— 照護管理 · EASY · MCQ —
一位末期病人向護理師詢問有關預立醫療決定（Advanced Directives）的資訊。護理師最恰當的回應為何？
A nurse is caring for a client who is terminally ill and requesting information about advanced directives. What is the most appropriate nursing response?
- AI can explain the different types of directives and provide the necessary forms✓ 正解我可以解釋不同類型的指示書並提供必要表單
- BThis is a legal decision that requires a lawyer to be present這是法律決定，需要律師在場
- CYou should sign a Do Not Resuscitate (DNR) order immediately你應該立即簽署不施行心肺復甦術（DNR）醫囑
- DI will call the social worker to discuss this with you我會叫社工來與你討論此事
— Explanation · 中文詳解 —
預立醫療決定（Advanced Directives）包含生前遺囑（Living Will）與醫療授權代理人（Durable Power of Attorney for Healthcare）。護理師在倫理上需尊重病人的自主權（Autonomy），協助其理解法律權利並提供資源。護理師不應強迫病人簽署，也不應推卸責任，而是提供資訊讓病人做出知情決定。
The nurse should respect the client's autonomy by providing education on advanced directives and supplying necessary forms. This empowers the client to make informed decisions without requiring immediate legal counsel or pushing for specific orders like a DNR.
✦ 台美臨床差異
美國醫院非常重視Advanced Directives的執行，入院時護理師通常會詢問是否有Living Will。台灣雖然也有相關法規（如病人自主權利法），但臨床普及度與觀念推廣仍不如美國成熟。