露癌症诊断的日本病人比以前更多了。在今天的中国，大部分病人就算自己被诊断出癌症，也希望他们的医生能告诉他们真相。我们的研究表明，如果医生自己被诊断出癌症，81%的人是希望知道诊断结果的。为了尊重中国病人的“自主权”，是否应该用西方模式来取代“以家庭为基准的中国模式”，一直都存在争论。另一方面，有些人主张，亚洲的生命伦理学家必须发展出符合自身文化环境的生命伦理学。
我们的数据显示，如果病人恰好是医生自己的家庭成员，则有近一半的医生希望能隐瞒诊断。包括中国在内的现代亚洲社会一直在经历某种转型，主要是因为受到西方文化的影响。当代中国文化融合了从古至今，从西方到东方的诸多价值观和信仰。自九十年代后半页以来，被披露癌症诊断的日本病人比以前更多了。在今天的中国，大部分病人就算自己被诊断出癌症，也希望他们的医生能告诉他们真相。我们的研究表明，如果医生自己被诊断出癌症，81%的人是希望知道诊断结果的。为了尊重中国病人的“自主权”，是否应该用西方模式来取代“以家庭为基准的中国模式”，一直都存在争论。另一方面，有些人主张，亚洲的生命伦理学家必须发展出符合自身文化环境的生命伦理学。
In light of the current tendency towards more disclosure globally, and the fact that the majority of cancer patients in China want to know their diagnosis, the authors proposed a suggestion for resolution based on traditional “Chinese family-based model”. Before the diagnosis is disclosed, the doctor, the patient, and the family should discuss about who will be informed first, regardless of whether the diagnosis is good or not. Indeed, it is the patient’s right to decide whether to know or not.
鉴于目前全球范围内信息披露变多的趋势，以及中国的大部分癌症患者希望知道自己的诊断，为了解决这个问题，作者们提出了一种基于传统的“中国式以家庭为基准的模式”的建议。在披露诊断结果之前，医生、病人和家属应该就先告知谁展开讨论，无论诊断结果是好是坏。决定是否知情确实是病人的权利。
鉴于目前全球范围内信息披露变多的趋势，以及中国的大部分癌症患者希望知道自己的诊断，为了解决这个问题，作者们提出了一种基于传统的“中国式以家庭为基准的模式”的建议。在披露诊断结果之前，医生、病人和家属应该就先告知谁展开讨论，无论诊断结果是好是坏。决定是否知情确实是病人的权利。
So the decision should be highly rely on the intention of the patient himself/herself. If the patient choose “to be informed”, he or she should first discuss with their family members, which might be helpful to make a better decision. They can also ask advice from the doctor, who can help them to make a more reasonable decision from more professional point of view.
因此，该决定应该在很大程度上取决于病人自己的意愿。如果病人选择“被告知”，他/她应该先和家庭成员讨论，这可能有助于更好地作出决定。他们也可以征求医生的建议，医生可以从更专业的角度帮助他们作出更合理的决定。
因此，该决定应该在很大程度上取决于病人自己的意愿。如果病人选择“被告知”，他/她应该先和家庭成员讨论，这可能有助于更好地作出决定。他们也可以征求医生的建议，医生可以从更专业的角度帮助他们作出更合理的决定。
评论翻译
Larsaf
Diagnosis? You are fine. But you may want to start taking drugs, just for the fun of it.
诊断结果？你没生病。但你可能需要开始服药了，服药其实还挺好玩的。
Diagnosis? You are fine. But you may want to start taking drugs, just for the fun of it.
诊断结果？你没生病。但你可能需要开始服药了，服药其实还挺好玩的。
“It’s just recreational chemotherapy. Nothing to worry about at all.”
（回）“这只是休养性质的化疗。完全不需要为此担心。”
（回）“这只是休养性质的化疗。完全不需要为此担心。”
"bro, you blacked out for a minute, hence the vomiting. You must of missed the fun part. We'll try again in 10-14 days"
（回）“兄弟，你昏迷了一分钟，所以就呕吐了。你肯定是把好玩的部分给错过了。我们会在10到14天内再试一次。”
（回）“兄弟，你昏迷了一分钟，所以就呕吐了。你肯定是把好玩的部分给错过了。我们会在10到14天内再试一次。”
ChaosSlave51
It's more like "you took some pills, now take some more pills. Don't worry what they do, they have long names. I'm the DR, you don't need to know."
倒不如说是这种情况：“你之前服过药，现在再多吃几种药。至于这些药的药效你就不用操心了，那药的名字可长了。我是医生，你不需要知道这些。”
It's more like "you took some pills, now take some more pills. Don't worry what they do, they have long names. I'm the DR, you don't need to know."
倒不如说是这种情况：“你之前服过药，现在再多吃几种药。至于这些药的药效你就不用操心了，那药的名字可长了。我是医生，你不需要知道这些。”
For my work, I have to ask a lot of people about the medications they take. It's been shocking to me how many people, when asked why they are on a particular drug, reply with "I don't know, my doctor just said I should take it, so I do."
（回）在我的工作中，我不得不询问很多人他们服药的情况。竟然有那么多人在被问及为什么要服用某种药物时回答说：“我也不知道，我的医生说我应该服用，于是我就服用了。”这事一直都很让我震惊。
（回）在我的工作中，我不得不询问很多人他们服药的情况。竟然有那么多人在被问及为什么要服用某种药物时回答说：“我也不知道，我的医生说我应该服用，于是我就服用了。”这事一直都很让我震惊。
Tbf it's shocking how many times I hear, "I don't know, my doctor said I should take it, but I don't." I knew several people, including my FIL, who died bc they simply didn't take life-saving medication, like their blood pressure, diabetes, or heart meds. My FIL was only 50, was convinced the doctors didn't know anything and he didn't need it.
（回）说实话，我听到“我也不清楚，我的医生说我应该吃这药，但我没有吃”的次数如此之多，实在让人震惊。我认识几个人，包括我的岳父，他们就是因为没有服用救命的药而死去的，比如他们的高血压药、糖尿病药或心脏病药。我的岳父只活了50岁，他坚信医生什么都不懂，他也不需要吃这些药。
（回）说实话，我听到“我也不清楚，我的医生说我应该吃这药，但我没有吃”的次数如此之多，实在让人震惊。我认识几个人，包括我的岳父，他们就是因为没有服用救命的药而死去的，比如他们的高血压药、糖尿病药或心脏病药。我的岳父只活了50岁，他坚信医生什么都不懂，他也不需要吃这些药。
Oh yeah, I've run into that too. Including a person who said that she did one of the blood pressure things at CVS and her blood pressure wasn't high so she stopped taking her blood pressure meds because she "didn't need them anymore".
It took everything in me to not say yeah, pretty sure you didn't have high blood pressure because you were on the damn meds when you took the test. That's...why you're on them.
（回）是啊，我也碰到过这种情况。其中有个人，还说她在CVS药局做过一个血压测试，而她的血压并不高，所以她把高血压药停了，因为她“不再需要它们了”。
我很努力地克制自己才没有说出，“是的，我非常肯定你没有高血压，因为你在接受测试时正在服用那该死的药。这就是为什么你要吃药。”
It took everything in me to not say yeah, pretty sure you didn't have high blood pressure because you were on the damn meds when you took the test. That's...why you're on them.
（回）是啊，我也碰到过这种情况。其中有个人，还说她在CVS药局做过一个血压测试，而她的血压并不高，所以她把高血压药停了，因为她“不再需要它们了”。
我很努力地克制自己才没有说出，“是的，我非常肯定你没有高血压，因为你在接受测试时正在服用那该死的药。这就是为什么你要吃药。”
As someone who lives in Asia, this is an actual thing. Show up to a clinic with a symptom, and they will prescribe you medication. The first time I did this, they gave me a real dirty look when I asked what it was and what it did. "Are you a doctor?"
I said "No, I just want to know what I am putting in my body"
Cue eye roll, followed by a perfunctory descxtion of the three pills i am to take for my minor ailment, followed by a fourth pill, to protect my stomach from the side effects of the other 3.
（回）作为一个生活在亚洲的人，我想说这事儿是真的。你带着症状去诊所，他们会给你开药。我第一次这样做的时候，我问他们这是什么药，有什么药效的时候，他们给了我一个非常轻蔑的眼神，说，“你是医生吗？”
我说：“不是，我只是想知道我吞进肚子里的是什么东西。”
他们翻了个白眼，然后很敷衍地告诉我，为了治疗我的小毛病，我得吃三片药，然后再吃第四片，以保护我的胃不受其他三片药副作用的影响。
I said "No, I just want to know what I am putting in my body"
Cue eye roll, followed by a perfunctory descxtion of the three pills i am to take for my minor ailment, followed by a fourth pill, to protect my stomach from the side effects of the other 3.
（回）作为一个生活在亚洲的人，我想说这事儿是真的。你带着症状去诊所，他们会给你开药。我第一次这样做的时候，我问他们这是什么药，有什么药效的时候，他们给了我一个非常轻蔑的眼神，说，“你是医生吗？”
我说：“不是，我只是想知道我吞进肚子里的是什么东西。”
他们翻了个白眼，然后很敷衍地告诉我，为了治疗我的小毛病，我得吃三片药，然后再吃第四片，以保护我的胃不受其他三片药副作用的影响。
It's always been very frustrating to me when my mum gives me something to take when I'm ill and doesn't know what's in it but apparently it's from a doctor/herbalist so it's good for me. Yeah, I want to know what I'm taking and if it contraindicates (if that's the term) with what I'm already taking.
（回）当我生病的时候，我妈妈会给我一些药吃，但我不知道那是什么药，显然是医生/中医给她的，所以对我是有好处的，这种情况总是很让我懊恼。是的，我想知道我服用的是什么，以及它是否和我正在服用的东西犯了禁忌（好像是这样说的）。
（回）当我生病的时候，我妈妈会给我一些药吃，但我不知道那是什么药，显然是医生/中医给她的，所以对我是有好处的，这种情况总是很让我懊恼。是的，我想知道我服用的是什么，以及它是否和我正在服用的东西犯了禁忌（好像是这样说的）。
Ptolemaeus_II
Doctors and nurses are generally taught to talk to patients on a sixth grade level because the general public are a bunch of idiots.
医生和护士一般都会被教导说要用六年级的智力水平和病人交谈，因为普罗大众就是一群白痴。
Doctors and nurses are generally taught to talk to patients on a sixth grade level because the general public are a bunch of idiots.
医生和护士一般都会被教导说要用六年级的智力水平和病人交谈，因为普罗大众就是一群白痴。
Jellybeanpdx
We’re not Chinese but a Central Asian culture so it must be localized in that region as well. When my dad had his kidney removed he refused to tell anybody besides immediate family about it too, it’s like he was ashamed of it. My nephew also had a kidney removed and my sisters make him wear swim shirts in the summer to hide the scar if he is with friends. The whole thing makes me sick.
我们不是中国人，而是一种中亚文化，这在我们那个地区肯定也是种本土化的做法。我父亲摘除肾脏的时候，他也不愿意告诉除直系亲属以外的任何人，仿佛此事让他感到羞耻似的。我的侄子也摘除了一个肾脏，我的姐妹们逼他在夏天和朋友们在一起时穿冲浪衫以遮掩疤痕。这整件事让我感到恶心。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
We’re not Chinese but a Central Asian culture so it must be localized in that region as well. When my dad had his kidney removed he refused to tell anybody besides immediate family about it too, it’s like he was ashamed of it. My nephew also had a kidney removed and my sisters make him wear swim shirts in the summer to hide the scar if he is with friends. The whole thing makes me sick.
我们不是中国人，而是一种中亚文化，这在我们那个地区肯定也是种本土化的做法。我父亲摘除肾脏的时候，他也不愿意告诉除直系亲属以外的任何人，仿佛此事让他感到羞耻似的。我的侄子也摘除了一个肾脏，我的姐妹们逼他在夏天和朋友们在一起时穿冲浪衫以遮掩疤痕。这整件事让我感到恶心。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
All the way up into the 1970s it was not unheard of for this to happen in the US as well.
（回）一直到二十世纪七十年代，这种做法在美国也不是没有听说过。
（回）一直到二十世纪七十年代，这种做法在美国也不是没有听说过。
SwampYankeeDan
If I was dying and people didn't tell me... They damn well better hope I am incapacitated completely before I find out. I love my family but to not allow me to prepare or do anything specific with my remaining time I would absolutely kill them. No exaggeration. Deny me the truth and knowledge of my remaining time and I will remove your remaining time as well. There is nothing more fucked up than that. Now getting hit by a car and being comforted on the side of the road in the last minutes of my life is a very different scenario. Your not being denied the knowledge and ability to live and do what is important to you.
如果我快死了，人们却不告诉我...那他们最好希望在我发现真相前我已经完全丧失了能力。我爱我的家人，但要是不允许我在剩下的时间里准备或做任何特定的事情，我绝对会杀了他们。我一点没夸张。不让我知道我究竟剩下多少时间，那我也会把你们剩下的时间给清除了。没有什么比这更糟糕的了。但如果是被车撞了，在我生命的最后几分钟里被人拉到路边安慰，则就是完全不同的情况了。在这种情况下，你没有被剥夺知情权和生活的能力，也没有被剥夺去做对你来说很重要事情的权利。
If I was dying and people didn't tell me... They damn well better hope I am incapacitated completely before I find out. I love my family but to not allow me to prepare or do anything specific with my remaining time I would absolutely kill them. No exaggeration. Deny me the truth and knowledge of my remaining time and I will remove your remaining time as well. There is nothing more fucked up than that. Now getting hit by a car and being comforted on the side of the road in the last minutes of my life is a very different scenario. Your not being denied the knowledge and ability to live and do what is important to you.
如果我快死了，人们却不告诉我...那他们最好希望在我发现真相前我已经完全丧失了能力。我爱我的家人，但要是不允许我在剩下的时间里准备或做任何特定的事情，我绝对会杀了他们。我一点没夸张。不让我知道我究竟剩下多少时间，那我也会把你们剩下的时间给清除了。没有什么比这更糟糕的了。但如果是被车撞了，在我生命的最后几分钟里被人拉到路边安慰，则就是完全不同的情况了。在这种情况下，你没有被剥夺知情权和生活的能力，也没有被剥夺去做对你来说很重要事情的权利。
I completely agree. I decided to go against my mom and sisters wishes and tell him the truth and bought plane tickets (live on opposite coasts) and unfortunately he passed before I got there. He had to have known he wasn’t getting better though.
（回）我完全同意。之前我决定违背我妈妈和姐姐的意愿，告诉了他真相，还买了飞机票（我住在海的另一边），不幸的是，他在我赶到之前就去世了。不过，他肯定已经知道自己的病情不会好转了。
（回）我完全同意。之前我决定违背我妈妈和姐姐的意愿，告诉了他真相，还买了飞机票（我住在海的另一边），不幸的是，他在我赶到之前就去世了。不过，他肯定已经知道自己的病情不会好转了。
BSB8728
I had to tell my MIL that nothing more could be done for her cancer. Unfortunately, she also had Parkinson's/Lewy Body dementia and forgot about the prognosis a short time later.
我不得不告知我的岳母说，医生对她的癌症已经无能为力了。不幸的是，她还患有帕金森综合征/路易体痴呆症，不久之后就忘记了这个预后。
I had to tell my MIL that nothing more could be done for her cancer. Unfortunately, she also had Parkinson's/Lewy Body dementia and forgot about the prognosis a short time later.
我不得不告知我的岳母说，医生对她的癌症已经无能为力了。不幸的是，她还患有帕金森综合征/路易体痴呆症，不久之后就忘记了这个预后。
I’ve already told my mom that I will lie to repeatedly if she reaches this stage. I see no point in breaking her heart. She agrees.
（回）我已经知会我母亲了，如果她到了这个阶段，我会反复对她撒谎。我觉得没有必要伤她的心。她也同意。
（回）我已经知会我母亲了，如果她到了这个阶段，我会反复对她撒谎。我觉得没有必要伤她的心。她也同意。
Exactly. At first it sucks to lie, but in the long run it’s a mercy
（回）正是。一开始，撒谎会让你很糟心，但从长远看，这是慈悲的做法。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
（回）正是。一开始，撒谎会让你很糟心，但从长远看，这是慈悲的做法。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
Man, when I get old, stop giving me things to think about. I'm going to lose all my memories, all my higher intellectual functions. Seriously just pump me full of weed and put on Spongebob, let me chill until my time is up.
（回）等我老了，就不要再让我费脑子想事情了。我会失去所有的记忆，所有的高级智力功能。说真的，只要使劲给我大麻抽，再给我穿上海绵宝宝的衣服，让我一个人静静地待着，直到我的死期降临。
（回）等我老了，就不要再让我费脑子想事情了。我会失去所有的记忆，所有的高级智力功能。说真的，只要使劲给我大麻抽，再给我穿上海绵宝宝的衣服，让我一个人静静地待着，直到我的死期降临。
cdrstudy
Can confirm. My grandpa had prostate cancer but not very aggressive and they never told him. He died of other causes at 92.
我可以证明。我爷爷患有前列腺癌，但病势并不猛，他们从来都没有告诉过他。他在92岁时死于其他原因。
Can confirm. My grandpa had prostate cancer but not very aggressive and they never told him. He died of other causes at 92.
我可以证明。我爷爷患有前列腺癌，但病势并不猛，他们从来都没有告诉过他。他在92岁时死于其他原因。
In the medical field we say that most elderly men will die with prostate cancer, but few people die from prostate cancer. (Don’t get me wrong, it can absolutely kill you, but it can also be a very slow and progressive disease that won’t cause trouble for decades if you treat it)
（回）在医学领域，我们会说，大多数老年男性会带着前列腺癌死去，但很少有人直接死于前列腺癌。(不要误会我的意思，它绝对能杀死你，但它也可以是一种进展非常缓慢且逐步发展的疾病，如果你开展治疗，在几十年内都不会给你造成麻烦）。
（回）在医学领域，我们会说，大多数老年男性会带着前列腺癌死去，但很少有人直接死于前列腺癌。(不要误会我的意思，它绝对能杀死你，但它也可以是一种进展非常缓慢且逐步发展的疾病，如果你开展治疗，在几十年内都不会给你造成麻烦）。
My grandpa has prostate cancer and skin cancer, along with alzheimers, and he's 91. Doctors said putting him through chemo would just ruin his body at this point, he'll die long before the cancer even does him any harm, so no one told him.
（回）我爷爷患有前列腺癌和皮肤癌，外加阿尔兹海默症，而他今年已经91岁了。医生说，让他在这个年纪接受化疗只会毁掉他的身体，他等不到癌症给他造成什么伤害就会死去，所以没有人告诉他。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
（回）我爷爷患有前列腺癌和皮肤癌，外加阿尔兹海默症，而他今年已经91岁了。医生说，让他在这个年纪接受化疗只会毁掉他的身体，他等不到癌症给他造成什么伤害就会死去，所以没有人告诉他。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处
Gemmabeta
It's still a fairly common practice in a lot of places around the world.
And it was also pretty common in Europe and America until the 1970s.
在世界各地的很多地方，这仍是一种相当普遍的做法。
而且，在二十世纪七十年代之前，这在欧洲和美国也是相当普遍的做法。
It's still a fairly common practice in a lot of places around the world.
And it was also pretty common in Europe and America until the 1970s.
在世界各地的很多地方，这仍是一种相当普遍的做法。
而且，在二十世纪七十年代之前，这在欧洲和美国也是相当普遍的做法。
I was a floor nurse in the 70s. It was very common not to tell the patients. This was when the family doctor had a very paternal role and was never questioned. The word cancer was barely spoken. It was called the Big C. Patients also were able to stay in the hospital for weeks or months. Waiting for their morphine or Dilaudid shots every 4 hours, not knowing what was wrong. No hospice back then, no real pain management. Too bad if they needed more pain med. They might become addicted before they die! It was horrible.
（回）七十年代时我是一名楼层护士。当时不告知病人是非常普遍的做法。那个时候，家庭医生扮演的角色有如父亲，是从来不会被质疑的。癌症这个词几乎不会被提及。病人也可以在医院里待上几周或几个月。每隔四小时就等着打吗啡或盐酸二氢吗啡酮（译注：阿片类镇痛药），并不清楚自己的身体出了什么问题。那时候还没有临终关怀这回事，也不存在真正的疼痛管理。如果他们需要更多的止痛药，可就太糟糕了。他们很可能在死前就上瘾了！这是很可怕的。
（回）七十年代时我是一名楼层护士。当时不告知病人是非常普遍的做法。那个时候，家庭医生扮演的角色有如父亲，是从来不会被质疑的。癌症这个词几乎不会被提及。病人也可以在医院里待上几周或几个月。每隔四小时就等着打吗啡或盐酸二氢吗啡酮（译注：阿片类镇痛药），并不清楚自己的身体出了什么问题。那时候还没有临终关怀这回事，也不存在真正的疼痛管理。如果他们需要更多的止痛药，可就太糟糕了。他们很可能在死前就上瘾了！这是很可怕的。
Bttr-Trt-5812
I would live my life very differently if I had a terminal illness than if I simply felt ill and didn't know what was wrong. In more ways than this, information is power and should be a freedom and right.
如果我得了不治之症，那我的活法，就会和我仅仅感到不适而不知道出了什么问题的情况截然不同。在很多方面，知情就是力量，知情也应该是一种自由和权利。
I would live my life very differently if I had a terminal illness than if I simply felt ill and didn't know what was wrong. In more ways than this, information is power and should be a freedom and right.
如果我得了不治之症，那我的活法，就会和我仅仅感到不适而不知道出了什么问题的情况截然不同。在很多方面，知情就是力量，知情也应该是一种自由和权利。
This absolutely.
If I was very sick, I'd put off doing anything. I'd want to focus all my energy on recovery, and there's no point in trying to go have fun when you're so sick and miserable. Best to put it off until you're better, you'll be able to enjoy it more.
But if I was terminal, I'd want to do everything I could. Get as much use as possible out of what energy I had left, see and do everything I could with my remaining time.
（回）如果我病得很重，那我会把所有事情都推掉。我想把我所有的精力集中在康复上，当你病得很重也备受折磨的时候，再去找乐子就没啥意义了。最好能把这些推迟到你好转再做，到那时你会更享受。
但如果我得了绝症，那我想做的一切，只要做得到我都会去做。尽可能多地利用我剩下的能量，在我剩下的时间里去看我想看的一切，去做我能做的一切。
If I was very sick, I'd put off doing anything. I'd want to focus all my energy on recovery, and there's no point in trying to go have fun when you're so sick and miserable. Best to put it off until you're better, you'll be able to enjoy it more.
But if I was terminal, I'd want to do everything I could. Get as much use as possible out of what energy I had left, see and do everything I could with my remaining time.
（回）如果我病得很重，那我会把所有事情都推掉。我想把我所有的精力集中在康复上，当你病得很重也备受折磨的时候，再去找乐子就没啥意义了。最好能把这些推迟到你好转再做，到那时你会更享受。
但如果我得了绝症，那我想做的一切，只要做得到我都会去做。尽可能多地利用我剩下的能量，在我剩下的时间里去看我想看的一切，去做我能做的一切。
Blakechi
Greece is like this. Wife's dad had pancreatic cancer. The c word was never mentioned. It's taboo.
希腊也是这种做法。我老婆的父亲患上了胰腺癌。从来没有人去提C字打头的那个词。这是禁忌。
Greece is like this. Wife's dad had pancreatic cancer. The c word was never mentioned. It's taboo.
希腊也是这种做法。我老婆的父亲患上了胰腺癌。从来没有人去提C字打头的那个词。这是禁忌。
Still?
（回）至今都是这样？
（回）至今都是这样？
Yes. My father passed a month ago, from the same type of cancer. It was so fast, nothing could be done, so we went with an "inflammation of the bowels" and gave him all the fun drugs his heart desired. He died happy, with family around him,but the word 'cancer' was never uttered. Even the media avoid it, the call it "the cursed disease" like it's the plague of Justinian or something.
（回）是的。我父亲在一个月前去世了，得的也是这种癌症。病势发展如此之快，医生无能为力了，所以我们选择的说法是“肠炎”，而且，所有他想要的那些“带来愉悦”的药物，我们也都给他开了。他走的时候很幸福，家人都围绕在他身边，但“癌症”这个词从来没有人提起。连媒体都避而不谈，还称其为“被诅咒的病”，说的好像它是查士丁尼大瘟疫似的。
（译注：查士丁尼大瘟疫指公元541至542年在拜占庭帝国爆发的第一次大规模鼠疫）
（回）是的。我父亲在一个月前去世了，得的也是这种癌症。病势发展如此之快，医生无能为力了，所以我们选择的说法是“肠炎”，而且，所有他想要的那些“带来愉悦”的药物，我们也都给他开了。他走的时候很幸福，家人都围绕在他身边，但“癌症”这个词从来没有人提起。连媒体都避而不谈，还称其为“被诅咒的病”，说的好像它是查士丁尼大瘟疫似的。
（译注：查士丁尼大瘟疫指公元541至542年在拜占庭帝国爆发的第一次大规模鼠疫）
WeNeedToTalkAboutMe
ER did an episode about this, where a Chinese immigrant couple didn't want the father's elderly mother told she had cancer. But the doctor overseeing her care accidentally blew it because she said "cancer" in front of her and the old woman understood it (her family apparently thought that just because she didn't speak any English she couldn't understand it either).
As a corollary, the couple's American-born daughter was very against her parents not telling grandma, but they ignored her.
美剧《急诊室的故事》中，有一集就是在说这个问题，一对中国移民夫妇不想告诉男方的老母亲她得了癌症。但负责照看她的那个医生不小心说漏了嘴，因为她在她面前提到了“癌症”这个词，而老太太听懂了（很显然，她的家人以为老太太完全不会说英语，那自然就听不懂英语）。
而下文就是，这对夫妇在美国出生的那个女儿非常反对她父母不告知祖母的做法，但他们没有理会她。
ER did an episode about this, where a Chinese immigrant couple didn't want the father's elderly mother told she had cancer. But the doctor overseeing her care accidentally blew it because she said "cancer" in front of her and the old woman understood it (her family apparently thought that just because she didn't speak any English she couldn't understand it either).
As a corollary, the couple's American-born daughter was very against her parents not telling grandma, but they ignored her.
美剧《急诊室的故事》中，有一集就是在说这个问题，一对中国移民夫妇不想告诉男方的老母亲她得了癌症。但负责照看她的那个医生不小心说漏了嘴，因为她在她面前提到了“癌症”这个词，而老太太听懂了（很显然，她的家人以为老太太完全不会说英语，那自然就听不懂英语）。
而下文就是，这对夫妇在美国出生的那个女儿非常反对她父母不告知祖母的做法，但他们没有理会她。
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