加護病房收到了一名大規模蜘蛛膜下腔出血的 72 歲男性入院。病患已經立有具約束力的預立醫療指示 (Advance Directive)，並指定小女兒為醫療代理人 (DPAHC)。病患抵達時已昏迷插管。病患的大兒子抵達並要求立即拔除呼吸器。護理師的法定職責為何？
An intensive care nurse receives an admission report regarding a 72-year-old male with a massive subarachnoid hemorrhage. The transferring facility reports the client has an established legally binding Advance Directive and a designated durable power of attorney for health care (DPAHC). When the client arrives, he is intubated, comatose, and unable to make decisions. The client's oldest son arrives and demands the immediate removal of the ventilator. The designated DPAHC is the client's youngest daughter. What is the nurse's legal requirement?
- ADefer the medical decision strictly to the oldest son, following standard hierarchical next-of-kin protocols.遵循標準親屬階層協議，嚴格將醫療決定權讓給最年長的兒子。
- BCollaborate with hospital risk management to establish an ethics committee review explicitly bridging the sibling conflict.與醫院風險管理部門合作，成立倫理委員會審查，明確解決兄弟間的衝突。
- CExplain that the customized Advance Directive document absolutely overrides any living human surrogate, maintaining the ventilator indefinitely.解釋說客製化的預立醫療指示絕對凌駕於任何活體代理人之上，並無限期維持呼吸器。
- DInform the son that the designated youngest daughter legally possesses sole and absolute medical decision-making authority.✓ 正解告知兒子，指定的小女兒在法律上擁有單獨且絕對的醫療決策權。
本題測驗生前預立醫療指示與醫療代理人排序 (Advance Directives / DPAHC)。醫療保健持久授權書 (DPAHC) 是一項由病患在意識清醒時指定的合法醫療替代決策者。一旦病患失去決策能力，這名『指定代理人』的醫療決策權力是至高無上的，它絕對凌駕於傳統的親屬順位法則 (Spouse -> adult children -> parents)。即使大兒子是長子，在法律上也無權干涉。護理師必須立刻澄清，病患的小女兒才是唯一擁有法定決策權者（選 D 正確）。
A designated durable power of attorney for health care (DPAHC) holds the sole legal authority to make medical decisions when the patient lacks capacity, superseding traditional next-of-kin hierarchies. Therefore, the nurse must recognize the youngest daughter as the exclusive decision-maker rather than deferring to the oldest son.
醫療代理人的法律排序。「病患清醒時親自指定的人 > 配偶 > 成年子女 > 父母」。長出 DPAHC 就破除一切親屬順位。