安寧緩和醫療條例中的末期病患與病人自主權

Terminally Ill and Patient Right of Autonomy in Hospice Palliative Care Act of Taiwan

孫效智(Hsiao-Chih Sun)

《政治與社會哲學評論》 41期 (2012/06) Pp. 45-91

https://doi.org/10.6523/168451532012060041002

摘要

本文探討第二次修法後的《安寧緩和醫療條例》所仍面對的重大倫理與法律議題。首先是第一條的修法所引發的問題，其次則是第七條修法的問題。第一條的修法看似無關宏旨，實則關係到病人自主權、關係性自主概念以及末期病人的爭議，也涉及到法規範次序之間的融貫性。第七條第二次修法新增了「最近親屬一致同意並經醫學倫理委員會審查通過後便得撤除病人心肺復甦術」的規定。本文將探討這個規定的理念以及它在執法層面上的問題。探討的基礎即本文前半部有關病人自主權及關係性自主的討論，該規定在執行面上是否窒礙難行以及問題該如何解決，都是本文所要探討對象。

關鍵字

安寧緩和醫療條例 ； 病人自主權 ； 關係性自主 ； 末期病人 ； 共融決策

並列摘要

The purpose of this paper is to explore some of the most significant ethical and legal issues of the Hospice Palliative Care Act of Taiwan after its second amendment. The main questions are twofold. The first group of questions is related to problems surrounding art. 1, especially those concerning patient right of autonomy, the concept of relational autonomy and controversies about the definition of terminally ill patient, while the second one is concerned with questions arising from the second amendment of art. 7, which allows terminally ill patients who are unconscious and do not have signed any advance directive concerning DNR to have the life-supporting systems defined in art. 3 withdrawn with the consent of their family and the approval of ethics committee of the hospital. Based on the conclusions derived from the discussion in the first part of the paper, the ideas behind the new regulation of art. 7 are critically analyzed. The question as to whether there will be difficulties in the practices following the new regulation of art. 7 and how to solve them will also be dealt with.

並列關鍵字

Hospice Palliative Care Act of Taiwan ； patient right of autonomy ； relational autonomy ； terminally ill ； collegiality of decision-making

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楊秀儀(2004)。救到死為止？從國際間安樂死爭議之發展評析台灣「安寧緩和醫療條例」。國立臺灣大學法學論叢。33(3)，1-43。

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