護理師照護一位昏迷且需要緊急手術的病人，此時家屬不在場。關於知情同意，護理師的最佳行動為何？
The nurse is caring for a client who is unconscious and requires emergency surgery. No family members are present. What is the nurse's best action regarding informed consent?
- AProceed with surgery under the principle of implied consent.✓ 正解基於默示同意原則進行手術。
- BDelay the surgery until a legal guardian can be reached.延遲手術直到聯絡到法定監護人。
- CWait for a court order to authorize the life-saving procedure.等待法院命令以授權挽救生命的程序。
- DAsk another nurse to sign the consent form as a witness.請另一位護理師作為見證人簽署同意書。
法律與倫理原則在緊急情況下有特別規範。當病人生命垂危且無法表達意願時，若延遲手術會造成不可逆的嚴重傷害或死亡，醫療團隊可依據「默許同意」（Implied Consent）原則進行救命處置。這是基於一個法律假設：一般人在這種情況下都會同意接受能救命的醫療介入。護理師此時的職責是確保已盡力聯絡家屬並詳細記錄現況，而非阻礙救治。選項 B、C 都會因為延誤時間而危害病人生命；選項 D 是錯誤的程序，護理師見證的是「簽名」而非「同意權」，且不能代替病人授權手術。
Legal and ethical principles provide special provisions in emergencies. When a client's life is in immediate danger and the client cannot express their wishes, and delaying surgery would cause irreversible serious harm or death, the healthcare team may proceed under the principle of 'implied consent.' This is based on the legal assumption that a reasonable person would consent to life-saving medical intervention in such a situation. The nurse's responsibility at this time is to ensure that every effort has been made to contact the family and to thoroughly document the situation, rather than to obstruct treatment. Options B and C would endanger the client's life by causing delay; option D is an incorrect procedure, since a nurse witnesses 'signatures,' not 'consent,' and cannot authorize surgery on behalf of the client.
美國法律對於 Implied Consent 有明確保護；台灣《醫療法》第 63、64 條亦規定，遇有緊急情況，醫師得先為必要之處置，不在此限，兩者邏輯相似，但在實務上台灣醫療人員常因擔心醫療糾紛而較傾向反覆聯繫家屬。