病人自主權利法之芻議

The Suggestions Patient Autonomy Act

臺灣於2015年12月立法三讀通過「病人自主權利法」，於2016年1月6日總統公告全文19條，預計2019年1月6日正式施行，成為亞洲第一個訂立此法的國家。觀諸病人自主權利法立法重要核心為「臨終醫療自主權」、「預立醫療照護諮商前置」、「預立醫療決定」、「醫療委任代理人」四大部分，其中，僅「預立醫療照護諮商前置」未曾出現在國內法域，其餘三部分或多或少曾出現在安寧緩和醫療條例或醫療法內。當一個相同法律概念（或用詞）出現在不同部法律規範中，會出現在解釋、適用主體、範圍、程序等是否應相同處理？倘若不同處理時，就其不同處理是否具事務特殊性之必然合法性等須受審視。而就本法相較國內法獨創「預立醫療照護諮商前置」，雖說於立法理由載明「參考香港食物及衛生局2009年頒布之《在香港引入預設醫療指示概念諮詢文件》」，此部分在操作上實質內容是否與醫師說明義務內容是重複？還在相異？假若操作不當，將會產生助長日後醫療糾紛發生。以下，本文基於時間及篇幅考量，僅就此四大部分作深入探討。本文提出僅為讓本法能在正式施行前，盡些許棉薄之力。

The Patient Self-Determination Act was legislated by the Legislature Yuan on December, 2015 in Taiwan. Then, President announced the 19 articles of Patient Self-Determination Act, on January 6, 2016. That act will be carried out on January 6, 2019. Taiwan becomes the first country with the act in Asia. The core of the act is based on final medical autonomy, the preposition advisory of advance care planning, advance care planning decision, and medical surrogate. However, only the preposition advisory of advance care planning is not setting on current laws in Taiwan, and the others appeared on the articles of Palliative Care and Medical Laws. While a same concept of laws or articles appear in different laws, different explanations and applicable subjects will be derivative. Thus, we need to further review that special explanations, and applicable subjects meet the specification. If the operating of Preposition advisory of advance care planning will overlap to Physician’s obligation or not. The operating mistake may produce the risk of medical dispute. Because of limit of time and space, I just discussed the four parts mentioned before. I hope this article help the operating preposition advisory of advance care planning.