Boisaubin E V
J Am Diet Assoc. 1984 May;84(5):529-31.
Nutritional support is well accepted medically, morally, and legally and should be provided to all patients with hope of recovery. In the responsive terminal patient, nutritional support should be continued if the patient desires it and might benefit from it indirectly. Oral feeding is the easiest and safest method. Enteral feeding may present some risks, and hyperalimentation may not commonly be indicated because of the risks, costs, and restrictions placed upon the patient. The patient's wishes, when known, should have the highest priority, and benefits should always outweigh the risks. In the unresponsive terminal patient, there would appear to be no advantage in continuing nutritional support, since no benefit can occur. The dietitian can play an essential role in planning nutritional support with the health team for the still responsive patient and help the family make the best medical and moral decision when the patient is unresponsive and death approaches.
营养支持在医学、道德和法律上都得到了广泛认可，应该提供给所有有望康复的患者。对于有反应的终末期患者，如果患者有需求且可能间接从中受益，就应继续提供营养支持。经口喂养是最简单、最安全的方法。肠内喂养可能存在一些风险，而由于风险、成本以及对患者的限制，通常不建议进行胃肠外营养。在已知患者意愿的情况下，应将其意愿置于最高优先级，且益处应始终大于风险。对于无反应的终末期患者，继续营养支持似乎没有任何益处，因为不会产生任何效果。营养师在与医疗团队为仍有反应的患者规划营养支持方面可以发挥重要作用，并在患者无反应且接近死亡时，帮助家属做出最佳的医疗和道德决策。
