Craig G M
J Med Ethics. 1996 Jun;22(3):147-53. doi: 10.1136/jme.22.3.147.
The author reviews and continues the debate initiated by her recent paper in this journal. The paper was critical of certain aspects of palliative medicine, and caused Ashby and Stoffell to modify the framework they proposed in 1991. It now takes account of the need for artificial hydration to satisfy thirst, or other symptoms due to lack of fluid intake in the terminally ill. There is also a more positive attitude to the emotional needs and ethical views of the patient's family and care-givers. However, clinical concerns about the general reluctance to use artificial hydration in terminal care remain, and doubts persist about the ethical and legal arguments used by some palliative medicine specialists and others, to justify their approach. Published contributions to the debate to date, in professional journals, are reviewed. Key statements relating to the care of sedated terminally ill patients are discussed, and where necessary criticised.
作者回顾并继续了她近期在本期刊发表的论文所引发的辩论。该论文对姑息医学的某些方面提出了批评，并促使阿什比和斯托费尔修改了他们在1991年提出的框架。现在该框架考虑到了通过人工补液来缓解口渴或因绝症患者液体摄入不足导致的其他症状的必要性。同时，对患者家属和护理人员的情感需求及伦理观点也有了更积极的态度。然而，对于临终关怀中普遍不愿使用人工补液的临床担忧依然存在，并且对于一些姑息医学专家及其他人用于证明其做法合理的伦理和法律论据仍存疑虑。本文回顾了迄今为止在专业期刊上发表的关于这场辩论的文章。讨论了与镇静的绝症患者护理相关的关键陈述，并在必要时进行了批评。
