Van Hollen Cecilia Coale
Department of Anthropology, Maxwell School of Citizenship & Public Affairs.
Med Anthropol Q. 2018 Mar;32(1):59-84. doi: 10.1111/maq.12406. Epub 2017 Sep 18.
Medical practitioners, bioethicists, psychologists, and anthropologists have debated whether it is ethical to disclose or withhold information from patients about cancer diagnoses. This debate is framed as pitting universal individual human rights against cultural pluralism. The rights-based argument asserts that people have a right to information about their own health to make the best decisions about their treatment. The cultural variation argument suggests that in some cultural contexts there is a perception that information about one's cancer diagnosis may cause more harm than good due to the psychological trauma this may cause. Based on ethnographic research with cancer patients in India, I argue that both sides of this debate overemphasize the importance of the content of the information that may be disclosed or withheld and underestimate the central ways in which the act of disclosing or withholding information is evaluated as a symbol of care of paramount concern to patients.
医学从业者、生物伦理学家、心理学家和人类学家一直在争论,向癌症患者披露或隐瞒诊断信息是否符合伦理道德。这场争论被描述为将普遍的个人人权与文化多元主义对立起来。基于权利的论点主张,人们有权了解自己的健康状况,以便对治疗做出最佳决策。文化差异论点则表明,在某些文化背景下,人们认为,由于癌症诊断信息可能造成心理创伤,其带来的坏处可能多于好处。基于对印度癌症患者的人种志研究,我认为这场争论的双方都过分强调了可能被披露或隐瞒的信息内容的重要性,而低估了披露或隐瞒信息这一行为被视为对患者至关重要的关怀象征的核心方式。