- 期刊
維生餵食管的拔或不拔－生命倫理學之四原則的反省
Nasogastric Tube Pull Out or Not Pull Out-Introspection of the Fourth of Principle of Bioethics
摘要
對末期病人來說，不管是安寧療護或緩和醫療，其醫療的目標是從對疾病的治癒移轉為消解苦痛的照護，一般不再以醫療科技措施來延長生命，而是專注於增進舒適感的照護，然而仍存在著是否給予鼻胃管灌食作為最基本的治療之道德困境。主張給予灌食者認為這是一種治療的義務，不可拔除；然而主張拔除或不給予營養者卻認為依自律原則，人有選擇死亡的權利。本文希望從倫理的觀點探討末期病人醫療營養給予之必要性，藉由自律、不傷害、仁愛、與公義等生命倫理四原則論証末期病人對於醫療營養給予有拒絕之權利。其次探討末期病人處於意識不清或無法自主時，代理人如何落實病人自律原則之精神，在仁愛與不傷害原則下，顧全病人之最佳利益。
並列摘要
To patients in terminal stage, no matter hospice care or palliative care, the goal of its medical treatment is from curing moving and transferring to and clearing up the looking after of the pain to the disease, generally no longer lengthen the life with the medical science and technology measure, but absorbed in promoting the looking after of comfort, but still offer the nasogastric tube to supply the nutrition as the most basic treatment of morals dilemmas. Maintain that offers on artificial feeding the terminal patients to think this is a kind of obligatory treatment, can't remove; But maintain the persons who offer nutrition or not think in accordance with the principle of autonomy, people have the right to choose death. This text hopes to probe into the necessity that patient's medical nutrition offers in terminal stage from the view of ethics , contain by four principle doctrine by autonomy, nonmaleficence, beneficence, and justice, prove patient to offer right refused to have to medical nutrition. Secondly probe into the patient in terminal stage when being unclear or unable to act on one's own in consciousness, how the surrogate implements the spirit that the patient contains the principle of autonomy, under the principle of nonmaleficence and beneficence , show consideration for the patient's best interests.