# 重度精神分裂症成人因命令幻聽試圖縱火被送ED,拒絕自願住院。最能反映非自願精神科住院法律與倫理依據之陳述?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375127&lang=zh-tw  
> language: zh-TW  
> subject: NCLEX-RN  
> category: SIPC

## 題目

重度精神分裂症成人因命令幻聽試圖縱火被送ED,拒絕自願住院。最能反映非自願精神科住院法律與倫理依據之陳述?

## 選項

1. 僅家屬要求即足以非自願住院
2. 需立即傷害自己/他人或grave disability,並於最少限制環境照護 **✔ 正確答案**
3. 任何有活動性幻覺者均應至少非自願住院30天
4. 72小時hold期間病人可隨時AMA離院

**正確答案: 2**

## 解析

非自願精神科住院需法律準則:立即危及自己、他人或grave disability(因精神疾病無法滿足基本需要)。最少限制原則 — 門診、部分住院、自願、再非自願。州72小時hold(如加州5150)用於評估;hold期間不可AMA。僅家屬要求不足 — 須符合臨床與法律準則。活動性幻覺本身非必要住院 — 須有危險或grave disability。

## 深入解析

住院期間病人仍保有權利:人道照護、通訊(有限)、申訴程序、除緊急外可拒絕治療。住院非懲罰。

## 臨床情境

警官帶來。無醫學問題。家屬亦擔心安全。

## 重要概念

- **Grave disability** — 因精神疾病無法滿足基本需要(衣食住安全)。
- **最少限制** — 精神衛生介入應使用所需之最低限制之原則。
- **72小時hold** — 評估用之緊急民事commitment — 各州名稱不同。

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