瑞士醫療協助死亡法制初探

A Preliminary Legal Research of Medical Aid in Dying in Switzerland

關於病人積極死亡自主方式選擇，向來有支持與反對兩立場。世界醫師會於2019年10月宣布「安樂死與醫師協助自殺宣言」，仍保持堅決反對，但不再稱安樂死為不道德，醫師若參與病人積極死亡自主方式選擇，亦不再以不道德譴責之。自1942年起，依據瑞士「刑法」第115條，非基於自私動機的醫療協助死亡不違法，可作為善終選項之一，且不限制僅瑞士籍方可申請。本文舉例說明僅向瑞士國民提供服務的出口，與開放外籍人士亦可申請的尊嚴與生命圈。本文比較臺灣與瑞士善終經驗相異處，在於善終法制專法有無不同、善終方式選擇社會共識不同與適用主體是否僅限於本國籍人士不同。臺灣善終發展特色，可歸納為：發展逐步按序（法制面）、累積理論實務（經驗面）及思索不法內涵（配套面）。瑞士善終發展特色，可歸納為：解釋彈性的保持（法制面）、機構產業的創新（經驗面）及口服注射的多元（執行面）。

In terms of positive patient death autonomy way choice, both two support and opposition standpoints exist. In October 2019, the World Medical Association announced the“Declaration on Euthanasia and Physician-Assisted Suicide”, still firmly opposed it. But, euthanasia isn’t called unethical. Physicians participating positive patient death autonomy way choice aren’t condemned, either. Since 1942, according to Article 115 of the“Swiss Criminal Code”, medical aid in dying not based on selfish motives isn’t illegal and could be one good death option not restricted to Swiss nationals only. This article mentions exit, which provides service to Swiss nationals only, while Dignitas and Lifecircle are open for foreigners to apply, too. Comparing good death experience differences in Taiwan and Switzerland, including special law of good death legal system, social consensus of good death way choice, and whether applicable subjects are limited to nationals only. Developing characteristics of good death in Taiwan include legal development in order, empirical accumulation of theory and practice, and supporting thinking of illegal meaning. Developing characteristics of good death in Switzerland include maintaining explaining flexible in alegal aspect, innovation of institution and industry in an experience aspect, and diversity of oral medicine and injection in an implementing aspect.