末期之醫療決定與刑法評價

Terminal Medical Care and the Criminal Law Evaluation

韓政道(Cheng-Tao Han)

《中正大學法學集刊》 48期 (2015/07) Pp. 251-296

摘要

自1980年代後期，圍繞於安樂死、尊嚴死、醫師協助自殺等議題中，終末期醫療就持續受到醫療先進諸國於醫療臨床上的爭論與關注。在此背景下，我國也於2000年制定了安寧緩和醫療條例，為末期醫療的實踐，建立了準則性的法律規範。然而，無論是維生醫療設備的終止或不介入，皆已直接涉及病人的生命法益與自主決定權等之侵害與保障問題。對於現性立法框架的妥適性，就須透過刑法理論的檢驗予以支持。本文以下將在刑法的視野下，探討末期醫療處置的適法性。同時，針對我國現行實施的《安寧緩和醫療條例》，其中有關維生設備的不予與撤除，程序上是否有給末期病人充分合理的自主空間，以及有無達到尊重生命法益的基本要求。這些重要問題，本文也將借助參考日本的法制經驗，一併予以觀照。

關鍵字

末期醫療 ； 末期病人 ； 無效醫療 ； 限期嘗試治療成效 ； 心肺復甦術 ； 維生醫療 ； 安樂死 ； 尊嚴死 ； 意願書 ； 自主決定

並列摘要

Since the late 1980s, issues pertaining to Terminal Care have been discussed in the health care practices of several developed countries especially euthanasia, death with dignity and physician-assisted suicide. In this context, Taiwan has also developed Hospice Palliative Care Act in 2000, for Terminal Care practice guidelines for the establishment of legal norms. However, whether Life-sustaining treatment (LST) withholdingor withdrawing, directly related to the patient's life, such as legal interests and rights of independent decision security issues. For Botox framework of existing legislation, it must be supported by examination of criminal law theory. The following article will be under criminal law perspective, and to explore appropriate methods of Terminal Care. Meanwhile, for the Hospice Palliative Care Act, which Life-sustaining treatment (LST) withholding or withdrawing, whether terminally ill patients to self-sufficient and reasonable space program, as well as whether the reach of legal interest to respect the basic requirements of life. These important issues, this article will refer to Japan's legal system by means of experience, together with contemplation.

並列關鍵字

Terminal Care ； Terminal Illness Patients ； Medical Futility ； Time-Limited Trials ； Cardiopulmonary Resuscitation ； Life- Sustaining Treatment ； Euthanasia ； Death with Dignity ； The Letter of Intent ； Self-Determination

參考文獻

王志嘉(2014)。醫師、病人誰說的算？：病人自主之刑法實例剖析。元照。

王皇玉(2011)。刑法上的生命、死亡與醫療。承法。

何建志(2013)。醫療法律與醫學倫理。元照。

張麗卿(2014)。醫療人權與刑法正義。元照。

張麗卿(2012)。刑法總則理論與運用。五南。