摘要
重症照護領域中，面對腦死病患是一門相當特殊的課題。不同於許多其他疾病的生命末期狀態，腦死的發生往往突如其來，使家屬在猝不及防的心理狀態下必須馬上試著理解並接受這病況的嚴重程度，甚至開始思考及做出與其相關的決策，包括是否簽署拒絕心肺復甦同意書或器官捐贈。近五十年來，國內外對於生命末期照護逐浙走向更人性化且讓病人或家屬有更多自主性，不論是治療的不給予或撤除，拒絕心肺復甦乃至解除瀕死痛苦的用藥等由不同角度切入醫學倫理的探討；晚近十年，這關懷的議題更逐浙由病人照護具體化地擴展到家屬照護。在器官捐贈被大力推廣的今天，腦死病患及其家屬將是我們愈益頻繁面對的族群：當病人因驟然的創傷或疾病住進加護病房，全身安滿管路，不言不動，安寧照護被及家屬的層面近至當下的陪伴安撫，遠至日後的關懷問訊，都有助於家屬走出喪親之慟。觀察結果中，大部分家屬對於施諸病人的醫療行爲普遍感到滿意，情緒面的照顧略顯不足，而硬體資源的短缺與隱和的缺乏亦是較常被揭露的困境。對於此一情境，除了正視硬體設備改善空閒，加重社工人員或心理師在整個醫療團隊中的角色俾提供更即時且全面的支持外，醫療及護理人員春成過程中的溝通技巧亦應強化教育訓練。
並列摘要
Brain death is a sudden and traumatic event following a severe injury to the brain. The sudden onset and short course made it different from other chronic diseases in end-of-life care. Scant of psychological preparation and unfamiliarity to medical terms hinder relatives of braindead patients from indeed understanding when bad news is broken. For fifty years, humanity and autonomy are more and more highlighted in end-of-life care, including therapy withholding or withdrawing, do not resuscitation and medication which relieving dying rattles or shortening dying processes. In this recent decade, palliative care was further expanded to include the family, not only the patients.Most patients with brain death spend the last days of life in an intensive care unit (ICU), where some family will be approached to ask for organ donation. What comforts the relatives and helps them recover from bereavement can be a timely considerate word or a little while staying with them. In a research in the United Kingdom, most family valued the physical care their relatives had received, but communication and breaking bad news was a cause for concern. The facility of Many ICUs such as cramped relative's room and little privacy to say final goodbye was also mentioned. This similar situation is also noticed in our country. To deal with these problems, besides facility improvement, palliative care team should offer the support through the last days and into period of bereavement; staff training on how to communicate bad news should also be stressed.