— 基本照護與舒適 · MEDIUM · MCQ —
護理師準備進行侵入性治療並需取得知情同意書。下列哪位病人目前不具備法律行為能力？
A nurse is preparing a client for a procedure and needs to obtain informed consent. Which client would be considered unable to provide legal consent?
- AA 70-year-old with early-stage dementia患有早期失智症的 70 歲長者
- BA 45-year-old with a broken arm who is alert and oriented手臂骨折但意識清楚且定向感良好的 45 歲長者
- CA 30-year-old with a minor psychiatric history有輕微精神病史的 30 歲長者
- DA 25-year-old who received IV morphine 15 minutes ago✓ 正解15 分鐘前接受靜脈注射嗎啡的 25 歲長者
— Explanation · 中文詳解 —
知情同意（Informed Consent）的法律基礎在於病人必須具備「決定能力（Capacity）」。這意味著病人必須在意識清醒、思緒清晰且未受藥物影響的情況下進行決策。嗎啡（Morphine）作為中樞神經抑制劑與強效鎮痛劑，會影響病人的認知功能、意識狀態與判斷力，因此在給予後簽署法律文件被視為無效。
Legal informed consent requires the client to have decision-making capacity, meaning they must be alert, oriented, and free from impairing influences. Since IV morphine is a central nervous system depressant that alters cognition and judgment, a client who recently received it lacks the capacity to provide valid consent.
✦ 台美臨床差異
美國法規對於「Capacity」的判斷非常嚴謹。若病人施用藥物，通常會要求醫師在藥效過後再進行解釋與簽署。台灣在實務上若遇到類似情況，常會直接要求家屬代簽，但美國會更強調尊重病人的自主權與等待窗口。