中高齡救護志工對病人自主權及善終意涵認知之研究：「以南投縣鳳凰志工為例」

Study on the Understanding of Patient Autonomy and the Meaning of a Good Death by Middle-aged and Elderly Emergency Medical Volunteers: A Case Study of the Phoenix Volunteers in Nantou County

《病人自主權利法》是亞洲首部強調病人自主權的法律，明確規定病人的醫療決策應受到尊重，不容他人干預，包括家屬。然而，在急救現場救護志工經常遇到患者已無生命跡象也曾簽署放棄急救同意書，但家屬堅持要求急救，讓救護志工感到困惑，因此，了解救護志工的服務經驗是否影響善終觀點及對病人自主權利法的認知程度，作為未來訓練課程規劃是非常重要的研究議題，本研究採質性研究法，以半結構式訪談大綱對南投縣五位中高齡救護志工進行深度訪談，結論如下:（1）志工服務經驗有助於正向、樂觀的面對死亡；（2）對病人自主權利法了解程度不足，但仍重視病人自主議題；（3）志工服務經驗有助於反思自身善終觀點；（4）期待善終，且樂於與家人討論及事先做好準備；（5）希望病人自主權利法課程融入訓練課程，強化對該法的認知。建議政府單位將病人自主權利法納入救護技術員訓練課程，提高相關法規的宣傳力度，讓社會大眾更關注與理解此議題。

The Patient Right to Autonomy Act is the first Asian law that emphasizes patient autonomy, explicitly stating that a patient's medical decisions should be respected without interference from others, including family members. However, emergency medical volunteers often encounter perplexing situations where patients show no signs of life and have previously signed Do Not Resuscitate (DNR) forms, yet their family members insist on emergency care. Therefore, understanding whether the service experiences of these volunteers affect their perspectives of good death and their understanding of the Patient Right to Autonomy Act is a crucial research topic for the planning of training programs in the future. This study employs a qualitative research approach where semi-structured indepth interviews are conducted with five middle-aged and elderly emergency medical volunteers in Nantou County, Taiwan. The conclusions drawn from the study are as follows: (1) Volunteer service experiences contribute to a positive and optimistic view towards death; (2) Volunteers’understanding of the Patient Right to Autonomy Act may be limited, but they still show concern about this issue (3) Volunteer service experiences facilitate reflection on volunteers’perspectives toward good death (4) Volunteers desire a good death and are willing to discuss and prepare with their families in advance; (5) They hope that courses on the Patient Right to Autonomy Act will be incorporated into training programs to promote understanding of the law. It is recommended that government agencies incorporate the Patient Right to Autonomy Act into training programs for emergency medical technicians and spread awareness of relevant regulations, in order to promote greater awareness and understanding of this issue in society.