生命质量
1.On brain tumors: we should operate in all cases of tumor for the sake of the relief it affords, even should it be found during the operation that cure by removal is impossible.
—— Victor Horsley, 1857——1916
【译文】关于脑肿瘤：我们应该对所有的肿瘤进行手术，以减轻症状，即使手术中发现不可能通过切除而获得治愈。
【点评】百年前除了一把刀之外没有其他更好的减轻脑肿瘤症状的办法。
2.The quality of survival is as much the surgeon's responsibility as the fact of survival.
—— Mark M.Ravitch, 1910——1989
【译文】外科医生对（患者）的生存质量与能否生存下来负有同等重要的责任。
3.Life has meaning (depth) as well as length; quality of life is its second dimension.
—— Ben Eiseman
【译文】生命有长度也要有意义（深度）；生命质量就是生命的第二维度。
4.A good Doctor can foresee the fatal outcome of an incurable illness, when he cannot help, the experienced Doctor will take care not to aggravate the sick person's malady by tiring and injurious efforts.
—— Hermann Boerhaave, 1668——1738
【译文】一个好的医生能预见不治之症的致命结果，当他无法提供帮助时，有经验的医生会注意避免使用导致患者疲劳和伤害的手段加重患者的疾病。
【注】原文中Doctor就是首字母大写的，或许有特别尊重之意吧。
5.In America ...when a patient asks you to take care of her, you will do everything within your power to cure her disease.Failing that, you will do everything within your power to prolong her life.And failing that, you will do everything within your power to relieve her suffering.The problem with that ethic is the word 'everything'.Everything may be unnecessary.
—— Alan Robert Spievack
【译文】在美国……当患者要求你照顾她时，你会尽一切所能治愈她的病。如果不能治愈，你会尽一切所能延长她的生命。如果还不行，你会尽一切所能减轻她的痛苦。此处有一伦理方面的问题是“一切”，“一切”可能是不必要的。
【点评】随着现代医学技术的进步，尤其是人工生命支持技术的进步，过分强调“尽一切可能”延长一个无意识或无生还希望患者的生命有时只是在无休止地浪费有限的医疗资源。
6.It is simply not enough for surgeons to aim at the three traditional, easily measurable parameters: operative mortality and morbidity(which we try to reduce)and long-term survival (which we attempt to increase).They must raise their sight to include aspects of quality of life.
—— Michael Trede(https://www.daowen.com)
【译文】外科医生不能单纯满足于手术死亡率和并发症的降低以及长期生存率的提高这三个传统的、易于衡量的指标，他们还必须扩大视野，将生活质量的各个方面都包括进去。
7.When a cure is not possible, surgeons must get away from focusing on treating the disease and remember to care for the individual patient.
【译文】当治愈不可能时，外科医生必须从专注于治疗疾病的状态跳出来，并别忘了为患者提供个体化的照顾。
8.A palliative operation should palliate the patient, not the surgeon.
【译文】姑息性手术应该是减轻患者的痛苦，而不是外科医生的。
【点评】姑息手术不等于简化手术，也不意味着减轻外科医生的责任。
9.It is difficult to make the asymptomatic patient feel better.
—— Stanley O.Hoerr, 1909——1990
【译文】很难使无症状的患者感觉更好。
【点评】意指只有当患者出现了影响其正常生活的症状时才有必要进行合适的姑息治疗。
10.That "it would have bled" or "would have obstructed" is not an indication for palliative surgery.
—— Moshe Schein
【译文】“可能引发出血”或“可能导致梗阻”都不是姑息手术的指征。
【点评】已经发生“出血”或“梗阻”才是姑息手术的指征。
11.Regardless of the anatomic site leading to the need for palliative intervention, decisions over surgical palliation must consider the medical prognosis of the cancer, the availability and success of nonsurgical treatments, and the individual patient’s quality and expectancy of life.
—— Thomas J.Miner
【译文】无论需要姑息性干预的解剖部位在哪里，在决定采用姑息手术时必须考虑到癌症的医学预后、非手术治疗的可行性和成功率，以及患者个人的生命质量和预期寿命。
12.Palliative care should not be associated exclusively with terminal care.Many patients need it early in the course of their disease.
【译文】不应到临终关怀时才想到姑息性治疗。许多患者应该及早开始。