标准治疗
1.It is rather dangerous for a surgeon to operate differently than is the custom of the other surgeons...we have suffered the disdain of shameful words on the part of laymen and of our colleagues, the surgeons; and even threats and dangers.
—— Henri de Mondeville, 1260——1320
【译文】一名外科医生的手术方式与其他外科医生的习惯不同是相当危险的……我们曾遭受过来自局外人，以及我们的同事，包括外科医生的恶语蔑视，甚至恐吓与威胁。
【考注】本句话的作者是法国著名外科医生，整形美容外科的鼻祖。他说这些话的背景是回忆当年他最先将Theodoric 有关外科伤口处理的最新方法引进到法国时曾遭到持传统伤口处理理念的内科医生甚至外科医生的广泛非议时的感悟。在任何年代，想与众不同、自成一家都不容易。
2.Surgical procedure cannot be standardized, applied at random and the result invariably predicted.To remove a gallbladder or drain a pelvic abscess is not the same operation in any two individuals for no two patients are alike, physically psychologically or surgically.
—— Max Thorek, 1880——1960
【译文】外科操作不能标准化、随机应用，结果不能准确预测。胆囊切除术或盆腔脓肿引流对任何两个不同的个体而言不可能是完全相同的手术，因为没有两个患者在生理、心理或外科手术方面完全相似。
3.There can be no malpractice without established practice; a physician cannot be convicted of deviating from accepted standards if no accepted standards exist.
—— James C.Mohr
【译文】没有建立操作的规范，就不存在所谓失当；没有一个可接受的既存标准，就无法判定医生是否背离了公认的标准。
【点评】可见指南与共识的重要性。
4.We know that many practicing physicians are not using well proven interventions or implementing well-publicized national guidelines.The legal definition of standard of care protects these physicians and encourages them to change slowly, it at all.
—— Daniel Merenstein
【译文】我们知道，许多执业医生不采用已被证实是行之有效的干预措施，也没有执行广为发布的国家指南。标准治疗的法律界定不仅保护这些医生，也鼓励他们慢慢改变，这就是其全部意义之所在。(https://www.daowen.com)
5.Many medical malpractice laws are based on medical professional guidelines for the standard of care for common illnesses and certain types of patients.It would not be possible to codify all of the possible variants in determining if the proper standard of care has been administered to the patient.It is for this reason that malpractice lawyers and judges rely on medical associations,doctor's guilds, and other professional community guidelines to litigate disputes over existing malpractice laws.
—— https://malpractice.laws.com/standard-of-care (December 23, 2019）
【译文】许多医疗过失法都是依据常见病和某些类型患者的标准治疗的医学专业指南而制定的。在判定是否为患者提供了合适的标准治疗时，法规不可能囊括所有可能的个体差异。正是由于这个原因，专门从事医疗过失（纠纷）的律师和法官就得依靠医学会、医师协会和其他专业社团的指南来对现行的医疗过失法进行争议诉讼。
【点评】看来这个有关医疗过失的诉讼情形与国内现状类似。
6.To physicians, the standard of care is the diagnostic and treatment process that a doctor should practice for a given illness, patient, and set of circumstances.This is not entirely different from the legal definition of the phrase, "standard of care." In fact, lawyers use this phrase to mean the level of care at which the average care provider gives the patient in a given area of medicine.These two definitions are very similar.The medical definition of the standard of care is more specific and scientific, whereas, the legal definition of the phrase is more oriented towards tradition and medical precedent.
—— https://malpractice.laws.com/standard-of-care (December 23, 2019)
【译文】对医生来说，标准治疗是医生针对特定的疾病、患者和症候所应该执行的诊断和治疗规程。这与法律上定义的“标准治疗”一词并无本质区别。事实上，律师使用这个词是指在给定的某个医学领域提供给患者的平均医治水平。这两个定义非常相似。标准治疗的医学定义更加具体和科学，而该词的法律定义更多地指向传统认同和之前的医疗判例。
7.In absence of malpractice laws, the guidelines AHA sets, or other medical associations, are used in malpractice suits as evidence.Businesses, including hospitals, must live up to their claims to avoid deceiving their clients.The standard of care must be the same for all patients.Doctors and hospitals are, for the most part, compliant with the fulfillment of their obligation to the patient.If a doctor makes a negligent error with regard to standard of care, then malpractice laws determine that the patient has a clear civil case against the hospital or the doctor.
—— https://malpractice.laws.com/standard-of-care (December 23, 2019)
【译文】在没有医疗过失法时，AHA（美国医院协会）或其他医学会制定的指南被用作医疗过失诉讼的证据。包括医院在内的各医疗机构必须符合其要求，以避免欺骗客户。所有患者的标准治疗必须相同。大多数情况下，医生和医院应该兑现其对患者应尽的义务。如果医生在标准治疗方面犯了疏忽性错误，那么医疗过失法就会判定患者有明确的针对医院或医生发起民事诉讼的权益。
8.A standard of care can also refer to informal or formal guidelines that are generally accepted in the medical community for the treatment of a disease or condition.It may be developed by a specialist society or organization and the title of standard of care awarded at their own discretion.It can be a clinical practice guideline, a formal diagnostic and treatment process a doctor will follow for a patient with a certain set of symptoms or a specific illness.That standard will follow guidelines and protocols that experts would agree with as most appropriate,also called “best practice.” Standards of care are developed in a number of ways;sometimes they are simply developed over time, and in other cases, they are the result of clinical trial findings.Clinical practice guidelines are collated by the National Guideline Clearinghouse.This allows access by physicians to stay current on what the standard of care is for their area.A standard of care in one community will not necessarily be the same standard in another.Further, one doctor's standard can vary from another doctor's standard.
【译文】标准治疗可以是医疗界所普遍接受的针对疾病或某种病状实施治疗的非正式或正式指南，它可由专业协会或组织制定，并自行决定去颁布某个标准治疗的称谓。它可以是一个临床实践指南，即医生针对某种症状或特定疾病的患者将遵循的一个正式诊断和治疗规程。该标准是专家们公认的最合适的指南和方案，也称为“最佳实践操作”。标准治疗可以多种方式制定，有时它们只需随着时间发展而更新，有些情况下，它们是临床试验结果的产物。临床实践指南由国家指南中心审核。这为医生们提供了一条及时更新其所在领域标准治疗的途径。一个社团的标准治疗没有必要完全等同于另一个社团的标准。而且，一名医生所遵循的标准也可以不同于另一名医生所遵循的标准。
9.The good thing about a standard of care is that there are so many to choose from.
【译文】标准治疗的好处是有了这么多的选择。