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題名:病人自主權利法--善終的抉擇
書刊名:東海大學法學研究
作者:張麗卿 引用關係
作者(外文):Chang, Li-ching
出版日期:2016
卷期:50
頁次:頁1-47
主題關鍵詞:病人自主權利法安寧緩和醫療條例醫療法善終自主權Patient autonomy actHospice palliative care actMedical care actA patient's autonomy right to a good death
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(16) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:16
  • 共同引用共同引用:28
  • 點閱點閱:56
每個人都要死亡,只是不知道何時死亡,將以何種方式死亡。死亡降臨的那一刻不可預測,但通常是發生不可治的大病或意外,使得醫療只能成為延緩死亡的過程,醫療因此成為沒有意義。為了更加尊重病人的自主決定權,必須讓人在最壞的時刻發生前,就預立意願書,決定自己在生命盡頭的處理方式。台灣《病人自主權利法》(以下稱本法)堪稱亞洲第一個善終權的立法。換言之,病人善終自主權是病人在特定情況下能夠依據自己真實意願,在醫師協助下自然而無痛苦或較小痛苦地走向生命終點的權利。不過,病人善終權不能遭到濫用。依照本法,可以預立善終權的人,必須二十歲以上的完全行為能力人,心智正常,沒有受到監護宣告。預立的意願,必須得到公證,而且還要經過醫療照護上的評估,並且正式記載在健保卡上。預立意願書之後,如果發生了特定的情況時,醫療機構即能依照病人的意願放棄醫療,但仍需提供必要的照護措施,以減緩病人的痛苦。本法對於醫護人員必有衝擊。傳統的觀念,醫護人員的職責是盡力救人,而不是協助死亡。本法尊重善終權,等於要求醫護人員依照病人的自願而協助死亡。所以,醫護人員的工作倫理將有一番調整,醫療機構也必須有相關的配套措施以資因應。本法制訂前,台灣已經有《安寧緩和醫療條例》,也有病人自主權利或善終權的相關規定。只是本法的規定更為全面,更為積極,更為細緻。本法正式公布後,至正式施行預留有三年的時間。施行前,還有若干規範內容及相關配套,留待討論與改進。這是法界與醫界所要共同努力的課題。
Everyone dies, and we just don't know when or how the death comes. Though the death is unpredictable, it usually makes medical treatment ineffective just as a procedure to postponing dying process while the death causes from an incurable illness or an accident. Having more respect for the patient's autonomy right, we should allow people to prewrite the letter of intent for deciding the way of how their lives end before the worst moment comes. "Patient Autonomy Act" in Taiwan is the first legislation about the right of good death in Asia. The autonomy right to choose good death means: under certain circumstances, the patient have the right to choose dying naturally and painlessly (or less painfully) according to his/her own true will with assistance from the doctor. However, the patient's autonomy right to choose good death must not be misused. According to the Act, the Advance Directive shall be made by a person who is with age of 20 years or above and have the legal capacity without being subject to the order of commencement of guardianship. Moreover, the intent of Advance Directive must be notarized, and registered on the National Health Insurance Card after it being assessed under medical healthcare profession. When the certain circumstance occurred, medical institution may be permitted to abandon medical treatment as the patient wishes while still providing necessary medical care to relieve his/her painfulness. The Act must have impact on healthcare professionals when their conventional obligation is to save people's lives instead of assisting people's deaths. Having respect for the patient's autonomy right to choose good death, the Act ask healthcare professionals to assist the patient's deaths according to his/her own will. Therefore, ethical issues of healthcare profession are supposed to be adjusted a lot, and relevant complementary measures would need to be provided from healthcare institutions as well. There is an act called "Hospice Palliative Care Act" enforced in Taiwan before this Act been made; however, this Act regulates more comprehensively, actively, and subtly. This Act will take effect in three years after its promulgation. Before then, several contents and relevant complementary measures about the Act are still necessary to be discussed and improved, which is an important task that needs to work on between the law and medicine fields.
期刊論文
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2.Hilgendorf, Eric(2014)。Zur Strafwürdigkeit organisierter Sterbehilfe。JZ,69(11),545-552。  new window
3.陳子平(2003)。安樂死。月旦法學教室,10,44-47。  延伸查詢new window
4.黃馨葆、蔡兆勳、陳慶餘、邱泰源(20110700)。生命末期照顧如何達到好的成本效益。安寧療護,16(2),205-216。new window  延伸查詢new window
5.陳祖裕(20030100)。無效醫療。應用倫理研究通訊,25,54-63。new window  延伸查詢new window
6.陳振崑(20041100)。從儒家倫理看醫病關係。哲學與文化,31(11)=366,45-61。new window  延伸查詢new window
7.林東茂(20150300)。死亡協助的刑法問題。高大法學論叢,10(2),93-97+99-117+119-121。new window  延伸查詢new window
8.Rissing-van Saan, Ruth(2011)。Strafrechtliche Aspekte der aktiven Sterbehilfe, Nach dem Urteil des 2. Strafsenats des BGH, Urt. v. 25.6.2010-2 StR 454/09。ZIS,544-551。  new window
9.陳秀丹(2012)。回歸醫療本質,讓愛真誠流動。綠主張,110,20-21。  延伸查詢new window
10.張麗卿(20150515)。醫療常規與專斷醫療的刑法容許性--評析拒絕輸血案。臺灣法學雜誌,272,15-31。  延伸查詢new window
11.陳彥元(2013)。必須是急重症醫療的一部分。慧炬,581,24-26。  延伸查詢new window
12.葛謹(20090100)。植物人權益和安寧緩和醫療條例之發展。臺灣醫界,52(1),30-38。  延伸查詢new window
13.龔學德(2015)。美國醫療無效糾紛解決機制及其對我國的啟示。醫學與法學,7(4),31-37。  延伸查詢new window
14.Nguyen, Christina Q.(2015)。Death as Liberty。U. S. F. L. Rev.,49(2),387-410。  new window
15.Walker, R. M.(2001)。Suicide: the Legal Slippery Slope。Cancer Control,8(1),25-31。  new window
16.周佑政、鄧桂芬、江慧珺、張嘉芳(20151219)。亞洲第一部病人自主權利法5類重病者有善終權。天下雜誌。  延伸查詢new window
圖書
1.王皇玉(2011)。刑法上的生命、死亡與醫療。承法數位文化有限公司。  延伸查詢new window
2.植木哲(200710)。医療の法律学。有斐閣。  延伸查詢new window
3.曾育裕(2010)。醫護法規。五南出版社。  延伸查詢new window
4.Eisele, Jörg(2014)。Strafrecht Besonderer Teil。Stuttgart。  new window
5.Wessels, Johannes、Hettinger, Michael(2015)。Strafrecht Besonderer Teil。Heidelberg。  new window
6.山中敬一(2014)。医事刑法概論(1):序論.医療過誤。成文堂。  延伸查詢new window
7.村山淳子(2015)。医療契約論--その典型的なるもの。日本評論社。  延伸查詢new window
8.井田良(2015)。刑法各論。弘文堂。  延伸查詢new window
9.田山輝明(2015)。成年後見人の医療代諾権と法定代理権。三省堂。  延伸查詢new window
10.甲斐克則(2006)。尊厳死と刑法。成文堂。  延伸查詢new window
11.Clift, Eleanor(2009)。Two Weeks of Life: A Memoir of Love。Death, & Politics。  new window
12.Fischer, Thomas(2016)。Strafgesetzbuch und Nebengesetze。München。  new window
13.Gössel, Heinz、Dölling, Dieter(2004)。Strafrecht Besonderer Teil。Heidelberg。  new window
14.Hilgendorf, Eric(2016)。Einführung in das Medizinstrafrecht。München:C. H. Beck。  new window
15.Kindhäuser, Urs(2014)。Strafgesetzbuch, Lehr- und Praxiskommentar。Baden-Baden。  new window
16.Rengier, Rudolf(2015)。Strafrecht Allgemeiner Teil。München。  new window
17.山口厚(2007)。刑法総論。有斐閣。  延伸查詢new window
18.王志嘉(2014)。醫師、病人誰說的算?:病人自主之刑法基礎理論。元照。  延伸查詢new window
19.Lackner, Karl、Kühl, Kristian(2014)。Strafgesetzbuch Kommentar。München。  new window
其他
1.中央健保局。健保重大傷病範圍表,http://www.nhi.gov.tw/webdata/webdata.aspx?menu=18&menu_id=683&webdata_id=406。  new window
2.「把決定生死的權利交還給病人」17張圖看懂病人自主權利法草案,http://www.ly.gov.tw/03_leg/030l_main/eg_bilI/billView.action?id=10464&1gno=00078&stage=8&atcid=10464。  延伸查詢new window
3.伊莉沙白‧庫伯勒--羅斯和她的生死學,http://lifeanddeathtogetherbegin.blogspot.tw/2007/03/Kubler-ross.html。  延伸查詢new window
4.黃興文。健保卡加註拒急救5年增25萬人,https://tw.news.yahoo.com/%E5%81%A5%E4%BF%9D%E5%8D%A1%E5%8A%A0%E8%A8%BB%E6%8B%92%E6%80%A5%E6%95%91-5%E5%B9%B4%E5%A2%9E25%E8%90%AC%E4%BA%BA-150200664.html。  new window
5.創世福利基金會。關於植物人,http://www.genesis.org.tw/service.php。  延伸查詢new window
6.彭懷真。名家觀點善終不能光靠感性,http://www.ly.gov.tw/03_leg/0301_main/dispatch/dispatchView.action?id=61101&lgno=00078&stage=8。  new window
7.參與永久植物狀態相關的文獻報導,http://big5.wiki8.com/yongjiuzhiwuzhuangtai_133358/Literature.html。  延伸查詢new window
8.衛生福利部。保障病人自主,病人自主權利法三讀通過!,http://www.mohw.gov.tw/CHT/Ministry/Index.aspx。  延伸查詢new window
9.Multi-Society Task Force on PVS(1994)。Medical aspects of the persistent vegetative state, 330 the New England Journal of Medicine 1499-1508,http://www.nejm.org/doi/full/10.1056/NEJM199405263302107。  new window
圖書論文
1.高金桂(2012)。加工自殺罪之探討--以教唆自殺為中心。甘添貴教授七秩華誕祝壽論文集。台北:承法。  延伸查詢new window
2.Rosenau, Henning(2011)。Aktive Sterbehilfe。Festschrift für Claus Roxin zum 80. Geburtstag。Berlin。  new window
3.Roxin, Claus(2010)。Zur strafrechtlichen Beurteilung der Sterbehilfe。Handbuch des Medizinstrafrechts。Stuttgart。  new window
4.箕岡真子(2013)。認知症ケアの倫理。終末期医療と医事法。信山社。  延伸查詢new window
5.Hilgendorf, Eric(2007)。Zur Strafwürdigkeit von Sterbehilfegesellschaften. Aktuelle Strafbarkeitspro-bleme im Kontext der assistierten Selbsttötung。Jahrbuch fuer Recht und Ethik。Frankfurt。  new window
 
 
 
 
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