探討不施予心肺復甦術的倫理議題

The Ethical Issues of Do-Not-Resuscitate

蔣欣欣(Hsien-Hsien Chiang) ； 彭美慈(Samantha Peng Mei-Che) ； 余玉眉(Chao Yu Yu-Mei) ； 蘇逸玲(Yiet-Ling Su)

《榮總護理》 23卷1期 (2006/03) Pp. 87-96

https://doi.org/10.6142/VGHN.23.1.87

摘要

本研究旨在探究護理人員面對不施予心肺復甦術所遭遇的困境，以質性研究之焦點團體訪談收集資料，進行14次焦點團體，每次團體進行時都以分享「醫院裡的哲學家」一書的內容為開端，參加團體的護理人員共計11人，每次團體人數5~10人。團體及訪談資料轉成文字後，以繼續比較分析找出各項主題。內容分析分別找出（一）家屬方面：對不施予心肺復甦術意義的誤解、救與不救間的矛盾。（二）醫護人員方面：自身預設的立場、告知責任的歸屬、告知內容的可理解性、告知的時機。最後討論照顧臨終病人面臨不施予心肺復甦術時由誰告知、告知什麼、何時告知、如何告知等專業態度。

關鍵字

倫理困境 ； 不施予心肺復甦術 ； 焦點團體 ； 抉擇

並列摘要

This study aimed to understand the ethical dilemmas nurses encountered in patient care situations where Do-Not-Resuscitate (DNR) order was made. Focus group interviews were conducted to capture the nurses' experience. A total of 11 nurses voluntarily participated in the interviews in 14 sessions, with five to ten nurses attending each session. The nurses were encouraged to share their own clinical encounters upon reading the relevant ethical cases described in the book entitled Philosopher in the Hospital. The interviews were audio-recorded and transcribed verbatim for qualitative analysis using constant comparative method. Emergent themes were categorized into family concerns and health professional concerns. The family concerns revolved around issues of misconception in relation to the meaning of DNR order, and the conflict between forgoing or continuing resuscitative measures. For the health professionals, some brought their unreflective personal standpoints to the patient care situation, and some were uncertain about who should be accountable in the DNR decision-making. Confusion arose regarding the use of evasive wording and the optimal time for information disclosure.

並列關鍵字

ethical dilemmas ； DNR ； focus group ； decision-making