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临终亲人该不该插鼻胃管的再省思
A Serious Re-consideration Towards Intubating Dying Loved Ones
大家一定会问：“你怎么知道妈妈的时间快到了？”答案是“将心比心，而且是长时间的亲情互动与关怀了解。”我决定不让医护人员为妈妈插鼻胃管，绝对不是在妈妈住进医院后，我才“临时起意”或者是“一时”的判断，而是基于母子间长期的亲情互动与了解，包括妈妈的人生态度，个性，脾气，好恶。。。等等，而且不只是我，几个弟弟也都非常了解妈妈的生死观与个人需求。
Everyone will certainly ask:"How do you know when your mother's about to pass away?" My answer is "I imagine myself in the shoes of my mother, and this is based on long-term interaction, care and mutual understanding." I decided not to let medical staff insert nasogastric tubes to my mother, this was definitely not something decided intuitively or "on-the-spot"" judgement, it was based on long-term interaction and understanding, including her attitude towards life, personality, temper, preferences... etc. It was not just me, my younger brothers also understand her view towards life and death and personal needs.
俗谚说：“千金难买早知道，万金难买后悔药。”之前所谈的那些道理，都是我累积了四十多年的生死思维以及二十多年的临终关怀经验与见闻所得，也可以说是我早就知道的事，如果我不坚持，绝对会让全家人都后悔莫及。
As quoted by folks:"It is diffucult to buy [if I know it earlier...] with thousand of dollars and it is even harder to buy medicine which can cure regrets with ten thousands of dollars." The principles that I talked about before were experience and knowledge I acquired in the past. They are the thoughts I accumulated for more than 40 years with regarding to life and death, and also more than 20 years of hospice care experince. I could predict what would happen when my mom passed on. If I did not insist on what I was suppose to do, my family and I would absolutely regreat.
最后还有一点要特别补充说明的，就是所谓的“临终脱水现象”，这是一种临终阶段身体变化的自然过程。临终阶段的病人会出现脱水现象，主要是因为病人“无法”，也“不需要”再进食及喝水，其实这样可以减轻病人身体的负担，有利于往生，就像“落叶归根”一样。这时候如果再不断地为病人喂食乃至灌食，等于是不断地增加临终病人的身体负担，结果反而会造成“临终水肿现象”，其实是非常不利于往生的。
Finally, there is one pint that needs to be particularly mentioned. It is the so-called "dehydration phenomemom at the end of life." This is a natural process of physical change at the end of life. Dying patient will experience dehydration, mainly because the patient "cannot" and "does not need" to eat and drink. In fact, this can reduce the burden on the patient, facilitating a good death, it is just like "falling leaf is getting back to its tree's root". At this time, if we continue to feed patient or even feed him through tube regardless of his appetite to eat, we are continuing increasing the physical burden of the dying patient. As a result, it will in turn cause the "phenomenon of terminal edema", and this is indeed very bad towards having a good death.
其实真正的临终关怀，是亲人灵性生命之“安顿，转化与开展”的课题，此时医疗所扮演的角色，应该是“旁助”病人善终及往生，而不是“阻碍”及“破坏”，“要不要插管”的答案就很清楚了。
The real hospice care is about "settling down, transforming and developing" our loves one spiritually. At this time, the role of medical care shoule be "assisting" the patient in hospice to have a comfortable death, rather than "hindering" and "destroying". The answer for "whether to intubate" will then be very clear.
我再问各位读者：“将来您要告别人生舞台的时候，希望身上会插几根管子啊？”您一定会大声地说：“一根都不要！”同理，您希望您的亲人在临终时身上会插几根管子啊？将心比心，应该也是“一根都不要！”您说是不？
I would like to ask reader again:"When you are going to [say goodbye], how many tubes do you hope to get intubated?" You will say aloud:"None!" Similarly, how many tubes do you hope your loved ones to have when he is dying? If you think in his shoes, you will say "None!", won't you?
俗谚说：“千金难买早知道，万金难买后悔药。”之前所谈的那些道理，都是我累积了四十多年的生死思维以及二十多年的临终关怀经验与见闻所得，也可以说是我早就知道的事，如果我不坚持，绝对会让全家人都后悔莫及。
As quoted by folks:"It is diffucult to buy [if I know it earlier...] with thousand of dollars and it is even harder to buy medicine which can cure regrets with ten thousands of dollars." The principles that I talked about before were experience and knowledge I acquired in the past. They are the thoughts I accumulated for more than 40 years with regarding to life and death, and also more than 20 years of hospice care experince. I could predict what would happen when my mom passed on. If I did not insist on what I was suppose to do, my family and I would absolutely regreat.
最后还有一点要特别补充说明的，就是所谓的“临终脱水现象”，这是一种临终阶段身体变化的自然过程。临终阶段的病人会出现脱水现象，主要是因为病人“无法”，也“不需要”再进食及喝水，其实这样可以减轻病人身体的负担，有利于往生，就像“落叶归根”一样。这时候如果再不断地为病人喂食乃至灌食，等于是不断地增加临终病人的身体负担，结果反而会造成“临终水肿现象”，其实是非常不利于往生的。
Finally, there is one pint that needs to be particularly mentioned. It is the so-called "dehydration phenomemom at the end of life." This is a natural process of physical change at the end of life. Dying patient will experience dehydration, mainly because the patient "cannot" and "does not need" to eat and drink. In fact, this can reduce the burden on the patient, facilitating a good death, it is just like "falling leaf is getting back to its tree's root". At this time, if we continue to feed patient or even feed him through tube regardless of his appetite to eat, we are continuing increasing the physical burden of the dying patient. As a result, it will in turn cause the "phenomenon of terminal edema", and this is indeed very bad towards having a good death.
其实真正的临终关怀，是亲人灵性生命之“安顿，转化与开展”的课题，此时医疗所扮演的角色，应该是“旁助”病人善终及往生，而不是“阻碍”及“破坏”，“要不要插管”的答案就很清楚了。
The real hospice care is about "settling down, transforming and developing" our loves one spiritually. At this time, the role of medical care shoule be "assisting" the patient in hospice to have a comfortable death, rather than "hindering" and "destroying". The answer for "whether to intubate" will then be very clear.
我再问各位读者：“将来您要告别人生舞台的时候，希望身上会插几根管子啊？”您一定会大声地说：“一根都不要！”同理，您希望您的亲人在临终时身上会插几根管子啊？将心比心，应该也是“一根都不要！”您说是不？
I would like to ask reader again:"When you are going to [say goodbye], how many tubes do you hope to get intubated?" You will say aloud:"None!" Similarly, how many tubes do you hope your loved ones to have when he is dying? If you think in his shoes, you will say "None!", won't you?
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