Chadfield-Mohr S M, Byatt C M
Queen Elizabeth Hospital, King's Lynn, Norfolk, UK.
Postgrad Med J. 1997 Aug;73(862):476-80. doi: 10.1136/pgmj.73.862.476.
The question of whether terminally ill patients should artificially be given fluids has been debated since before palliative care became a recognised specialty. Arguments have been adduced from physiological, comfort, legal psychological, and emotional perspectives. Palliative care specialists agree that the priority is preventing the symptoms associated with dehydration, rather than the dehydration itself. However, the majority of terminally ill patients are cared for in settings outside hospices, and those admitted to hospital will tend to be exposed to a more technical approach. There are no randomised controlled trials in this area, and although an ethical minefield, we should not be afraid to manage individual patients according to the principles of palliative care where control of symptoms, not normalising of physiological variables, is the primary objective.
自姑息治疗成为一门公认的专业之前，关于是否应该给晚期患者人工补液的问题就一直存在争议。人们从生理、舒适、法律、心理和情感等角度提出了论据。姑息治疗专家一致认为，首要任务是预防与脱水相关的症状，而不是脱水本身。然而，大多数晚期患者是在临终关怀机构以外的环境中接受护理的，而那些住院的患者往往会面临更具技术性的治疗方法。该领域没有随机对照试验，尽管这是一个道德雷区，但我们不应害怕根据姑息治疗的原则来管理个体患者，即以控制症状而非使生理变量正常化为首要目标。
