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台灣老人醫療自主權的省思

The Medical Autonomy of Elderly in Taiwan

摘要


台灣老年人口增長迅速,伴隨平均餘命的延長,老年人已成為醫療體系主要的消費族群。尊重自主為醫學倫理的重要核心價值,然而其意涵,卻會受到家庭、社會與醫療文化的影響;而針對高齡病人,因老化所帶來身、心、社會各方面能力之衰退,如何在我國特殊文化背景下,維護高齡者的醫療自主權,實值得深思。本文將彙整相關議題之文獻論述,由老人的弱勢情境、華人文化及現行醫療決策情境等面向,闡述高齡者面對醫療決定之處境,進而對如何實踐高齡病人醫療自主之照護理想提出建言。

關鍵字

老人 醫療自主 醫療決定

並列摘要


The elderly population is increasing rapidly in Taiwan. With the average life expectancy on the rise, the elderly have become major consumers of healthcare products and services. Factors that influence respect for autonomy, a core value of medical ethics, may be related to family, society, and the medical culture. Especially in patients who are already elderly, aging causes declines in physical, mental and societal capacities. Practicing a respect for patient autonomy is particularly challenging for healthcare professionals in Taiwan due the unique culture background of elderly Taiwanese patients. This article reviews and integrates the literature related to the issue of patient autonomy and elaborates on medical decision-making among elderly patients in Taiwan in the contexts of: the disadvantages faced by the elderly, the background of Chinese culture, and the current medical decision-making environment. A few suggestions are proposed to help preserve the medical-decision-making autonomy of elderly patients in Taiwan.

並列關鍵字

elderly medical decision autonomy

參考文獻


胡哲瑊(2013).從告知後同意論高齡者之醫療困境與保障(未發表的碩士論文).桃園縣:中原大學財經法律學系研究所。[Hu, C. C. (2013). On the dilemma of decision-making in elder people’s healthcare practice from the perspective of informed consent (Unpublished master’s thesis). Chung Yuan Christian University, Taoyuan County, Taiwan, ROC.]
莊曉青、廖庭萱、許碧珊(2008).老人醫療自主權.當代醫學,35(3),245-248。[Chuang, X. Q., Liao, T. H., & Hsu, P. S. (2008). Autonomy for elderly people. Medicine Today, 35(3), 245-248.]
陳佳雯、張妤玥、高旭繁、陸 洛(2013).老了,就不中用了?台灣高齡者最適老化之歷程探究.本土心理學研究,40,87-140。[Chen, J. W., Chang, Y. Y., Kao, S. F., & Lu, L. (2013). Getting old is terrible? The optimal aging process among older Taiwanese. Indigenous Psychological Research in Chinese Societies, 40, 87-140.] doi:10.6254/2013.40.87
葉光輝(2009).臺灣民眾的代間交換行為:孝道觀點的探討.本土心理學研究,31,97-141。[Yeh, K. H. (2009). Intergenerational exchange behaviors in Taiwan: The filial piety perspective. Indigenous Psychological Research in Chinese Societies, 31, 97-141.]
蔡甫昌(2000).生命倫理四原則方法.醫學教育,4(2),140-154。[Tsai, D. F. C. (2000). The four principles approach to bioethics. Journal of Medical Education, 4(2), 140-154.]

被引用紀錄


孫婉娜、蘇靖幃、李淑琄、何孟修、林嘉雯、林怡初、許心恬(2017)。生命末期醫療決策概念分析高雄護理雜誌34(3),59-68。https://doi.org/10.6692/KJN.201712_34(3).0006
蔡宜蓉、毛慧芬、林佳萱、李玉春、張玲慧(2021)。以質性研究探討台灣推動復能服務之困境與因應策略-從服務提供者觀點分析台灣公共衛生雜誌40(4),394-405。https://doi.org/10.6288/TJPH.202108_40(4).110039
李淑婷、謝雨珊(2020)。解放性決策之概念分析台灣專科護理師學刊7(1),36-43。https://www.airitilibrary.com/Article/Detail?DocID=P20150413001-202011-202011250016-202011250016-36-43

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