醫學倫理與法律病例研討

Medical Ethics and Legal Case Conference

（顧及人權隱私，人名、醫院名稱、病患基本資料已作修改）據檢舉人指出，94年5月15日，李醫師未向愛愛醫院和衛生署申請人體實驗，僅要求47歲肝癌末期病危的陳姓婦人家屬簽立同意書，就使用沒有任何藥品標籤的玻璃瓶裝液體，替病人塗抹身體，並先後兩次替病患注射十c.c.；另外兩百八十c.c.經鼻胃管餵食，剩下的不明液體被他帶走，當天晚上胡婦就不幸病逝。李醫師表示，為病人注射的是芝麻油萃取物，是向愛愛環境醫學研究所莊教授拿的，當時並未向莊教授說明做什麼用途。莊也向《香蕉晚報》記者證實，李醫師確曾跟他拿芝麻油萃取物，「就是一般的芝麻油嘛！常用在按摩，具美容解壓、抗氧化功能。」他說，因芝麻油的芝麻酚有抗敗血症效果，初步已在白老鼠實驗證實。對於李醫師涉嫌違法注射芝麻油做人體實驗，《香蕉晚報》記者也訪問已過世陳婦的家屬，但她家人不願接受採訪；她的長子在電話中回答：「我們覺得沒有問題，我們沒有意見。」從這個案例，我們可以反思： 以芝麻油替病危患者治療，是否涉及違法救人，是否有違人體試驗的精神？

This article explores the nursing The purpose of this article is to promote medically and ethically sound decision making in clinical practice related to the human trial. Sesame oil has been proved anti-septic effect in animal study and the parenteral administration of high conc. sesame oil lead to some conflicts. In this case, attending physicians attempted to make the best decisions, sparing the patient and family from the burdens associated with these difficult choices. This paternalism emphasized beneficence to the exclusion of other principles, particularly autonomy. Unfortunately, physicians are not always able to determine what is in their patients' best interests, and biases are unavoidable. The therapeutic human trial might just do harm to the patient, thus against the principle of nonmaleficence, and provides only futile intervention. In facing clinical critical condition, should attending physician chose best medical care or human trial ? In this potential legal situation, pos and cons side offer different views of medical ethics and legal. process on a patient diagnosed with hepatocellular carcinoma with the compression of the spinal cord during the time from March, 20 to April, 16 in 2005. Researcher used Roy's adaptation theory , which is concerned with the physical function, self cincept, and role function, independence. Data collected through observation, conversation, and physical examination. The main nursing problems during the hospitalization include the difficulties of physical function, the potential risk of infection, and a sense of hopeless. I establish the nursing-patient relationship by a positive attitude that gives care continually and actively. Aside from physical care, I use nursing skills like encouraging him to have social activities and offering him medical information to help the patient feel valuable and meaningful toward life, and to help the patient to receive the fact of the last stage of the disease. Supported by the nurse and family, the patient can adjust well to face the fact of illness and life in the future.