Ethical Implications of Nutrition Therapy at the End of Life

被引：3
作者：
Bower K.L. [1 ,5 ]
Shilling D.M. [2 ]
Bonnes S.L. [2 ]
Shah A. [3 ]
Lawson C.M. [4 ]
Collier B.R. [1 ]
Whitehead P.B. [5 ]
机构：
[1] Carilion Clinic, Department of Surgery, Virginia Tech Carilion School of Medicine, 1906 Belleview Ave., Roanoke, 24014, VA
[2] Mayo Clinic, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN
[3] Cooper University Health Care, Cooper Medical School of Rowan University Digestive Health Institute, Camden, NJ
[4] Division of Trauma and Critical Care Surgery, Univeristy of Tennessee, Knoxville, TN
[5] Carilion Clinic Palliative Medicine, Virginia Tech Carilion School of Medicine, 1906 Belleview Ave, Roanoke, 24014, VA
来源：
Current Gastroenterology Reports | 2023年 / 25卷 / 3期
关键词：
Artificial nutrition; End of life; Enteral nutrition; Ethics; Medically administered nutrition; Parenteral nutrition; Shared decision-making;
D O I：
10.1007/s11894-023-00862-z
中图分类号：
学科分类号：
摘要：
Purpose of Review: Provide an evidence-based resource to inform ethically sound recommendations regarding end of life nutrition therapy. Recent Findings: • Some patients with a reasonable performance status can temporarily benefit from medically administered nutrition and hydration(MANH) at the end of life. • MANH is contraindicated in advanced dementia. • MANH eventually becomes nonbeneficial or harmful in terms of survival, function, and comfort for all patients at end of life. • Shared decision-making is a practice based on relational autonomy, and the ethical gold standard in end of life decisions. Summary: A treatment should be offered if there is expectation of benefit, but clinicians are not obligated to offer non-beneficial treatments. A decision to proceed or not should be based on the patient’s values and preferences, a discussion of all potential outcomes, prognosis for given outcomes taking into consideration disease trajectory and functional status, and physician guidance provided in the form of a recommendation. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
引用
收藏
页码：69 / 74
页数：5
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