An Analysis of Patient Family's Authority to Participate in Medical Decision-Making

• Main Authors: Hsiu-Ju Yang, 楊琇茹
• Other Authors: Wenmay Rei
• Format: Others
• Language: zh-TW
• Published: 2004
• Online Access: http://ndltd.ncl.edu.tw/handle/e3e2h9

碩士 === 中原大學 === 財經法律研究所 === 92 === Abstract This Study is about patient family’s role in medical decision-making. It argues that complex moral reasons call for the participation of patient family. However, these moral reasons do not support a single model of the patient family’s authority for all patients. Rather, they suggest important differences among the roles of patient family should play in decision making for different kinds of patients: competent adults, incompetent adults, minors. Briefly summarized, the differences in authorities are as follows: First, when the patients are competent adults, to harmonize patient’s autonomy and patient family’s interest both to protect the patient and the family itself, members of the patients’ family should have a participatory role in the medical decision-making, without depriving patient’s to make the ultimate decision. Second, in making decisions for incompetent adults, the patient family’s principal authority should be limited by the patients’ best interests. The patients’ family should try to ensure that the patient’s interests are understood and considered. Third, when the patients are minors, the patient family’s role is to construct, as well as to pursue, a reasonable account of the minors’ best interests. The scheme of this study comprises seven parts as follows: Chapter I is a preface, illustrating the motives, methods, limitations and realm of this paper. Chapter II analyzes the rationale of patient autonomy, then, discusses the doctrine of informed consent. Chapter III, the protection of confidentiality between physician and patient is a well established principle in medical ethics and law. Despite widespread acceptance, the confidentiality doctrine is not absolute. A physician may disclose his or her patient’s private medical information, pursuant to the patients’ agreement; or in cases where is it necessary to protect patient or public interests. But, under the law of Taiwan, the physician can disclose the patient’s medical information to patient family. Does this violate the patient’s privacy of medical information? Chapter IV looks into various law and rationale in Taiwan that grants decision-making power to patients’ family. Patients’ family provides emotional and financial support and performs a wide range of caregiving tasks. The patient family plays an important role in patient’s life. Any account of the role of patient family in medical decision-making must take account of the fact that lives are shared. Not only do patients’ family have obligations to patients, but patients have obligations to their families. From the perspective of sociology of law and communitarianism this chapter analyzes the justification of patient family’s authority. Chapter V, this chapter discusses the patient family’s authority, when competent adult patients and incompetent adult patients confront the medically indicated procedures, or non-medically indicated procedures, or organ donation. Chapter VI, this chapter discusses the patient family’s authority, when minors confront the medically indicated procedures, or non-medically indicated procedures, or organ donation. Chapter VII is conclusion. It concludes that it is important to find out the justification of patient family’s authority to participate in medical decision-making, but, more importantly, how do we determine an appropriate balance of patient’s interests and patient family’s interests.