Fatati Giuseppe
Recenti Prog Med. 2015 Feb;106(2):81-4. doi: 10.1701/1790.19490.
Artificial nutrition (AN) is a relatively new medical treatment which started in the 1960 with parenteral nutrition (PN) and over the last 20 years has come to include enteral nutrition (EN) in hospitals and homes. Enormous clinical progress and continual evolution in techniques aimed at rendering organ funtion substitution more complete and efficient have come to the point where AN can only be suitably performed (indications for therapy, treatment regimen and monitoring) in specialized institutions. However, there has been much discussion about whether artificial nutrition should be considered a medical intervention or an essential intervention of care: in 2004 the Terri Schiavo case became worldwide news and the suspension of AN was decided by the law courts. In Italy, on 5 September 2014, the Council of State gave its opinion on case of Eluana Englaro. In 2007 the Italian Association for Dietetics and Clinical Nutrition (ADI) and the Professional Board of Physicians of the Province of Terni, have shared a paper that takes into account the scientific, technical and ethical considerations of AN in the light of the relative codes. The intent of this position paper was to supply a framework of clinical practices, ethical principles, and professional guidelines that will impart information and can assist decision making regarding AN and hydration. The document is still relevant today.
人工营养(AN)是一种相对较新的医学治疗方法,始于20世纪60年代的肠外营养(PN),在过去20年里,医院和家庭中也开始采用肠内营养(EN)。旨在使器官功能替代更加完整和高效的技术取得了巨大的临床进展并不断演变,以至于人工营养只能在专门机构中进行(治疗适应症、治疗方案和监测)。然而,关于人工营养应被视为一种医疗干预还是一种基本的护理干预,一直存在很多讨论:2004年,特里·夏沃案成为全球新闻,法院决定暂停人工营养。2014年9月5日,意大利国务委员会就埃卢阿娜·恩格拉罗案发表了意见。2007年,意大利饮食与临床营养协会(ADI)和特尔尼省医师专业委员会共同发表了一篇论文,该论文根据相关准则考虑了人工营养的科学、技术和伦理因素。本立场文件的目的是提供一个临床实践、伦理原则和专业指南的框架,该框架将提供信息并有助于就人工营养和补液做出决策。该文件如今仍然具有相关性。