A 65-year-old woman is evaluated in the emergency department for sudden onset of right hemiparesis and aphasia. Blood pressure is 178/106 mm Hg, heart rate 98 beats/min, respiratory rate 24 breaths/min, pulse oxymetry 98% on 2-liter nasal cannula, and National Institutes of Health Stroke Scale score is 16. The on-call neurologist recommends IV recombinant plasminogen activator (rtPA). However, there are no family members with which to discuss potential risks, benefits, or alternatives.
On the basis of which of the following principles is a physician allowed to administer IV rtPA to this patient?
A. Autonomy
B. Nonmaleficence
C. Implied consent
D. Utilitarianism
答案解析：
在紧急或危及生命和时间危急的情况下，医生有责任保全生命。在极少数危及生命的疾病中，如败血症或心肌梗死，患者可参与知情同意过程。然而，医生经常使用隐含的同意原则对缺乏决策能力或代理人的患者进行挽救生命的干预。暗示同意的紧急原则允许提供者提供某些干预措施，如果不及时进行，可能导致发病率和死亡率增加。如果满足以下条件，医生可以使用默示同意原则：相关治疗代表所治疗疾病的常规和惯用标准治疗，在等待明确同意时延迟治疗显然对患者有害，如果患者有能力这样做，通常预期他/她会同意所讨论的治疗。
正确答案：C
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