管灌餵食的醫療與倫理考量

Medical and Ethical Consideration in Decision Making of Tube-feeding

李雅玲(Ya-Ling Lee) ； 黃俐穎(Li-Ying Huang) ； 黃勝堅(Sheng-Jean Huang)

《北市醫學雜誌》 13卷3期 (2016/09) Pp. 1-8

https://doi.org/10.6200/TCMJ.2016.13.3.01

摘要

管灌餵食是對於有咀嚼吞嚥障礙的病人的一個常見的、給予人工營養或水分的方法。管灌餵食對於病患的營養給予及改善病患的營養狀態，自然會有一定程度的功能。但對於認知功能逐漸喪失、失智症患者、生命末期或接受安寧療護、甚至是處於植物人狀態的病人而言，管灌餵食的適應症及優缺點？抑或是在決定開始給予、不給予或拔除餵食管時，對醫療照護團隊及家屬等替代決定者而言，都是非常困難及複雜的過程。所以，管灌餵食無論是在醫療專業、倫理或是法律層面上的考量，都是需要進一步來作釐清及討論的。

關鍵字

吞嚥障礙 ； 管灌餵食 ； 重度失智症

並列摘要

Tube-feeding is a common way to provide artificial nutrition and hydration for dysphasia patients, which improves their nutrition status to certain extents. But what are the indications, benefits and advantages of tube-feeding to the patients who are losing cognitive function gradually, dementia, at the end of life or palliative care, or even more, patients in persistent vegetative state? The decision process is complicated and difficult for healthcare professionals and substitute decision making family members in deciding the initiation of giving, withholding or withdrawing tube-feeding for the patients. Thus, further clarification and discussion for tube-feeding is required at medical professional, ethical and legal levels.

並列關鍵字

dysphagia ； tube-feeding ； advanced dementia