Newcomer Kelley Finch, Fine Robert L, Newman Antoinette Fidelia
Department of Hospice and Palliative Medicine, University of Texas, Southwestern Medical Center, Dallas, TX, USA.
Baylor Scott and White Office of Clinical Ethics and Palliative Care, Dallas, TX, USA.
J Palliat Care. 2023 Oct;38(4):407-411. doi: 10.1177/08258597211014359. Epub 2021 May 3.
Supportive Palliative Care and Hospice professionals frequently attend to Minimally Conscious State (MCS) patients near the end of life and in so doing, face decisions over maintenance or withdrawal of artificial nutrition and hydration. Although both withholding and withdrawal of artificial nutrition and hydration (ANH) in such circumstances are considered by experts in ethics and law to be acceptable, not all families nor health care professionals agree. This paper will explore basic aspects of serious brain injuries, especially MCS, the psychological role of food in interpersonal relationships, and lessons from clinical ethics that can help in goals of care discussions about withdrawal of ANH.
支持性姑息治疗和临终关怀专业人员经常在生命末期照料处于最低意识状态（MCS）的患者，在此过程中，他们面临着维持或停止人工营养和水分补充的决策。尽管在这种情况下停止和撤回人工营养和水分补充（ANH）在伦理和法律专家看来是可以接受的，但并非所有家庭和医疗保健专业人员都认同。本文将探讨严重脑损伤的基本方面，特别是最低意识状态，食物在人际关系中的心理作用，以及临床伦理中有助于关于撤回ANH的护理目标讨论的经验教训。
