Long S O, Long B D
Soc Sci Med. 1982;16(24):2101-8. doi: 10.1016/0277-9536(82)90259-3.
Japanese patients having terminal cancer are generally not told their true diagnosis. Japanese physicians deem it unethical to reveal a 'death sentence' and the patient's family provides support by reassuring the patient that he will recover. This behavior, strange to many Americans, seems best explained by a symbolic interactionist approach. The Japanese public views cancer as a polluting force leading to death. Family members express their concern in this stressful situation, not by open verbal communication, but by immersing themselves in proper role behavior. The patient also has a specific role in the deception, although he may suspect the true diagnosis. An ironic situation results in that an 'independent' American patient has wider opportunities for support as death approaches, but a 'dependent' Japanese patient faces death alone. As cancer technology changes public images, we suspect that cancer will be more openly discussed. Yet the symbolic behavior that surrounds cancer in Japan today will continue whenever death is seen as prolonged, deforming, and uncontrollable.
患有晚期癌症的日本患者通常不会被告知其真实诊断结果。日本医生认为透露“死刑判决”是不道德的，而患者家属会通过安慰患者说他会康复来给予支持。这种行为对许多美国人来说很奇怪，似乎最好用符号互动理论来解释。日本公众将癌症视为导致死亡的污染力量。家庭成员在这种压力情境下表达关心，不是通过公开的言语交流，而是通过全身心投入适当的角色行为。患者在这种欺骗行为中也扮演着特定角色，尽管他可能怀疑真实诊断结果。具有讽刺意味的是，“独立”的美国患者在临近死亡时获得支持的机会更多，而“依赖”的日本患者却独自面对死亡。随着癌症治疗技术改变公众观念，我们怀疑癌症将会得到更公开的讨论。然而，只要死亡被视为漫长、变形且无法控制的，如今在日本围绕癌症的符号行为就会持续存在。
