病人自主权利法扩充特殊拒绝医疗权之必要性-元照出版.PDF

病人自主權利法擴充特殊拒絕醫療權之必要性 The Necessity of the Enactment of Patient Autonomy Act Concerning the Extension of the Right of Refusing Life-Sustaining Treatment 孫效智教授 國立臺灣大學哲學系 Johannes Hsiao-Chih Sun Professor, Department of philosophy, National Taiwan University 摘要 病人自主權利法擴大特殊拒絕權之適用範圍，背後預設現行法接受的特殊拒 絕權非常有限，此一預設稱之為現行法保護生命論。與之相對的則有現行法保護 自主論，該理論主張現行法已充分保護特殊拒絕權，無進一步立法之必要。本文 先探討特殊拒絕權在倫理及憲法上的性質，再據以分析現行法，指出醫療法與醫 師法並無特殊拒絕權；法定急救義務亦不宜理解為強制締約義務；最後，無論安 寧緩和醫療條例或病人自主權利法，均非特殊拒絕權之補充性規定。以病人自主 權利法來擴充特殊拒絕權，顯屬必要。 Abstract The enactment of Patient Autonomy Act (hereinafter “PAC”) enlarges the scope of current patient’s Right of Refusing Life-Sustaining Treatment (hereinafter “RRLST”). PAC presupposes the primacy of life protection thesis in the now-in-force legal system. As a result, existing laws does not accept RRLST at all or, at most, accept it in a very limited sense. On the contrary, the primacy of patient autonomy thesis claims that RRLST is firmly guaranteed in the current state of law and PAC is therefore superfluous. This article first analyses the status of RRLST in ethical and constitutional terms, then discusses the should-be interpretation of this right in 1 existing laws in order to demonstrate that neither Medical Care Act nor Physicians Act recognizes RRLST. The so-called Physicians’ legal duty to provide urgent care would not be properly interpreted if it was construed only as compulsory for Physicians to have a civil-law like contractual-relationship with the patient. Furthermore, neither Hospice Palliative Care Act nor Patient Autonomy Act are just supplementary regulations concerning RRLST. As conclusion, the enactment of PAC is justifiable bec