Division of Experimental Medicine, Faculty of Medicine, McGill University, and Palliative Care Research, Jewish General Hospital, Montreal, Quebec, Canada.
Eur J Cancer Care (Engl). 2010 Sep;19(5):589-93. doi: 10.1111/j.1365-2354.2009.01100.x. Epub 2009 Dec 3.
While autonomy has gradually become a key concept in the doctor-patient relationship, truth-telling is far from being the norm in many countries in the world. Despite the general agreement on the benefits of open communication between physicians and cancer patients, there is still strong resistance against disclosure of cancer diagnosis and prognosis in many cultures. Although fear of causing psychological morbidity to patients and their reluctance to find out the truth are two main justifications of non-disclosure attitudes, there are other important contributing factors that need to be further explored and better understood including those related to the relatives, doctors and healthcare systems. Cultural disparities in attitudes towards truth-telling persist; however, these differences should not be used as excuses not to respect the rights and individual preferences of cancer patients by making assumptions based on their age, sex, type of cancer, language and/or cultural background.
虽然自主性逐渐成为医患关系中的一个关键概念，但在世界上许多国家，说实话远非常态。尽管普遍认为医生与癌症患者之间进行坦诚沟通有诸多好处，但在许多文化中，仍然强烈反对透露癌症的诊断和预后。尽管担心给患者造成心理伤害以及不愿了解真相是不透露态度的两个主要理由，但还有其他一些重要的促成因素需要进一步探讨和更好地理解，包括与亲属、医生和医疗保健系统有关的因素。在对待说实话的态度上，文化差异仍然存在；然而，这些差异不应该成为不尊重癌症患者权利和个人意愿的借口，而应该根据他们的年龄、性别、癌症类型、语言和/或文化背景做出假设。
