论临终患者的营养与水分 withholding：姑息医学是否做得太过？ （注：这里“withholding”直译为“ withholding”不太好理解其准确意思，可能是“ withholding nutrition and hydration”整体意思是“停止提供营养和水分” ，可根据实际准确含义对译文进行更优化调整）
On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far?
作者信息
Craig G M
出版信息
J Med Ethics. 1994 Sep;20(3):139-43; discussion 144-5. doi: 10.1136/jme.20.3.139.
Abstract
This paper explores ethical issues relating to the management of patients who are terminally ill and unable to maintain their own nutrition and hydration. A policy of sedation without hydration or nutrition is used in palliative medicine under certain circumstances. The author argues that this policy is dangerous, medically, ethically and legally, and can be disturbing for relatives. The role of the family in management is discussed. This issue requires wide debate by the public and the profession.
摘要
本文探讨了与身患绝症且无法自主维持营养和水分摄入的患者管理相关的伦理问题。在某些情况下，姑息治疗中会采用不提供水分或营养的镇静政策。作者认为，这一政策在医学、伦理和法律上都是危险的，而且可能会让亲属感到不安。文中讨论了家庭在管理中的作用。这个问题需要公众和专业人士展开广泛辩论。
相似文献
1
On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far?论临终患者的营养与水分 withholding：姑息医学是否做得太过？ （注：这里“withholding”直译为“ withholding”不太好理解其准确意思，可能是“ withholding nutrition and hydration”整体意思是“停止提供营养和水分” ，可根据实际准确含义对译文进行更优化调整）
J Med Ethics. 1994 Sep;20(3):139-43; discussion 144-5. doi: 10.1136/jme.20.3.139.
2
Palliative care ethics: non-provision of artificial nutrition and hydration to terminally ill sedated patients.姑息治疗伦理：不给处于终末期且已镇静的患者提供人工营养和水分补充
J Med Ethics. 1994 Sep;20(3):131-2, 187. doi: 10.1136/jme.20.3.131.
3
On withholding artificial hydration and nutrition from terminally ill sedated patients. The debate continues.关于对处于终末期且已接受镇静治疗的患者停止人工补液和营养支持。争论仍在继续。
J Med Ethics. 1996 Jun;22(3):147-53. doi: 10.1136/jme.22.3.147.
4
Is sedation without hydration or nourishment in terminal care lawful?临终关怀中不进行补液或营养支持的镇静是否合法？
Med Leg J. 1994;62(Pt. 4):198-201. doi: 10.1177/002581729406200405.
5
On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far? A commentary.关于对绝症患者停止营养和水分供给：姑息治疗是否做得太过？一篇评论。
J Med Ethics. 1994 Sep;20(3):144-5. doi: 10.1136/jme.20.3.144.
6
Nutrition and hydration: moral and pastoral reflections. National Conference of Catholic Bishops Committee for Pro-life Activities.营养与水合作用：道德与牧灵思考。美国天主教主教全国会议生命活动委员会。
J Contemp Health Law Policy. 1999 Spring;15(2):455-77.
7
On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far? A reply.关于对绝症患者停止营养和水分供应：姑息医学是否做得太过了？一则回应。
J Med Ethics. 1995 Jun;21(3):141-3. doi: 10.1136/jme.21.3.141.
8
Palliative care and killing: understanding ethical distinctions.
Bioethics Forum. 1997 Fall;13(3):25-30.
9
Terminal sedation--a possible compromise in the euthanasia debate?临终镇静——安乐死辩论中的一种可能妥协？
Bull Med Ethics. 2000 Nov(163):13-22.
10
U.S. Catholic bishops on nutrition and hydration: a second opinion.
J Clin Ethics. 1993 Fall;4(3):253-5.
引用本文的文献
1
Multinational Association of Supportive Care in Cancer (MASCC) expert opinion/guidance on the use of clinically assisted hydration in patients with advanced cancer.多国癌症支持治疗协会（MASCC）关于在晚期癌症患者中使用临床辅助补液的专家意见/指南。
Support Care Cancer. 2024 Mar 13;32(4):228. doi: 10.1007/s00520-024-08421-6.
2
["Terminal" dehydration, part 2 : Medical indications and therapeutic approach].["终末期”脱水，第2部分：医学指征与治疗方法]
Anaesthesist. 2018 Nov;67(11):879-892. doi: 10.1007/s00101-018-0502-x.
3
Controversies surrounding continuous deep sedation at the end of life: the parliamentary and societal debates in France.临终时持续深度镇静引发的争议：法国的议会与社会辩论
BMC Med Ethics. 2016 Jun 29;17(1):36. doi: 10.1186/s12910-016-0116-2.
4
Continuous deep sedation and homicide: an unsolved problem in law and professional morality.持续深度镇静与杀人行为：法律与职业道德中一个未解决的问题。
Med Health Care Philos. 2016 Jun;19(2):285-97. doi: 10.1007/s11019-015-9680-3.
5
Alternative forms of hydration in patients with cancer in the last days of life: study protocol for a randomised controlled trial.终末期癌症患者的替代补液方式：一项随机对照试验的研究方案。
Trials. 2015 Oct 14;16:464. doi: 10.1186/s13063-015-0988-3.
6
Medically assisted hydration for adult palliative care patients.成年姑息治疗患者的医学辅助补液
Cochrane Database Syst Rev. 2014 Apr 23;2014(4):CD006273. doi: 10.1002/14651858.CD006273.pub3.
7
The meaning of parenteral hydration to family caregivers and patients with advanced cancer receiving hospice care.肠外补液对接受临终关怀的晚期癌症患者及其家属照护者的意义。
J Pain Symptom Manage. 2012 May;43(5):855-65. doi: 10.1016/j.jpainsymman.2011.06.016. Epub 2012 Mar 27.
8
[Parenteral nutrition: at what price? An ethical orientation to "percutaneous endoscopic gastrostomy" (PEG catheter) nutrition].
Med Klin (Munich). 2002 Sep 15;97(9):558-63. doi: 10.1007/s00063-002-1196-y.
9
Practical guide to palliative sedation.姑息性镇静实用指南。
Curr Oncol Rep. 2002 May;4(3):242-9. doi: 10.1007/s11912-002-0022-2.
10
Applying best interests to persistent vegetative state--a principled distortion?将最佳利益原则应用于持续性植物状态——一种有原则的歪曲？
J Med Ethics. 1998 Apr;24(2):86-92. doi: 10.1136/jme.24.2.86.
本文引用的文献
1
The ailment.
Br J Med Psychol. 1957 Sep 6;30(3):129-45. doi: 10.1111/j.2044-8341.1957.tb01193.x.
2
Are intravenous fluids morally required for a dying patient?对于濒死患者而言，静脉输液在道德上是必需的吗？
Arch Intern Med. 1983 May;143(5):975-8.
3
Therapeutic ratio and defined phases: proposal of ethical framework for palliative care.治疗比率与特定阶段：姑息治疗伦理框架提案
BMJ. 1991 Jun 1;302(6788):1322-4. doi: 10.1136/bmj.302.6788.1322.
4
Assisted death: a reply.协助死亡：一则回应。
Lancet. 1990 Sep 29;336(8718):796-8. doi: 10.1016/0140-6736(90)93253-l.
5
Euthanasia.安乐死
BMJ. 1992 Nov 14;305(6863):1225. doi: 10.1136/bmj.305.6863.1225.
6
Euthanasia.安乐死
BMJ. 1992 Oct 17;305(6859):951. doi: 10.1136/bmj.305.6859.951-a.
7
Managing the persistent vegetative state.持续性植物状态的管理
BMJ. 1992 Aug 29;305(6852):486-7. doi: 10.1136/bmj.305.6852.486.
Zotero 插件