末期病人斷食善終之倫理議題探討

An Exploration on Ethical Issues of Voluntary Stopping Eating and Drinking (VSED) in Terminal Patient

以病人為中心及尊重病人自主，已成為當代醫學倫理之基本原則，為保障病人自主權，台灣也於2019年開始「施行病人自主權利法」。自主停止飲食在臨終照護頜域引起諸多討論，相關的倫理議題隨之浮現，本文列舉一臨床個案，並逐步討論末期病人自主停止飲食之倫理考量、倫理爭議、宗教觀點，以及現行法律與準則，最後回顧本案並提出建議，期望能藉此提升病人的照護品質，達到病醫雙贏。

Patient-centered care and respecting patient's autonomy have become essential ethical principles of contemporary medical practice. Patient Right to Autonomy Act has been implemented in 2019 in Taiwan and endorsed such concept. Voluntary stopping of eating and drinking （VSED） has been promoted by some clinicians in Taiwan recently and has triggered heated ethical debates in the field of terminal care and palliative medicine. In this article, the authors present a clinical case and discussed the relevant ethical issues and controversies, religious perspective to VSED, related law and professional guidelines, and analyze the case. It is hoped that through these reflections the ethical issues of VSED can be clarified and the end of life care and palliative medicine for terminal patients can be promoted.