Monturo Cheryl, Hook Kevin
West Chester University College of Health Sciences, Department of Nursing, 222C Sturzebecker Health Sciences Center, West Chester, PA 19383, USA.
Nurs Clin North Am. 2009 Dec;44(4):505-15. doi: 10.1016/j.cnur.2009.07.005.
The withdrawal, withholding, or implementation of life-sustaining treatments such as artificial nutrition and hydration challenge nurses on a daily basis. To meet these challenges, nurses need the composite skills of moral and ethical discernment, practical wisdom and a knowledge base that justifies reasoning and actions that support patient and family decision making. Nurses' moral knowledge develops through experiential learning, didactic learning, and deliberation of ethical principles that merge with moral intuition, ethical codes, and moral theories. Only when a nurse becomes skilled and confident in gathering empiric and ethical knowledge can he or she fully act as a moral agent in assisting families faced with making highly emotional decisions regarding the provision, withholding, or withdrawal of artificial nutrition and hydration.
诸如人工营养与补液等维持生命治疗的撤除、停止或实施，每天都在考验着护士。为应对这些挑战，护士需要具备道德与伦理辨别、实践智慧以及知识基础等综合技能，这些技能能够为支持患者及家属决策的推理和行动提供依据。护士的道德知识通过经验学习、讲授式学习以及对与道德直觉、道德规范和道德理论相融合的伦理原则的思考而得以发展。只有当护士在收集实证和伦理知识方面变得熟练且自信时，他或她才能充分发挥道德主体的作用，协助面临有关提供、停止或撤除人工营养与补液等高度情绪化决策的家庭。
