Gillick M R
Hebrew Rehabilitation Center for Aged, Boston, Massachusetts, USA.
J Med Ethics. 2001 Feb;27(1):12-5. doi: 10.1136/jme.27.1.12.
Several religious traditions are widely believed to advocate the use of life-sustaining treatment in all circumstances. Hence, many believe that these faiths would require the use of a feeding tube in patients with advanced dementia who have lost interest in or the capacity to swallow food. This article explores whether one such tradition--halachic Judaism--in fact demands the use of artificial nutrition and hydration in this setting. Traditional (halachic) arguments have been advanced holding that treatment can be withheld in persons who are dying, in individuals whose condition causes great suffering, or in the event that the treatment would produce suffering. Individuals with advanced dementia can be considered to be dying, often suffer as a result of their dementia, and are likely to suffer from the use of a feeding tube. Given these observations and the absence of a compelling case for distinguishing between tube feeding and other forms of medical treatment, traditional Judaism appears compatible with withholding artificial nutrition for individuals with advanced dementia.
人们普遍认为，有几种宗教传统主张在所有情况下都使用维持生命的治疗方法。因此，许多人认为，这些宗教信仰要求对那些对吞咽食物失去兴趣或丧失吞咽能力的晚期痴呆患者使用喂食管。本文探讨了这样一种传统——犹太教哈拉卡法——在这种情况下是否实际上要求使用人工营养和补水。传统（哈拉卡法）观点认为，对于濒死之人、病情导致巨大痛苦的人或治疗会带来痛苦的情况，可以停止治疗。晚期痴呆患者可被视为濒死之人，他们常常因痴呆而受苦，而且使用喂食管也可能让他们遭受痛苦。鉴于这些观察结果，且没有令人信服的理由区分管饲与其他形式的医疗治疗，传统犹太教似乎与不给晚期痴呆患者使用人工营养的做法相符。
