摘要
病人擁有依其自主意願選擇死亡方式「善終權」，涉及病人生命權與病人自主權保障之間立法權衡的界線。本文透過法學與臨床醫學相關的文獻分析，探討我國關於病人善終權益制度的發展脈絡，並與外國法制做差異比較。 綜觀外國之立法例，有些准許「積極安樂死」，有些准許「醫師協助自殺」，有些准許「自然死」而不限制疾病種類及進程。相較之下，我國現有的制度包括安寧緩和醫療條例與病人自主權利法，均僅允許病人自然死之善終權益，且所適用之臨床條件與醫療選擇範圍均嚴格限制，顯然採取較為保守的立法模式。 安寧緩和醫療條例於民國89年施行，這是我國首度有法律明文肯認病人有選擇按照疾病病程自然死亡不受醫療干預加工延長生命的權益，可稱為自然死或尊嚴死。雖然其後又經歷三次修法，但適用對象僅限於末期病人，且得拒絕的醫療選項範圍僅限於只能延長瀕死過程的無效醫療，對於病人善終權的保障仍顯不足。 病人自主權利法於民國105年公布生效，並於今年1月正式施行，這是亞洲第一部保障病人自主權利的專法，建構以病人為主體之基本原則，確立病人本人對於臨床醫療處置，享有知情、選擇與決定的自主權利；在「善終權」方面，允許病人在參與預立醫療照護諮商的知情流程後，簽署預立醫療決定，於將來失去意思表達能力時仍可拒絕醫療，所適用之臨床條件不再限於末期病人，且可拒絕之醫療處置範圍亦擴張及於部分有效醫療，同時兼顧醫師專業裁量權限以利於維持良好醫病關係。
並列摘要
Patient’s “Right to Good Death” draws a line balancing between patients' right to life and right to autonomy. Through the literature analysis related to law and clinical medicine, this thesis explores the development of legal system of patient’s right to good death in Taiwan, and compares it with foreign legal system. Some legislation in the foreign countries permit “active euthanasia”, some allow “physician-assisted suicide”, and some permit “natural death” without limiting the type and progress of the disease. In contrast, only natural death with strictly limited clinical conditions and medical options is permitted in legislation in Taiwan. The Hospice Palliative Care Act was enacted in the 89th year of the Republic Era. This is the first time for Taiwan to have a statue protecting patient’s right to good death. A terminally ill patient is permitted to refuse the life-sustaining treatment according to the letter of his or her intent. The law was further amended three times to gradually broaden the scope of protection, but it was still not considered to be enough. The Patient Right to Autonomy Act was promulgated in the 105th of the Republic Era, and then came into force this year in January. This is the first act to safeguard patient’s right to autonomy in Asia, and also protect patient’s right to good death which broadens scope of application not limited to terminally ill patients anymore. Persons with full disposing capacity may participate in the informed process of advance care planning and then make advance decisions, which include the willingness to accept or refuse life-sustaining treatment and/or artificial nutrition and hydration under the specific clinical conditions.