Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Carrera 7 No. 117 - 15, Bogotá, Colombia.
Clin Nutr ESPEN. 2021 Feb;41:23-29. doi: 10.1016/j.clnesp.2020.12.010. Epub 2020 Dec 31.
When the natural oral intake of food and liquids is disturbed the role of caregivers is to assist the patient in order to cover the individual's need for nutrition by nutrition therapy. Nutrition therapy is a medical intervention, which requires an indication for achieving a treatment goal and the informed consent of the competent patient. Withholding and withdrawing nutrition therapy and artificial hydration must be evaluated in specific situations (terminally ill, palliative care, dementia, aged patients) and always case by case according to the patients' cultural and spiritual needs. In the case of ethical issues or dilemmas, application of the four principles of autonomy, beneficence, non-maleficence, and justice is recommended. These principles assist the caregiver in the decision as whether to feed or not to feed. Caregivers must emphasize the right to self-determination and thus to respect the autonomy of the patient, and also the particular vulnerability of the patient suffering from or at risk of malnutrition. Caregivers must be ethically capable of responding to the nutritional needs according to the patient's will and desires even if the patient is not capable of self-determination, always looking for the best benefit to the patient and avoiding harm.
当患者正常的饮食摄入受到干扰时，护理人员的职责是协助患者，通过营养治疗来满足其个体的营养需求。营养治疗是一种医疗干预措施，需要有治疗目标的适应证，并获得有能力做出决定的患者的知情同意。在特定情况下（终末期疾病、姑息治疗、痴呆、老年患者）必须评估停止和终止营养治疗和人工补液，并始终根据患者的文化和精神需求进行个案评估。在涉及伦理问题或困境时，建议应用自主、善行、不伤害和公正这四项原则。这些原则可以帮助护理人员决定是否喂养。护理人员必须强调自决权，从而尊重患者的自主权，同时也要尊重患有或有营养不良风险的患者的特殊脆弱性。护理人员必须在道德上能够根据患者的意愿和需求来满足其营养需求，即使患者没有能力自主决定，始终寻求对患者最有利的结果，并避免伤害。
