醫療自主權之代理行使──評析最高法院106年度台上字第2418號民事判決

Exercise of Medical Autonomy Agent: Comment on the Civil Judgment No. 2418 of the Supreme Court in 106

自主決定權專屬於病人本人，倘病人因昏迷等原因，事實上無法行使自主權時，應由誰來「代理同意」？本案認為醫師以「理性病人」及「病人最大利益」考量下，得背離家屬意見，而為適當的醫療處置，不啻改由醫師代為決定醫療行為，回復醫療父權主義，不但背離醫療法規，也與以往實務見解乖離，如此之突破創見，是否導致醫療人員無所適從？造成司法實務難解之矛盾！

The decision-making power is exclusive to the patient himself. If the patient is in fact unable to exercise his or her autonomy due to coma, etc., who should “agently agree”? In this case, it is considered that doctors can deviate from the family members’ opinions in consideration of the “rational patient” and “the patient’s best interests” for proper medical treatment. Instead, the doctor should decide on the medical behavior and restore medical patriarchy. Divorced from past practical insights, does such a breakthrough ingenuity cause medical staff to be confused? Conflicts in judicial practice!