臺灣《病人自主權利法》的倫理分析

An Ethical Analysis of Patient Right to Autonomy Act of Taiwan

亞洲第一部《病人自主權利法》已於今年1月6日，在臺灣正式上路。《病人自主權利法》是繼《安寧緩和醫療條例》後，以病人為主體，攸關病人權益的根本大法。本文先藉此法與《安寧緩和醫療條例》之比較，以說明此法的基本原理和增強病人的權益的保護之處。本文再進一步依生命醫藥倫理學的基本原理分析此法案所含具的倫理意義。此一法案基本上奠基在「尊重自律原則」中所含的「病人自主自律」的權利，而落實此原則的運作則是著名的「諮詢同意原則」。本文試依此兩原則以展示此法在倫理上和執行上，如何達到病人的自主自律的權利和往前發展和修訂的問題。

The first Asian law of Patient Right to Autonomy Act was passed three years ago and implemented on 6 January, 2019. It is a bill after the Act of Palliative Treatment, taking the patient as the subject of decision, and it concerns the rights of terminal patients. In this paper, I begin with a comparison of the two bills to show the basic principles and the way it promotes the protection of the patient's right in medical treatment. Its ethical justifications is further analyzed according to bioethical principles, namely the basic principle of respect of autonomy and the practical procedures in the principle of informed consent. I try to show how to fulfil the respect of the right of patients' autonomy and selfdetermination with some suggestions for further improvement.