Gordon D R
Center for the Study and Prevention of Cancer, Florence, Italy.
Cult Med Psychiatry. 1990 Jun;14(2):275-97. doi: 10.1007/BF00046665.
Individuals and societies embody illnesses in different ways, in part determined by the way a person knows and lives his or her diagnosis and prognosis. Based on research in Northern Italy, on the experiences and meanings of cancer and on the practice of nondisclosure of the diagnosis, we find nondisclosure reflects a world divided--life/death, good/bad, mind/body--with the unwanted converted to "other." The strong association of cancer with death, suffering, and hopelessness in much of Italy, coupled with the tremendous power attributed to naming and "sentencing" makes nondisclosure a major mechanism for keeping the "condemned" in this social world, and keeping death, decay, and suffering in the "other." It is the social reality that is dominant here, such that informing a patient of cancer can be tantamount to social death.
个人和社会以不同方式体现疾病，部分取决于一个人了解和面对自身诊断及预后的方式。基于对意大利北部的研究、对癌症经历和意义的研究以及对不透露诊断情况的实践，我们发现不透露反映了一个分裂的世界——生与死、好与坏、身心——其中不受欢迎的被转化为“他者”。在意大利大部分地区，癌症与死亡、痛苦和绝望紧密相连，再加上赋予命名和“宣判”的巨大力量，使得不透露成为将“被定罪者”留在这个社会世界、将死亡、衰败和痛苦留在“他者”世界的主要机制。这里占主导地位的是社会现实，以至于告知患者患癌可能等同于社会死亡。
