— 照護管理 · MEDIUM · MCQ —
一位病人剛被診斷為末期癌症，家屬要求不要告訴病人診斷結果，護理師應如何處理？
A nurse is caring for a client who has just received a diagnosis of terminal cancer. The family is requesting that the diagnosis not be disclosed to the client. How should the nurse proceed?
- ADiscuss the family's concerns with the attending physician and the healthcare team✓ 正解與主治醫師及醫療團隊討論家屬的擔憂
- BRespect the family's wishes to prevent emotional distress to the client尊重家屬不希望病人情緒困擾的意願
- CIgnore the family's request and provide the medical chart to the client忽略家屬的要求並將病歷提供給病人
- DTell the client the diagnosis directly to uphold the principle of autonomy為維護自主原則，直接向病人告知診斷結果
— Explanation · 中文詳解 —
醫療倫理中，尊重病人自主權（Autonomy）與家庭隱私權常產生衝突。護理師應協助釐清病人的意願，但不能單方面決定隱瞞或告知。最妥當的方式是將團隊與家屬召集起來，透過跨領域團隊討論，確保決策符合法律規範及病人的最佳利益與知情同意權。
The nurse must balance the client's right to autonomy with family concerns by collaborating with the healthcare team. Discussing the situation with the physician ensures that ethical and legal standards are upheld while determining the best approach for disclosure.
✦ 台美臨床差異
美國非常強調病人自主權；台灣文化中家庭共決（Family-centered）色彩較重，護理師需在兩者間取得平衡。