消極死亡協助與病人自主決定權－－德國學說、立法與實務的相互影響

Passive Euthanasia and Patient Right of Autonomy: Interaction of German Doctrine, Legislation and Practice

任何人基於對自己身體的自主決定權，縱使患有重病亦沒有就醫的義務，而享有不需先經醫療諮詢的拒絕醫療權利。因此，不論是病人的家屬，或是醫師，任何人都沒有權利可在違反病人的意願下對其進行醫療干預，違反病人意願的續行干預乃是違法的干預。原本獲得病人承諾所已經進行的醫療干預，在病人進入死亡的直接階段時，自應停止無效的延緩生命措施；在病人尚未進入死亡的直接階段，則取決於病人是否具有續行醫療的意願，如病人撤回或取消原本的承諾，則醫師已喪失醫療干預的正當化基礎，就必須尊重病人的意願停止醫療干預的續行。至於中斷治療的方式，不論作為或不作為，亦不管從釋義學的哪個角度切入，都不會構成殺人罪（含受囑託殺人罪）的作為犯或不作為犯。「安寧緩和醫療條例」以及甫通過的「病人自主權利法」，對於病人的醫療自主權利作出過多的限制，實有未妥，法院應當在尊重病人自主權的前提下，思考如何從刑法的釋義學觀點來合理評價醫師的中斷治療行為，而不是徒以是否符合形式的程序要件為標準。

Any person who, based on their physical autonomy, has no obligation to seek medical treatment even though suffering from serious illness, and possess the right to refuse medical treatments without advanced medical consultation. Neither family members nor doctors have the right to determinate or perform medical intervention against patient's will. It's also illegal if forcing patients to receive continuing treatment against their wish. Current medical treatment should be withdrawn if proved futile under pre-dying process. Regardless of whether the patient has entered the direct phase of death or not, doctors are unjustified to continue their medical treatment if patients withdrawal their commitments. As for the interruption of treatment manner, regardless of the act or omission, it would not constitute Homicide (including by exhortations to kill) as guilty or not as criminals. However, ＂Hospice and Palliative Care Ordinance＂ and ＂Patient Self-determination Act＂ legislated recently all put too much inappropriate limits to ＂patient autonomy＂. The court should respect patient autonomy under the premise of thinking about how to learn from the point of view of criminal law interpretation to a reasonable evaluation of interruption of treatment behavior, not only considering to fit the formal essentials of procedures.