Novack D H, Plumer R, Smith R L, Ochitill H, Morrow G R, Bennett J M
JAMA. 1979 Mar 2;241(9):897-900.
In answer to a questionnaire administered in 1961, 90% of responding physicians indicated a preference for not telling a cancer patient his diagnosis. To assess attitudinal changes, the same questionnaire was submitted to 699 university-hospital medical staff. Of 264 respondents, 97% indicated a preference for telling a cancer patient his diagnosis--a complete reversal of attitude. As in 1961, clinical experience was the major policy determinant, but the 1977 population emphasized the influence of medical school and hospital training. Our respondents indicated less likelihood that they would change their present policy or be swayed by research. Clinical experience was the determining factor in shaping two opposite policies. Physicians are still basing their policies on emotion-laden personal conviction rather than the outcome of properly designed scientific studies.
在回答1961年进行的一份调查问卷时，90%做出回应的医生表示倾向于不告知癌症患者其诊断结果。为了评估态度的变化，同样的问卷被发给了699名大学附属医院的医务人员。在264名受访者中，97%表示倾向于告知癌症患者其诊断结果——态度发生了彻底转变。与1961年一样，临床经验是主要的政策决定因素，但1977年的受访者强调了医学院校和医院培训的影响。我们的受访者表示他们改变现有政策或受研究影响的可能性较小。临床经验是形成两种相反政策的决定因素。医生们仍然将他们的政策基于充满情感的个人信念，而不是精心设计的科学研究的结果。
