Rojas Miranda Daniela, Fernández González Loreto
Rev Med Chil. 2015 Mar;143(3):352-7. doi: 10.4067/S0034-98872015000300010.
This article discusses the origin and implications of the "war on cancer" metaphor. Commonly present in mass media, the "war on cancer" notion circulates also among patients, their loved ones, their support networks, and oncological multidisciplinary teams. In our view when cancer is uprooted of its illness status, and conceptualized as an "enemy", myths about disease and those who suffer it (especially the idea of psychogenesis) are strengthened. Two topics in which the war metaphor is particularly problematic in the clinical context, are analyzed in depth. The first one is the relationship between the oncologic patient and his or her loved ones and support networks. When patients are insistently prompted to fight the disease and think positive, the expression of emotions associated to the adaptive process of receiving a diagnosis of cancer may be inhibited. Secondly, the war metaphor promotes an authoritarian view among the health teams and on the physician-patient relationship, undermining the patent's autonomy in the decision-making process, which may affect his global quality of life. Also, it encourages emotional isolation, concealment of psychiatric symptoms and conspiracies of silence. It is concluded that public policies to avoid the "war on" notion are required. Instead, education of the general population about wrong beliefs about cancer should be encouraged.
本文探讨了“抗癌战争”隐喻的起源及其影响。“抗癌战争”这一概念在大众媒体中普遍存在,在患者及其亲人、支持网络以及肿瘤多学科团队中也广泛流传。我们认为,当癌症被剥夺其疾病状态并被概念化为“敌人”时,关于疾病以及患病者的神话(尤其是心理成因的观念)就会得到强化。本文深入分析了战争隐喻在临床背景下特别成问题的两个主题。第一个是肿瘤患者与其亲人及支持网络之间的关系。当患者被不断敦促去对抗疾病并保持积极心态时,与接受癌症诊断这一适应过程相关的情感表达可能会受到抑制。其次,战争隐喻在医疗团队中以及医患关系上助长了一种专制观点,破坏了患者在决策过程中的自主权,这可能会影响其整体生活质量。此外,它还会导致情感孤立、精神症状的隐瞒以及沉默阴谋。结论是需要制定公共政策来避免“战争”这一概念。相反,应鼓励对普通民众进行关于癌症错误观念的教育。