篇名 | 協助同性伴侶參與末期愛滋病患不施行心肺復甦術之自主決定 |
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卷期 | 59:5 |
並列篇名 | Experience Assisting an AIDS-Infected Homosexual Patient and His Same-Sex Partner Make a Do-Not-Resuscitate Decision |
作者 | 王淑絹 、 賴霈妤 、 劉曉穎 、 柯文謙 、 柯乃熒 |
頁次 | 097-102 |
關鍵字 | 同性戀 、 愛滋病毒感染者 、 自主決定 、 同性伴侶 、 homosexual 、 patient with HIV 、 self-determinate decision 、 civil couples 、 MEDLINE 、 Scopus 、 TSCI |
出刊日期 | 201210 |
同性戀愛滋病病人在臨終時,期待委託他們的同性伴侶或是親密友人擔任醫療決策的代理人。雖然我國的民法定義中,同性婚姻不是合法的,但同性戀之愛滋病病人可經由「預立指示」的過程,委任同性伴侶為醫療代理人,完成預立醫囑。此篇案例報告為描述一位末期同性戀愛滋病患者合併肝衰竭,護理人員在病人意識清醒時透過預立醫療指示之過程,尊重並協助病人完成其委任同性伴侶為醫療代理人之護理經驗。護理人員透過認可同性伴侶的角色並給予情感支持外,同時與醫療團隊召開家庭會議,協助個案完成委任同性伴侶成為醫療代理人的心願,藉由個別性及完善的護理措施給予個案及同性伴侶情感支持,並在個案病程變化的同時,給予同性伴侶支持及協助其與個案父親的溝通,摒棄痛苦且無意義的急救過程,共同陪伴個案走過臨終期。臨床護理人員具備臨床專業知識外,更需同理同性戀伴侶在社會的處境,透過相關法律的協助,才能化身為病人的「代言人」,完成病人臨終自主決定的心願。
Family members play an important role in the process of writing advance directives. Homosexual men infected with HIV often wish to authorize their intimate same-sex partner or friends rather than immediate family members to make medical decisions on their behalf. Although same-sex marriage is currently illegal in Taiwan, HIV infected homosexual patients are able to write advance directives appointing their same-sex partner to be their surrogate decision maker for end-of-life medical decisions. This case report describes an experience assisting a homosexual patient with HIV to write his advance directives. The nurse assisted the patient and his partner to make a self-determined decision not to resuscitate. Family conferences held to discuss the patient's decisions regarding resuscitation helped legitimize his partner's primary role in making end-of-life healthcare decisions on his behalf. As an advocate for patient rights, nurses should understand the law as it relates to homosexuality and end-of-life decision making, inform patients on the durable power of autonomy, and help execute their advance directives.