醫療自主權與生命權的衝突──從刑法的視角觀察

Conflict between Autonomy in Medical Care and the Right to Life - An Observation from the Perspective of Criminal Law

醫療自主權與生命權的衝突，是一個相當複雜而敏感的議題，動輒涉及宗教、哲學、倫理、心理、醫學及法學等各個領域，牽涉層面極為廣泛。在刑法的視角下，醫療自主權與生命權發生衝突時，如何在保護生命及尊重個體意願之間找到適當的平衡，例如：病人是否可依其自由意志而實施安樂死或尊嚴死？當代學倫理強調尊重病人的醫療自主性，則病人可否擁有必要時可以結束自己生命的權利？病人基於信仰，明白表示不願意輸血急救，醫師得否違背病人意願輸血予以救治？若不中止懷孕，孕婦將有生命危險，但基於母愛，孕婦拒絕聽從醫囑而決定保住胎兒的生命，醫師應如何抉擇？每每涉及法律制度、醫學倫理以及醫師專業判斷等多重層面。
在時代與社會環境的變遷下，以病人為本位的思潮，已成為各醫事機構醫事人員的倫理守則。尊重病人自主權，更是以病人為本位思想的具體實現，病人可以參與醫療決策，包括治療選擇、隱私保護及資訊共享；醫事人員亦能理解病人的需求、意願及信念，得以創造雙贏的局面。因此，醫事人員，於治療前或治療過程中，對於治療選項、風險、利益以及可能的併發症等，應充分向病人說明，並獲得其同意，俾得以進行個體化的治療及護理，以提供最適切的醫護處置。

The conflict between autonomy in medical care and the right to life is a highly complex and sensitive issue that often involves various fields such as religion, philosophy, ethics, psychology, medicine, and law. From the perspective of criminal law, when a conflict arises between autonomy in medical care and the right to life, how can a proper balance be found between the protection of life and respect for the individual's will? For example, can a patient choose to undergo euthanasia of his own free will? While contemporary medical ethics emphasizes respecting a patient's autonomy in medical decisions, does a patient have the right to end their own life when deemed necessary? Can a doctor give a patient a blood transfusion against his or her will if the patient, out of his or her beliefs, explicitly refuses to have a blood transfusion to save his or her life? If a pregnant woman faces a life-threatening situation but decides to continue the pregnancy out of maternal love, how should a doctor make a decision? These situations often involve multiple aspects of legal systems, medical ethics, and the doctor's professional judgement.
With the evolution of times and social environment, patient-centered thinking has become the ethical guidelines for healthcare professionals in various healthcare institutions. Respecting patients’autonomy is a concrete realization of the patient-centered thinking, allowing patients to participate in healthcare decisions, including treatment choices, privacy protection, and information sharing. Healthcare professionals can understand the needs, preferences, and beliefs of patients, leading to mutually beneficial outcomes. Therefore, healthcare professionals should fully explain treatment options, risks, benefits, and potential complications to patients before or during treatment, and obtain their consent, enabling individualized treatment and care to provide the most appropriate healthcare interventions.