論醫療協助死亡－─以美國新墨西哥州為例

A Research of Medical Aid in Dying-An Example of New Mexio State, USA

本文宗旨在於探討美國新墨西哥州醫療協助死亡法制與案例，並與臺灣進行比較。美國新墨西哥州於2021年6月18日實施「生命末期選擇法」，本文分別從病人啟動、醫方審查與其他機制進行探討。大抵而言，相較於其他已實施醫療協助死亡的法域，美國新墨西哥州針對可開立藥物處方的主體予以擴大、選擇醫療協助死亡的流程設計予以簡化並縮短且賦予護理師角色多元化定位。在臺灣，病人自主意識方興未艾，不僅共識範圍仍在持續溝通，醫病關係亦藉由互動模式的摸索尋求認知一致最大化，醫療場域也在積累經驗以實踐病人善終目標。聚焦美國新墨西哥州與臺灣，雖分屬不同病人積極或消極死亡自主方式選擇，護理人員賦能認知、醫療保險制度設計與思維標準亦不同，但觀察在病人自主重視程度、死亡識能培養決心與醫病共決之溝通方式方面皆呈現相似性。冀望藉由比較法制與案例研究，可對臺灣病人自主深耕發展有所裨益。

The theme of this article is to discuss legal system and casesrelated to medical aid in dying in New Mexio State, USA and compareswith Taiwan. The “End-of-Life Options Act” is implemented on 18thJune, 2021 in New Mexio State, USA. This article discusses it throughpatient activation, medical review, and other mechanisms perspectives.In general, compared with other jurisdictions that have implementedmedical aid in dying, medication prescription subjects are expanded, theprocess designd for choosing medical aid in dying is simplified andshortened, and diversified nurses' roles are empowered in New MexioState, USA. In Taiwan, patient autonomy awareness is booming and thescope of consensus is still communicating. The physician-patientrelationship seeks to maximize cognitive consistency through exploringinteractive models. And, medical fields are accumulating experiences toimplement the goal of patient good death. Focusing on New MexioState, USA and Taiwan, although positive or negative patient death autonomy way choice, empowerment cognition of nurses, and medicalinsurance’s system design and thinking standard are different. There aresimilarities in observing the importance degree of patient autonomy,cultivation determination of death literacy, and physician-patient codeterminationcommunication methods. Through comparative legalresearch and case study, it is hoped to become beneficial to deepcultivation and development of patient autonomy in Taiwan.