病人及家屬在末期醫療照護抉擇上的倫理難題

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Title:	病人及家屬在末期醫療照護抉擇上的倫理難題
Other Titles:	The Ethical Dilemma of Patients and Family in Medical Decisions at the End of Life
Authors:	黃柏青 Huang, Po-Ching
Contributors:	國立中央大學哲學研究所 Graduate Institute of Philosophy, National Central University
Keywords:	末期醫療照護抉擇;安寧緩和醫療條例;病人自主權利法;預立醫療決定;預立醫療照護諮商 medical decisions at the end of life;Hospice Palliative Care Act;Patient Right to Autonomy Act;advance directives;advance care planning
Date:	2020-08-01
Issue Date:	2022-12-19 15:59:17 (UTC+8)
Publisher:	南華大學生死學系
Abstract:	末期病人經常需要各種緊急處置或醫療儀器來維持生命，儘管運用這些醫療措施，大部分末期病人也沒有恢復健康的可能性，而僅是維持其脆弱的生命徵象或延長其死亡的過程而已。在這種情形之下，醫師可能會建議不（繼續）施行侵入性或支持性的醫療措施，以避免導致病人不必要的受苦，此時就有可能會面臨「醫療照護抉擇」的倫理困境。本文在《安寧緩和醫療條例》（2013）與《病人自主權利法》（2019）等相關的法律規範之下分析及反省「醫療照護抉擇」、「預立醫療決定」等末期病人醫療照護常見的倫理議題。雖然台灣社會以往對於不施行、終止或撤除末期病人的維生醫療多持保守態度，然而透過理性的論述、廣泛的討論，再經由在地文化的調整和修正，目前「緩和醫療照護」與「預立醫療決定」的觀念已逐漸被接納並採用，讓末期病人可以選擇一個尊嚴安詳的方式離開人世。 Terminally ill patients usually need different kinds of emergency managements or medical appliances to sustain their lives. Despite providing terminally ill patients with these medical services, most of them have little chance of recovery. We could just keep the weak vital signs or prolong the dying process. Under the circumstances, the doctor would suggest withholding or withdrawing invasive or supportive medical treatments to prevent the patients from unnecessary suffering. At the same time, we would probably encounter the ethical dilemma of medical decisions. This essay will analyze and investigate the common ethical issues of terminal care through Hospice Palliative Care Act (2013) and Patient Right to Autonomy Act (2019). After extensive discussion and rational debate, the concepts of “palliative care” and “advance directives” have been gradually accepted and practiced in Taiwan. This progression lets terminally ill patients choose the medical care they want, and finally they can rest in peace.
Relation:	生死學研究 21期
Appears in Collections:	[The Journals of Nanhua University ] Journal of life-and-death studies [Department of Life-and-Death Studies] Journal of life-and-death studies

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