醫護人員對「安寧緩和醫療條例」之教育需求

The Natural Death Act was enacted in Taiwan in June 2000. The legalization not only represents respect for the dignity of the terminally ill. But also facilitates ethical decision-making in end-of-life care. The present study was designed to investigate the current status of DNR (Do Not Resuscitate) orders and to understand the training requirements for further Natural Death Act educational initiatives. A total of 69 medical professionals working in oncology wards and a palliative care unit were interviewed with a semi-structured questionnaire. Sixty-six respondents (95.7%) had been involved in DNR situations, and around half (53.0%) had consent from the families. One third (31.8%) of respondents were unsure of the legal status of DNR orders. Although only a small proportion (17.4%) fully understood the contents of the Natural Death Act, the majority (79.7%) of respondents supported the legislation. Nearly all respondents (97.1%) expressed a willingness to learn more about the contents of the Act. Staff in the palliative care unit scored higher in their support of the newly enacted legislation and in practicing in accordance with its regulations (P＜0.01, P＜0.01). Understanding the Act and practicing in accordance with its regulations were positively correlated (r=0.442, P＜0.001). Incorporation of the Natural Death Act and related issues into medical school curricula and provision of appropriate training for medical professionals appear to be the most useful educational strategies at this early stage. (Full text in Chinese)