一位加護病房護理師正在照護一名78歲、經歷大規模出血性中風後被宣告腦死的男性。這名病患是器官捐贈候選人。個案極度悲痛的妻子憤怒地大喊：『他受的苦已經夠多了！馬上關掉那台呼吸器，讓他的靈魂能平靜安息。』關於器官捐贈協議與倫理，護理師的首要處置為何？
An intensive care nurse is caring for a 78-year-old male who has been declared brain dead following a massive hemorrhagic stroke. The client is an organ donor candidate. The client's deeply grieving wife angrily yells, "He has suffered enough! Turn off that ventilator immediately so his soul can peacefully rest." What is the nurse's priority action regarding organ donation protocols and ethics?
- AExplain to the wife that the hospital legally owns the body now since he is an official organ donor candidate.向妻子解釋，由於他是正式的器官捐贈候選人，醫院現在依法擁有遺體。
- BImmediately turn off the mechanical ventilator to honor the wife's ethical surrogate autonomy securely.立即關閉機械通氣器，以安全地尊重妻子作為倫理代理人的自主權。
- CContact the designated regional Organ Procurement Organization (OPO) immediately before taking action on the ventilator.✓ 正解在對通氣器採取任何行動之前，立即聯繫指定的區域器官獲取組織（OPO）。
- DSedate the grieving wife for her hostility to prevent her from dangerously forcefully interfering with the life support.為防止妻子危險地強力干擾維生系統，因其敵意而對悲傷的妻子進行鎮靜。
本題測驗末期病患照護與器官捐贈的聯邦與臨床協議（End-of-Life / Organ Donation）。當病患達到腦死（Brain death）且具備器官捐贈可能時，美國聯邦法律嚴格要求護理師與醫院必須首先且立刻聯絡「器官勸募組織 (Organ Procurement Organization, OPO)」。OPO 擁有處理這類極度敏感與法律複雜議題的專職協調員（Coordinator）。在 OPO 協調員評估並親自與家屬溝通前，醫院『絕對不可』擅自撤除維生系統設備（Ventilator），否則器官將因缺血快速壞死而失去捐贈價值。選項 B 錯誤，雖然家屬有情感訴求，但法定程序上必須由 OPO 介入判斷病患生前的器官捐贈意願與法律效力，護士不能直接拔管。選項 A 是極端錯誤與冷血的法律誤導，醫院並未擁有遺體。選項 D 給家屬打鎮靜劑是嚴重的強制罪與醫療濫用行為。
This question tests end-of-life care and organ donation under federal and clinical protocols. When a client reaches brain death and is a potential organ donor, U.S. federal law strictly requires the nurse and the hospital to first and immediately contact the regional Organ Procurement Organization (OPO). The OPO has specialized coordinators trained to handle these highly sensitive and legally complex situations. Until the OPO coordinator has evaluated the situation and personally communicated with the family, the hospital absolutely must not unilaterally withdraw the ventilator; otherwise, the organs will quickly become nonviable from ischemia and lose donation potential. Option B is incorrect: although the family has emotional concerns, the legal process requires the OPO to assess the client's prior organ donation wishes and their legal validity; the nurse cannot simply extubate. Option A is grossly incorrect and a cold and misleading legal claim; the hospital does not own the body. Option D—sedating the family member—constitutes serious coercion and medical abuse.
美國有極強的 OPO 介入機制，護理師依法不能親自向家屬開口勸募器官，必須由 OPO 人員進行（以免引發利益衝突質疑）。台灣近年也推行由器官勸募協調師 (OPO) 介入說明的制度，與此概念完全對齊。