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Abstract：
The question over whether to administer clinically assisted nutrition and hydration (CANH) to a dying patient is controversial, with much debate concerning this sensitive issue. The administration of CANH poses clinical and ethical dilemmas, with supporting and opposing views. Proposed positive effects of CANH include preventing thirst, delirium, hypercalcemia, and opioid toxicity. However, CANH has been shown to increase the risk of aspiration, pressure ulcers, infections, and hospital admissions as well as potentially causing discomfort to the patient. Guidance from several national bodies generally advises that the risks and burdens of CANH outweigh the benefits in the dying patient. However, an individualized approach is needed, and the patient\'s wishes regarding CANH need consideration if they have capacity and can communicate. Otherwise, sensitive discussions are required with the family, enquiring about the patient\'s prior wishes if there is no advanced care plan and acting in the patient\'s best interests. The ethical principles of autonomy, beneficence, non-maleficence, and justice need to be applied being mindful of any cultural and religious beliefs and potential misperceptions.
摘要：
关于是否对垂死的患者进行临床辅助营养和水合（CANH）的问题是有争议的，关于这个敏感问题的争论很多。CANH的管理带来了临床和伦理困境，支持和反对的观点。CANH的积极作用包括预防口渴，谵妄,高钙血症,和阿片类药物毒性。然而,CANH已被证明会增加误吸的风险，压疮,感染,和入院以及可能给患者带来不适。一些国家机构的指导意见通常建议，CANH的风险和负担超过了垂死患者的收益。然而,需要一种个性化的方法，如果患者有能力并且可以沟通，则需要考虑患者对CANH的意愿。否则,需要与家人进行敏感的讨论，如果没有高级护理计划，并按照患者的最佳利益行事，询问患者的先前意愿。自治的伦理原则，仁慈,非恶意,和正义需要应用铭记任何文化和宗教信仰和潜在的误解。
