癌症病患及家屬對不予急救的認知與態度

The Recognition and Attitude of Cancer Patients and their Families on Do-not-resuscitate

呂佩佩(P. P. Lu) ； 陳美伶(M. L. Chen) ； 鍾昌宏(C. H. Chung) ； 唐婉如(W. R. Tang)

《腫瘤護理雜誌》 4卷1期 (2004/09) Pp. 15-22

https://doi.org/10.6880/TJON.200409_4(1).02

摘要

本文以文獻回顧的方式介紹心肺復甦術的起源及其在社會中造成的衝擊。首先統整癌症病房的病患接受急救措施後的成效，急救後能存活至出院的癌患比例介於0%-10.5%。接下來談到人們思索急救措施在現實環境中的必要性與合法性，美國的自然死法案與病人自決法案、國內的安寧緩和醫療條例相繼誕生，法律的制定實際反映出社會的需求。最後，彙整病患和家屬對於急救措施的看法，他們認爲臨床上不予急救是指心跳停止時，不挽回病患的生命。死亡是人生定數，且急救態度深受社會文化脈絡影響。病患提到討論急救議題會感到害怕，但是也承認這讓他們有時間去準備死亡。文獻回顧後發現國內少有研究把病患本人做爲研究對象，研究取向也偏向量性的實證研究。建議未來研究能詢問個案本身的想法，融入質性研究來深入探索此一複雜的醫療社會現象。

關鍵字

癌症 ； 病患 ； 家屬 ； 不予急救 ； 心肺復甦術

並列摘要

This paper discussed the origin of cardiopulmonary resuscitation and its social impact through literature review. First, the paper reviewed the outcomes of resuscitation on cancer patients, and found the ratio of patients that could be discharged from the hospital after the resuscitation is 0%-10.5%. Then, the paper discussed several issues, including the necessity and legitimacy of the resuscitation in the reality, the Natural Death Acts (NDA) and Patient Self Determination Act (PSDA) in the U.S., the Stipulation of Palliative Care Acts in Taiwan, and the reflection of the social urge in those acts. Lastly, the viewpoints of the cancer patients and their families on resuscitation were reviewed. Their definition of do-not-resuscitate is not saving the patient's life when the heartbeat stops. Death is the destiny of everyone, and the attitude toward resuscitation is heavily influenced by the cultural context. The patients expressed fear when discussing about resuscitation, yet they admitted that such discussion allows them to have time to prepare for death. Our literature review showed that researches in Taiwan rarely used patients as the subjects. Most research methods are oriented toward quantitative positivism. It is suggested that future studies should probe into the thoughts of the party involved, and incorporate qualitative methodology on this complicated social phenomenon.

並列關鍵字

Cancer ； patient ； family ； do-not-resuscitate ； cardiopulmonary resuscitation