医学文章《绝症》（英汉版）

黄达武

	或许，每一个人都需要临终关怀，请看医学文章： Terminal illness 绝症 译者前言：有一种翻译，叫“肓译”，其情形是：语言研究者并不具备专业文章的知识背景，翻译时只根据每一个句子的语法结构加以分析、同时借助专业的词典查出每个术语的意义，最后根据上下文意译出译文。医学文章《绝症》为大卫语言工作室“肓译”的第一次尝试。   Terminal illness is a medical term popularized in the 20th century to describe a disease that cannot be cured or adequately treated and that is reasonably expected to result in the death of the patient within a relatively short period of time. This term is more commonly used for progressive diseases such as cancer or advanced heart disease than for trauma. In popular use, it indicates a disease which will eventually end the life of the sufferer. 绝症是一个盛行于20世纪的医学术语，它用来形容不能治逾或不能充分治疗的疾病，在相当短暂的一段时间里，它自然而然地导致患者的死亡。这个术语，通常更多地用于癌症或晚期心脏病诸如此类逾来逾严重的疾病，而不是像外伤这样的病症。在通俗的用法当中，它意味着这样的一种疾病，这种病最终会结束患者的生命。 A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply terminal. Often, a patient is considered to be terminally ill when the life expectancy is estimated to be six months or less, under the assumption that the disease will run its normal course. The six-month standard is arbitrary, and best available estimates of longevity may be incorrect. Consequently, though a given patient may properly be considered terminal, this is not a guarantee that the patient will die within six months. Similarly, a patient with a slowly progressing disease, such as AIDS, may not be considered terminally ill because the best estimates of longevity were greater than six months. However this does not guarantee that the patient will not die unexpectedly early. In general, physicians slightly overestimate survival so that, for example, a person who is expected to live for about six weeks would likely die around four weeks. 染上这种病的患者，可以称为“绝症患者（terminal patient）”、“绝症病人（terminally ill）”或者更简单的“绝症者（terminal）”。在病情按常规发展、生命周期估计只有六个月或者更少的时间这样的情形下，一位病人通常被认为患上了绝症。六个月的标准并不是绝对的，最佳的现有的寿命估算很可能不正确。因此，尽管一个特定的病人很自然地被认为患了绝症，但不能万无一失地说该病人会在六个月内死亡。同样地，一位染上了像艾滋病这样慢慢发展疾病的患者，不能被认为是得了绝症，因为最长的寿命估算会超过六个月。然而，这也不能确保患者不会在意想不到的短时间内死亡。一般而言，医生会对绝症病人生存于人世的时间稍稍高估一点，比如，一位估计还能活6个星期左右的患者，很可能会在4个星期左右离开人世。 Contents 内容 [hide] 1 Stages 阶段 2 Management 管理 2.1 Caregiving 照顾 3 Refusal of nutrition and hydration 拒绝营养和进水 4 Dying 临终 5 See also 请参阅 6 References  参考资料 Stages 阶段 Each patient reacts differently to the news of carrying a terminal illness such as cancer. In general, almost all patients go through various stages of acceptance when a disease like cancer has been diagnosed. 每个病人，对患上了比如癌症这样致命绝症的消息，反应都不一样。通常，当像癌症这样的病得到确诊时，几乎所有的病人都会经过不同的接受阶段。 The first stage is disbelief. Most people are shocked that it could happen to them, there is extreme anxiety especially about the unknown. Shock, despair and anger are common. There is also guilt that perhaps one has done something wrong to receive such a diagnosis. Some individuals find it humorous; others become helpless and often start to bargain. This first stage is usually short lived and usually lasts from a few days to a few weeks. 第一个阶段是不相信。这种事居然会发生在他们身上，大多数的人很震惊，特别地，对未知的一切他们极端焦虑。震惊、绝望和恼怒，这样的反应最常见。也有愧疚心理，可能自己做错了啥事，以至于被诊断出了这种病。一些病人觉得很滑稽；别的变得很无助，通常开始讨价还价。第一阶段通常不会持久，一般持续几天到几个星期。 The second stage is depression which is usually a reaction to the diagnosis. The depression is mild to moderate in intensity and needs family support. Only in rare cases is any type of medical therapy required. It is understandable to be depressed when the diagnosis of a terminal illness is made. 第二阶段是沮丧，这通常是对诊断的一种反应。从强度来说，这种沮丧是缓和、适度的，需要家人的支持。只有极少数例子需要药物的治疗。当得了绝症的诊断作出后，感到沮丧确确实实是人情之常。 Duration of depression often can last several weeks but soon it fades and one goes into the final stage of acceptance. 沮丧的持续时间，通常会持续几个星期，但不久就慢慢淡化，患者开始进入接受的最后阶段。 Management 管理 Main article: End-of-life care 主要文章：临终关爱 By definition, there is no cure or adequate treatment for terminal illnesses. However, some kinds of medical treatments may be appropriate anyway, such as treatment to reduce pain or ease breathing. 根据定义，对绝症来说，已经不可能治愈或者有适合的治疗。然而，一些药物治疗无论如何还是适当的，比如减缓疼痛或者让呼吸舒畅的治疗。 Some terminally ill patients stop all debilitating treatments to reduce unwanted side effects. Others continue aggressive treatment in the hope of an unexpected success. Still others reject conventional medical treatment and pursue unproven treatments such as radical dietary modifications. Patients' choices about different treatments may change over time. 一些患绝症的病人停止所有使人变得衰弱的治疗以减少不必要的副作用。其他的人继续敢作敢为的治疗，希望取得意想不到的成功。还有一些人拒绝所有常规的药物治疗，追求像急剧改变饮食习惯等未被证实的治疗。患者对不同治疗的选择，会随着时间的流逝而加以改变。 Palliative care is normally offered to terminally ill patients, regardless of their overall disease management style, if it seems likely to help manage symptoms such as pain and improve quality of life. Hospice care, which can be provided at home or in a long-term care facility, additionally provides emotional and spiritual support for the patient and loved ones. Some complementary medicine approaches, such as relaxation therapy, massage, and acupuncture may relieve some symptoms and other causes of suffering. 如果看起来会帮助绝症患者控制疼痛等症状和提高他们生活的质量，不管他们综合的疾病管理方式如何，通常会对他们提供减压和止痛方面的关爱。既可在家也可以在长期照顾场所提供的收容所关爱，还对病人和心爱的人额外提供情绪上和精神上的支持。一些辅助的医疗方法，如放松治疗、按摩和针灸，有可能减轻一些症状和解除其他痛苦的起因。 Caregiving 照顾 For the person with a terminal illness, life does not abruptly stop and a caregiver is often needed. The caregiver may be a nurse, licensed practical nurse or a family member. The individual may require assistance from a caregiver to receive medications for pain and to control symptoms of nausea or vomiting. Moreover, the caregiver can assist the individual with daily living activities and assist with ambulation. Caregivers also provide assistance with food and psychological support and ensure that the individual is comfortable at all times. 对患上绝症的病人来说，生命不会突然停止，他们通常会需要照顾的人。照顾者可以是一位护士、一位领有执照有实际经验却无正式训练的护士，或者是一位家庭成员。患者可能需要照顾者的协助，以接受止痛的药物治疗和控制反胃或者呕吐的症状。此外，照顾人员可以协助患者进行日常的生活活动和离床活动。照顾者也可以在进食和心理支持上提供帮助，以确保患者在所有的时候都感到舒适。 All terminal patients have different needs and have unique support needs. The patient's family may also have questions and most caregivers can provide decent information to help ease the mind. Doctors generally do not provide with estimates for fear of instilling false hopes or obliterate an individual's hope. In most cases, the caregiver works along with physicians and follows professional instructions. Caregivers usually call the physician or a nurse if: 所有的绝症病人有不同的需要和独特支持的需要。患者的家人可能也有各种问题，大多数的照顾人员能提供得体的信息来帮助缓解他们精神上的忧虑。医生通常不会提供估计的信息，他们担心会灌输虚幻的希望或者抹杀患者的希望。在大多数场合下，照顾人员和医师一起配合，并遵从专业上的指导。在如下情况下，照顾者通常会呼叫医师或护士： The individual experiences excessive pain 患者正经历剧烈的疼痛 The individual is in distress or having difficulty breathing 患者处于危险境地或呼吸困难 The individual has difficulty passing urine or is constipated 患者排尿困难或便秘 The individual has fallen and appears hurt 患者倒地受伤 The individual is depressed and wants to harm him- or herself 患者情绪沮丧，想伤害自己 The individual refuses to take his or her prescribed medications, raising ethical concerns best addressed by a person with more extensive formal training 患者拒绝服他或她的处方药，涉及伦理，该问题最好由受过更全面正式训练的人士加以解答 The caregiver does not know how to handle the situation 照顾者不知如何处理目前的情形 Most caregivers become the patient's listeners and will allow the individual to express their fears and concerns without being judgmental. Caregivers reassure the patient and honor all advanced directives. Finally, caregivers also respect the individual's need for privacy and usually hold all information confidential. 大多数的照顾者会成为病人的听众，让患者在不受审判的前提下表达他们的恐惧和关心的问题。照顾者会打消患者的疑虑，遵从他们预先的指示。还有，照顾者也会尊重患者隐私方面的需要，通常会对所有的信息予以保密。 Refusal of nutrition and hydration 拒绝营养和进水 People who feel they are near the end of their life often intentionally refuse food and/or water. Published studies indicate that "within the context of adequate palliative care, the refusal of food and fluids does not contribute to suffering among the terminally ill", and might actually contribute to a comfortable passage from life: "At least for some persons, starvation does correlate with reported euphoria." 感觉自己正走向人生尽头的人，通常会有意地拒绝进食和/或喝水。公开出版的研究成果表明，“在足够的减压止痛关爱的氛围中，拒绝摄取食物和流食并不会增加绝症期中的苦楚”，实际上倒有可能添加生命里的一段舒适旅程：“至少对一些人来说，绝食和报告中的精神欢快息息相关。” Dying 临终 Patients, healthcare workers, and recently bereaved family members often describe a good death in terms of effective choices made in a few areas: 病人、卫生保健工作者以及新近失去家人的家庭成员，如果能在几个方面作出有效选择的话，他们会认为这就是“善终”： Assurance of effective pain and symptom management 有效的疼痛和病症管理得以确保 Education about death and its aftermath, especially as it relates to decision-making 进行死亡及其后果的教育，特别是和最后决定有关联的教育 Completion of any significant goals, such as resolving past conflicts 任何有意义的目标皆得以实现，比如解决过去的冲突 People who are terminally ill may or may not follow recognizable stages of grief. For example, a person who finds strength in denial may never reach a point of acceptance or accommodation and may react negatively to any statement that threatens this defense mechanism. Other people find comfort in meticulously arranging their financial and legal affairs or planning their funerals. [在人生的尽头]患有绝症的人可能或可能不循从可以识别的悲痛阶段。例如，在拒绝阶段发现自己有力量的患者可能不会抵达接受或适应阶段，可能对任何威胁到这个防卫机制的陈述相当抵触。别的病人对小心翼翼处理他们财产和法律事务或者计划他们的葬礼并不在意。 See also请参阅 Anticipatory grief 预料的伤心事 Do not resuscitate 不要苏醒 Euthanasia 安乐死 Interventionism (medicine) 干涉主义（医学） Liverpool Care Pathway for the dying patient 利物浦对临终病人的关爱途径 Advance health care directive 预先保健指示 References 参考资料 英文出处: http://en.wikipedia.org/wiki/Terminal_illness。 Retrieved on the date of 2011-06-8. 注：大卫语言工作室 黄达武助理研究员 提供汉译稿。译稿仅供有志者学习医学英语时参考。有关医学方面问题，请咨询医生等专业人士。英文原稿对所涉人、物的个人观点，不代表大卫语言工作室的观点。 2011-6-8

郁水啸翁

	Terminal illness is a medical term popularized in the 20th century to describe a disease that cannot be cured or adequately treated and that is reasonably expected to result in the death of the patient within a relatively short period of time. This term is more commonly used for progressive diseases such as cancer or advanced heart disease than for trauma. In popular use, it indicates a disease which will eventually end the life of the sufferer. 老翁译文 绝症是20世纪流行的医学术语，指无法治逾或不能有效治疗，短期内导致患者死亡的疾病，通常多指癌症或晚期心脏病等重症，不含外伤。通俗地说，绝症就是必将结束患者生命的病症。 翻译的基本要求：1、意思准确，不得有误；2、语言简洁明了，不拖泥带水；3、符合汉语表述习惯，没有“洋腔”“臊味”。4、汉语译文通常要比英语原文简短一半左右，否则译文可能水分太多。这些都是个人观点，仅供达武君和其他贝侬参考。

黄达武

	多谢郁水啸翁!意见中肯,今后我多多努力!达武