論醫病關係與病人自主──以台灣中部某醫學中心為例

A Research of Patient-doctor Relationship and Patient Autonomy; A Medical Center Example in Central Taiwan

台灣扮演地球村不可或缺的角色，2030年前，一方面須實踐聯合國永續發展目標，另一方面須面對21世紀「高齡化」與「科技化」的浪潮。本文於台灣「病人自主權利法」施行前完成，以量化研究方法分析台灣六都之一的某醫學中心，病人、家屬、醫師、護理人員與學生對於醫病關係、病人自主之認知與看法。觀察台灣臨床實際現狀，發現無論醫病關係或病人自主，對於認同理想醫病共享決策模式、病人自主之知悉、決定的權利，仍有差距。病人與家屬間、護理人員與學生間或醫師與護理人員間，對於醫病關係或病人自主之共識，有待凝聚。但，從學生觀點之差異性，已可預測醫病共享決策模式，在未來從事醫護工作者之心中已獲認同。故，本文宗旨即冀望隨著台灣法制成形與病人自主機制獲得落實後，本文可作為台灣醫病關係、病人自主意識轉變的參照之一。

Taiwan plays an indispensable part in the global society. On the one hand, Taiwan has to fulfill the sustainable development goal mentioned by the United Nations; on the other hand, Taiwan has to response the era of aging and technology before 2030. This article uses quantitative research method to analyze patients, relatives, doctors, nursing personnel, and students' cognitions and opinions of patient-doctor relationship and patient autonomy in one medical center in one of the six main cities in Taiwan before the implementation of the ''Patient Right to Autonomy Act''. Observing the clinical reality in Taiwan now, no matter patient-doctor relationship or patient autonomy, the discovery shows distance existing between agreeing the ideal shared decision making model and patient autonomy's knowing and deciding rights. The consensus of patient-doctor relationship or patient autonomy still needs to be built among patients and relatives, nursing personnel and students, or doctors and nursing personnel. But, the difference of the students' opinions can predict that the shared decision making model has been approved in the hearts of future doctors and nursing personnel. Therefore, the theme of this article is to expect that this article can become one of the references of changing awareness related to patient-doctor relationship and patient autonomy after fulfilling the legal system and patient autonomy mechanism in Taiwan.