| Summary: | 碩士 === 國立雲林科技大學 === 科技法律研究所 === 105 === The issue of patient autonomy, including death with dignity and euthanasia, after all, involves conflict of human dignity in the autonomy of a human and the right to dispose of life, that after disputes in medicines, jurisprudence, thanatology, hospice right, or patient autonomy, the legislators in Taiwan remained open-minded to draft the Laws of Hospice Palliative Care and Patient's Self-Determination. However, practical use of previously mentioned legislation is difficult as many procedural prerequisites were established, such as family member's involvement overrides patient autonomy; requirement of specialist in presence limits the entire procedure to medical institution; and the scope of exercising autonomy is not clearly defined.
The existing legislation apparently neglects the same right of patient's autonomy in residents of long-term care facilities and their differences from patients of medical institutions, including disparity in facility space, time, and hardware specification, that they are often subjected to endure through a series of repetitive and fruitless emergency procedures and denied of natural death, as demanded by the current law. Although medical institutions may be justified by the most advanced medical technologies and the role of overseer on right to dispose life, in terms of demand, the residents of nursing homes should have the same right of self-determination for disposal of life. In regard with nursing need, it is necessary to propose a corresponding concept of progressive hospice palliative care. However, legislators still fail to establish proper legislation to implement true patient's autonomy in nursing homes.
After the implementation of the long-term care service law, it is expected that the number of nursing homes will increase, as well as the number of residents, giving rise to those previously mentioned issues. This study reviewed the discrimination towards patient's autonomy in current medical and nursing practice and proposed legislative solutions, such as strengthening the public understanding of patient's autonomy; declaring officially marked health insurance card as legal effective medical instruction; and expanding to include other organizations as qualified body of medical instruction, in order to truly realize patient's autonomy for the nursing home residents.
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