Patient Autonomy and Related Criminal Issues

• Main Authors: Wang Chih-Chia, 王志嘉
• Other Authors: Chen Tz-Ping
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/46413596517623840299

博士 === 東吳大學 === 法律學系 === 101 === The purpose of this thesis is to discuss the criminal issues on the patient autonomy. First of all, we discuss the balance between patient autonomy and medical professionalism. We analyze the contents and features of the four principles of biomedical ethics (PBE)- the principles of respect for autonomy, nonmaleficence (do no harm), beneficence, and justice. The conclusion is that both the patients and the medical professionals should work together to get the best interests on the basis of the patient autonomy. To realize the contents of the patient autonomy in Criminal Law, we have to define and understand the characteristics of medical practices. The medical practices include two categories, broad ones and narrow ones. We have to get the patients' consents before performing most of the medical practices. The concepts of consent may come from two origins. One is the informed consent, which is originated from the Common Law. The other is the victim's promise (Einwilligung des Verletzten), which is originated from the Civil Law. Therefore, we compare the differences between consent and promise, and the differences between informed consent and victim’s promise. We find that the meanings between consent and promise are identical, but the meanings between informed consent and victim’s promise are different. Due to the complexity of medical practices, patient autonomy is based on "proper conduct performed in the course of due business." A proper conduct performed in the course of due business is composed of the patients’ consent and the medical professionalism. Therefore, we also discuss the effectiveness of the patients’ consent in various kinds of medical practices. Due to the medical professionalism, there are limits on the patient autonomy. We also discuss the managements of three types of inappropriate requests from the patients. In recent years, the issues on "natural death and good death" are valued. According to the Hospice-Palliative Care Act (the Natural Death Act), terminally ill patients are entitled to refuse life-sustaining treatment. We define the terminally ill patients, and we also discuss the courses and issues on legislation and 3-time amendments of the Hospice-Palliative Care Act. Moreover, we discuss the issues on refusing life-sustaining treatments on the non-terminally ill aged patients who have several chronic diseases. In summary, the patient autonomy is the most important issue in the fields of medicine and law. In this thesis, we discuss and integrate the concepts of the medical professionalism and the patient autonomy. We also investigate the viewpoints of the patient autonomy in our culture by questionnaires. We hope this thesis will be the bridge of the gap between medicine and law.