病人自主權利法修法芻議

Suggestions for Revision of Patient Right to Autonomy Act

《病人自主權利法》從2015年12月18日立法院三讀通過，經2016年1月6日公布，到2019年1月6日生效施行，筆者參與並統籌了本法立法暨相關子法擬定的艱辛過程。過程中有許多政治性或非理性的妥協，這一點在民主國家實不足為奇，不過，《病人自主權利法》已經施行1年多了，也許是時候回過頭來好好檢視哪些地方值得修正與調整，俾《病人自主權利法》的施行更符合病人與社會的需要。
《病人自主權利法》施行後，2019年5月有了第一次的修法，亦即第15條的修正。然而，綜觀《病人自主權利法》本身、《病人自主權利法施行細則》以及相關配套措施，仍有許多值得精進之處，本文之作正是希望彙整相關問題，加以討論分析，並提出調整修正之建議。
由於《病人自主權利法》以第7條為分水嶺，前半部規範病人自主權之基本原則，後半部則規範特殊拒絕醫療權之作法與機制，本文亦區分此兩部分以探討《病人自主權利法》的精進與修法建議。

Patient Right to Autonomy Act was enacted on December 18th, 2015, announced on January 6th, 2016, and came into effect and started to be implemented on January 6th, 2019. I have participated in and was as specialist in charge of the drafting during the process of the legislation and then was also responsible with superintendent Sheng-Jean Huang of Taipei City Hospital for the process of drafting the rules and related measures for implementation of the act. Both processes were difficult and full of political and populistic compromises that shall not be taken as unusual in democratic countries. More than one year of implementation of the act, however, it is timely to reflect and investigate whether there are some points in the act worthy of revision and adjustment so as to meet the needs of patients and society as good as possible.
The first and only amendment took place on May 24th, 2019. It dealt with the revision of Art. 15. On top of this amendment there are still many issues both in the act and in the rules and related measures for implementation of the act that shall come under close scrutiny to be evaluated whether further revisions are necessary. Accordingly, this article is to analyze all those issues in order to systematically present a package of suggestions for the possible amendment of the act in the future.
Since Art. 7 is the watershed of the act, of which the former part regulates the basic-principles of patient autonomy, while its latter part deals with the legal measures and mechanism of refusing life-sustaining treatment and/or artificial nutrition and hydration, this article is also divided in two parts to explore the amendment of the act and to advance systematic suggestions for its revision.