本文藉著台灣社會老年人口越來越多的趨勢,將在台灣常見的「老年人的自我決定權受到壓抑」之現象,結合「告知後同意」的概念,探討高齡者在醫療上的困境,以及如何保障。 「告知後同意」指的是醫師之醫療行為應取得病患之同意,在取得病患之同意前,亦應盡一定之告知義務,若是未為告知或是未取得同意即採取醫療行為,醫師可能會構成侵權行為而背負民刑法上之責任。而告知後同意的中心思想在於「尊重病患的自我決定權」。既然是自我決定權,有權做決定的原則上就應是病患本人,但是在病患是老年人時,常常做決定是家屬而非病患本人,此種現象是否妥適? 本文先敘述老年人人口的快速增長,而後分析老年人的自我決定權容易受到左右的背後原因,與西方文化及外國成文法做個比較後,做出應當修法的主張,建議將法條中的告知對象「病患或其家屬」改為「病患」,奠定以病患本人為主的原則,並且在之後加入代理同意之順位等規定作為例外情況下的補充。期許如此的修法,可以落實老年人在醫療上的自我決定權。
"Informed consent" means that the physician's shall obtain patient’s consent before the medical practice. Also before obtaining the consent of the patient, physician should make sure that the obligation of inform has been made. The core value/idea of informed consent is the right of self-determination. Since it’s the right to self-determination, whatever the patient’s age, he/she has the right to make decision for himself/herself. In Taiwan, the number of elders growing speedy, but their right to self-determination was not under proper protection. We can often see that the patient’s family member make decision, despite the one under medication. Also we can find that this phenomenon occurs significantly when the patient is an old people. This paper is narrating the ageing situation of Taiwan, and analyzing why the family member has the right to decide alternatively. Through comparing The Informed Consent’s Difference between eastern and western, wish to reach the conclusion that the words of informed consent of medical law should be under consideration again and proper modification.Hope this modification of law could make the right to self-determination of elders in Taiwan put into effect.