加護病房接收了急診室插管病患。她父母要求知道她吃了什麼藥。病歷顯示她在失去意識前，曾明確要求不可透露她的非法用藥史。護理師的倫理義務為何？
An intensive care nurse receives an admission from the ED: a 25-year-old female client intubated for an overdose. Her parents demand to know what drugs she took. The chart indicates the client explicitly requested absolute privacy regarding her illicit drug use just before losing consciousness. What is the nurse's ethical obligation?
- AInform the parents that the specific details cannot be released due to her prior privacy request.✓ 正解告知父母因病患先前要求隱私，無法提供具體細節
- BState that HIPAA regulations automatically waive privacy constraints when an adult is on a ventilator.表示 HIPAA 法規在成人使用呼吸器時自動豁免隱私限制
- CTransfer the parents to the hospital chaplain to disclose the sensitive drug information.將父母轉介給醫院牧靈人員以披露敏感藥物資訊
- DDisclose the results to the parents to promote coping.向父母披露結果以促進應對能力
本題涉及醫療倫理中的病患自主權 (Autonomy) 和保密原則 (Confidentiality)，以及美國的《健康保險可攜性與責任法案》(Health Insurance Portability and Accountability Act, HIPAA)。核心概念是，成年病患在有能力表達意願時，有權決定其醫療資訊是否被揭露。即使病患隨後失去意識，其先前明確表達的隱私要求仍應受到尊重，除非有法律規定或病患指定了醫療代理人 (healthcare proxy) 且代理人同意揭露。護理師的倫理義務是維護病患的隱私權，即使面對家屬的請求，也必須遵守病患的意願和法律規定。
The nurse must honor the client's explicit request for privacy regarding her medical information, as this right persists even after she loses consciousness. Disclosing specific drug use to the parents would violate HIPAA regulations and ethical principles of confidentiality. Unless a legal healthcare proxy authorizes release, the nurse should inform the parents that the information cannot be shared due to the client's prior directive.
成年病患的預立拒絕分享資訊是無敵的，家屬無權過問。