ISSN:0884-5336    

DOI:10.1177/088453369100600301

出版商:Sage Publications    

年代:1991

数据来源: WILEY

摘要:

As the practice of medicine becomes more complex, the health care team will increasingly be exposed to bioethical dilemmas in the care of the seriously ill patient. Among other issues, the much publicized Cruzan case has highlighted the concept of “advanced directives” whereby patients make known their wishes concerning life‐sustaining therapies in the event they become incompetent during hospital treatment. This article will focus on the current form of these directives and the significance they have for the nutrition support team.

ISSN:0884-5336    

DOI:10.1177/088453369100600302

出版商:Sage Publications    

年代:1991

数据来源: WILEY

摘要:

The Cruzan case portrayed ethics as high drama, an intense public struggle over the central issue of when it is right to withdraw nutrition support. There are, however, other, quieter ethical struggles that confront nutrition support teams daily and reach to the very core of each individual's integrity and character. These recurring dilemmas are no less powerful in their impact upon patient care and caregivers and no less potentially destructive to relationships and self‐esteem. This is ethics in ordinary time.

ISSN:0884-5336    

DOI:10.1177/088453369100600303

出版商:Sage Publications    

年代:1991

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369100600304

出版商:Sage Publications    

年代:1991

数据来源: WILEY

摘要:

A case of a neurosurgical patient diagnosed as being in a permanent vegetative state is presented. A family conference was used to discuss termination of life support. Because of the poor prognosis for recovery, it was decided to terminate ventilatory support but continue enteral nutrition and hydration therapy. In spite of the discontinuation of ventilatory support, the patient did not expire. After nutrition was discontinued, the patient did die. The distinction between ventilatory and nutrition support as life‐sustaining interventions is discussed.

ISSN:0884-5336    

DOI:10.1177/088453369100600305

出版商:Sage Publications    

年代:1991

数据来源: WILEY

摘要:

Recent advances in nutrition support present new challenges to the clinician in terms of the management of ethical issues. Four ethical dilemmas are reviewed to illustrate how food and hydration can be used to control others (e.g., family members, caregivers, health care team members), accelerate death, prolong life, or prolong death. In each case, consideration is given to the patient as a unique individual with unique personal and family dynamics. Options and resources available to the health care provider are discussed.

ISSN:0884-5336    

DOI:10.1177/088453369100600306

出版商:Sage Publications    

年代:1991

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369100600308

出版商:Sage Publications    

年代:1991

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369100600309

出版商:Sage Publications    

年代:1991

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369100600310

出版商:Sage Publications    

年代:1991

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369100600311

出版商:Sage Publications    

年代:1991

数据来源: WILEY