— 照護管理 · HARD · MCQ —
護理師照顧一位簽署 DNR（不施行心肺復甦術）的病人。家屬要求若病人呼吸停止仍需進行 CPR。護理師應如何回應？
A nurse is caring for a client with a DNR order. The family is asking to perform CPR if the client stops breathing. What is the nurse's best action?
- ACall the hospital legal department immediately立即聯繫醫院法律部門
- BAgree to perform CPR to avoid a legal lawsuit同意進行心肺復甦術以避免訴訟
- CIgnore the family and follow the DNR order strictly無視家屬並嚴格遵守不施行心肺復甦術指示
- DExplain the legal significance of the DNR order to the family✓ 正解向家屬解釋不施行心肺復甦術指示的法律意義
— Explanation · 中文詳解 —
面對 DNR 爭議，護理師應先確認病人的意願，並向家屬解釋 DNR 的法律效力與意涵，而非直接對抗或忽略。這通常涉及倫理衝突，需透過溝通釐清家屬的恐懼，必要時尋求醫師或社工協助，絕不能因害怕訴訟而違背病人的預立醫囑。
The nurse should explain the legal significance of the DNR order to the family, as open communication helps them understand the patient's choices and the legal framework. Ignoring the family or performing CPR against a valid order is inappropriate, and legal consultation is not the first-line response.
✦ 台美臨床差異
台灣針對 DNR（預立安寧緩和醫療意願書）執行與撤銷有嚴格法規，美式照護更強調病人自主權之『最終』效力，即使家屬反對也必須遵守。