一位癌症末期病人留有生前遺囑（Living Will），明確表示不採取維持生命措施。家屬現在要求若病人停止心跳，必須進行復甦。護理師最合適的行動為何？
A client with advanced cancer has a living will that specifies no life-sustaining measures. The family members are now requesting that the client be resuscitated if their heart stops. Which action is most appropriate for the nurse?
- AAsk the physician to convince the family to follow the will請醫師說服家屬遵循遺囑
- BFollow the instructions in the client's living will✓ 正解遵循病人生前遺囑中的指示
- CConsult the facility's ethics committee to resolve the conflict諮詢機構倫理委員會以解決衝突
- DFollow the family's wishes, as they are the legal next of kin順從家屬的意願，因為他們是法定最近親屬
本題涉及法律文件優先順序與病人的自主權（Autonomy）。當一個心智健全的成年人簽署了合法的「預立醫療指示」（Advance Directives），例如生前遺囑（Living Will），該文件的法律效力優於家屬的口頭要求。護理師與醫療團隊的首要任務是尊重病人的意願，即使家屬意見不同。雖然家屬的情緒與壓力需要支持，但法律上不能因為家屬的意見而違反病人已表達的明確拒絕。在實際操作中，護理師應確保病人意願已被記錄為醫囑（如 DNR 醫囑），並在衝突發生時，堅定地維護病人自主權。選項 C（倫理委員會）是後續協調手段，但在緊急時刻，應先遵循已知法律文件。選項 D 是錯誤的法律認知，遺囑優先於親屬權。
A valid living will from a previously competent adult is a legally binding advance directive that takes precedence over family members' subsequent wishes. The nurse must follow the documented directive (typically reflected in DNR orders) and support the family with communication and counseling. An ethics committee is appropriate when the directive is ambiguous, but here the document is clear; family members and next-of-kin cannot override a competent client's pre-established directives.
美國有《病人自決法》（PSDA），法律對 Advance Directives 的保護非常強大。台灣雖有《安寧緩和醫療條例》及後來的《病人自主權利法》，但在華人文化「孝道」壓力下，醫護人員有時會面臨家屬強大壓力而陷入兩難，實務上常需更長時間的家庭會議來達成共識。