隨著產品生命週期的縮短，大量的廢棄物對人類生存環境開始造成威脅，各國開始正視廢棄物管理的議題，紛紛立法來規範廢棄物的回收管理。企業為了成本、企業形象、法律規定等因素開始將逆物流(reverse logistic)納入其營運規劃。但在逆物流資訊難以取得以及具備大量的不確定因素下，許多企業選擇將逆物流外包給專業的逆物流業者，以專注在其核心能力之上。 在單純的外包模式下，企業時常面臨回收商無法穩定供給再生物料之問題，若再生物料使用比率無法達到法規要求，則需繳納高額的回收規費，部分企業甚至以新產品分解為新再生物料來補足再生物料短缺以迴避高額的回收規費；回收商則會面臨企業再生物料需求數量不穩定或是數量不足，單次運輸成本大幅提高，使其表現出只願回收退回商品取得回收補貼，但不分解販售再生物料，而是堆放退回商品於集散處的傾向。 本研究提出一綜合回收商及製造商之緊密營運模式，考量連續時期、利潤共享的條件下，建立一數量決策模型，以整體利潤最大化為目標，探討不穩定因素下之每期穩健再生物料分配決策。因應大環境之不穩定因素，將以建構情境為基礎之穩健最佳化模式求得穩健解。 / In recent year, enterprises consider reverse logistic in their processing because of cost, corporate image and government policy. But there are lots of uncertainty factors in the reverse logistic, in order to focus on enterprise’s professional skills, more and more enterprises outsource their reverse logistics. Both enterprise and professional reverse logistic processor have to spend more costs to keep their cooperation in recent outsourcing model. Thus, this thesis builds a model which combine enterprise's business model and professional reverse logistic processor's business model. In this model, assumes that profit should be share between both of them, and apply Robust optimization methods to solve uncertainty factors in reverse logistic. The thesis finds out the best distribution ratio of regeneration materials in each period.

過去的文獻中，資產配置的方法不外乎效率前緣、動態資產配置等方式，但是，單獨針對銀行探討的文章並不多見，所以本文的貢獻在於單獨針對銀行的資產配置行為進行研究，希望能利用『演化策略演算法』，進行『模擬最佳化』來解決銀行資產配置的問題。基本上這個方法是由兩個動作結合而成，先是模擬，再來尋求最佳解。所以，資產面我們選擇了現金、債券、股票、不動產四項標的，而負債面則模擬了定存、活存與借入款這三項業務，然後透過重複執行模型的方式來求出最適解。並與單期資產配置方法下的結果作一比較，發現運用演化策略演算法有較佳的結果，此外，在不同的亂數下，仍具有良好的穩健性，可作為一般銀行經理人參考之用。 / We focus on the bank’s asset allocation problem in this thesis. We use simulation optimization to solve the problem by evolution strategy, which is relatively new in the financial field. Simulation optimization consists of two steps: simulate numerous situations and search for the optimal asset portfolios. In the simulation, we set up four assets, including cash, bond, stock, and real estate and three business lines, including demand deposits, time deposits, and borrowings. Then we search for the optimal solution by running the ES algorithm. The results show that simulation optimization generates better results than one-period asset allocation. Furthermore, the evolution strategy method generates similar results using different random numbers.

本研究的第一部份是利用有效存續期間與有效凸性來衡量人壽保險人的利率風險。我們發現Tsai (2009)指出的壽險保單準備金之有效存續期間結構並非一般化的結果。當長期利率水準高於保單預定利率及保單解約率敏感於利差時，準備金之有效存續期間會呈現與Tsai (2009)相反的結構。我們進一步發現準備金之有效凸性會亦有可能呈現負值，且不易依照保單到期期限歸納出一般化的結構。負值的有效凸性起因於準備金並非利率的單調函數，且準備金與利率的函數關係隨保單到期期限而不同。我們的研究結果可以幫助人壽保險人執行更為精確的資產負債管理。 本研究的第二部分是利用模擬最佳化的方法，幫助銷售傳統壽險保單的保險人求解出適切的業務槓桿與資產配置策略。我們假設保險人在考量破產機率與報酬率的波動之下，將資本與淨保費收入投資於資本市場中，以追求較高的業主權益報酬率。以業務槓桿與資產配置相互影響為前提，我們求解出適切的業務槓桿與多期資產配置策略，並分析在不同的業務槓桿之下，保險人多期資產配置的差異。 / In the first part of this doctoral dissertation, we focus on a proper measurement on interest rate risk of life insurer’s liabilities, policy reserves, by incorporating the general effective duration and effective convexity measures. Tsai (2009) identified a term structure of the effective durations of life insurance reserves. We find that his results are not general. When the long-run mean of interest rates is higher than the policy crediting rate and the surrender rate is sensitive to the spread, the term structure would exhibit an opposite pattern to the one in Tsai (2009). We further find that the effective convexities might be negative and the term structure of the effective convexities exhibits no general pattern. The irregularities originate from negative effective convexities result from the relationship between mean reserves and initial short rate for different years to maturity. Our results can help life insurers to implement more accurate asset-liability management. In the second part, we analyze asset allocation and leverage strategies for a life insurer selling traditional insurance products by using a simulation optimization method. We assume that an insurer invests equity capital (from its shareholders) and premiums it receives from policyholders by choosing a portfolio intended to maximize the annual return of equity minus the penalty of insolvencies and risks. We regard the leverage as an internal factor in asset allocation. Based on these assumptions, we get a promising multiple-periods asset allocation and leverage, besides analyzing how leverage affects asset allocation strategies.

近年來有許多研究發現，適應性管制圖在偵測製程或產品幅度偏移時的速度比傳統的舒華特管制圖來的快，許多文獻也討論到利用適應性管制技術同時監控製程的平均數和變異數。隨著科技的發達，許多產品在製造上更加精密，現今普遍使用的固定參數管制圖並無法有效率的偵測出製程失控，導致巨大的成本損失。為了改善現有管制圖的偵測效率與有效控制製程失控下的損失，我們提出了三種適應性加權損失管制圖，包括變動抽樣間隔(VSI)、變動樣本數與抽樣間隔(VSI)、變動管制參數(VP)來偵測單一製程與兩相依製程的平均數和變異數。採用製程發生變動後到管制圖偵測出異常訊息所需的平均時間(AATS)與所需的總觀測數(ANOS)來衡量管制圖的偵測績效，並利用馬可夫鏈推導計算得之。從數值分析中發現，適應性加權損失管制圖在「偵測小偏移幅度時的偵測效率」與「成本的控制」明顯比傳統管制圖表現的更好，再加上每一個製程僅需採用單一管制圖，對使用者也較為簡便並且容易理解，因此適應性加權損失管制圖在實務上是值得被推薦使用的。 / Recent research has shown that control charts with adaptive features detect process shifts faster than traditional Shewhart charts. In this article, we propose three kinds of adaptive weighted loss (WL) control charts, variable sampling intervals (VSI) WL control charts , variable sample sizes and sampling intervals (VSSI) WL control charts and variable parameters (VP) WL control charts, to monitor the target and variance on a single process step and two dependent process steps simultaneously. These adaptive WL control charts may effectively distinguish which process step is out-of-control. We use the Markov chain approach to calculate the adjusted average time to signal (AATS) and average number of observations to signal (ANOS) in order to measure the performance of the proposed control charts. From the numerical examples and data analyses, we find the adaptive WL control charts have better detection abilities and performance than fixed parameters (FP) WL control charts and FP Z(X-bar)-Z(Sx^2) and Z(e-bar)-Z(Se^2) control charts. We also proposed the optimal adaptive WL control charts using an optimization technique to minimize AATS when users cannot specify the values of the variable parameters. In addition, we discuss the impact of misusing weighted loss of outgoing quality control chart. In conclusion, using a single chart to monitor a process is inherently easier than using two charts. The WL control charts are easy to understand for the users, and have better performance and detection abilities than the other charts, thus, we recommend the use of WL control charts in the real industrial process.

當線性模型中包含隨機效果項時，若將之視為固定效果或直接忽略，往往會造成嚴重的推測偏差，故應以混合線性模型為架構。若模式中只包含一個隨機效果項，則模式中有兩個變異數成份，若包含 個隨機效果項，則模式中有 個變異數成份。本論文主要在介紹至少兩個變異數成份時固定效果及隨機效果線性組合的最佳線性不偏推測量（BLUP），及其推測區間之推導與建立。然而BLUP實為變異數比率的函數，若變異數比率未知，而以最大概似法（Maximum Likelihood Method）或殘差最大概似法（Residual Maximum Likelihood Method）估計出變異數比率，再代入BLUP中，則得到的是經驗最佳線性不偏推測量（EBLUP）。至於推測區間則與EBLUP的均方誤有關，本論文先介紹如何求算其漸近不偏估計量，再介紹EBLUP之推測誤差除以 後，其自由度的估算方法，據以建構推測區間。 / When random effects are contained in the model, if they are treated as fixed effects or ignore, then it may result in serious prediction bias. Instead, mixed linear model is to be considered. If there is one source of random effects, then the model has two variance components, while it has variance components, if the model contains random effects. This study primarily presents the derivation of the best linear unbiased predictor (BLUP) of a linear combination of the fixed and random effects, and then the conduction of the prediction interval when the model contains at least two variance components. However, BLUP is a function of variance ratios. If the variance ratios are unknown, we can replace them by their maximum likelihood estimates or residual maximum likelihood estimates, then we can get empirical best linear unbiased predictor (EBLUP). Because prediction interval is relating to the mean squared error (MSE) of EBLUP, so the study first introduces how to get its approximate unbiased estimator, m_a , then introduces how to evaluate the degrees of freedom of the ratio of the prediction error for the EBLUP and m_a ^1/2 , in order to use both of them to establish the prediction interval.

本研究以策略管理理論「策略形態分析」法與「策略矩陣分析」法為基礎，發展出新的分析架構–「價值單元展開分析」法，並與策略矩陣整合成為策略系統模型。藉由個案研究，驗證此策略系統模型如何使管理者能更精確地衡量未來策略規劃之選擇，最佳化公司未來競爭策略方向。 筆者以個案探討新創科技公司在持續變動與競爭之產業中，競爭策略分析與規劃之方法。以3D感測產業作為分析與研究之個案產業，並以其中一新創科技公司–L科技公司作為個案探討之對象，提出一以新創科技公司為出發點，在衡量現有與發展未來競爭策略時，可供利用與權衡的分析方法。 「價值單元展開分析」法追尋理性與系統化思考，為公司導入嚴謹明確、量化、及標準化的度量衡工具，使公司得以更加周詳完備與深入地分析其條件前提，將策略最佳化。且此架構具高度延展性，得充分配合公司進行各種思考面向之分析。此外，「價值單元展開分析」法亦可完全結合與相容於「策略矩陣分析」法之中，形成易於溝通與同步的策略系統模型，利用此特點解決公司在策略規劃時可能遭遇之混沌與困難，將效率、效益、及效能用在得當之處，使公司未來發展更符合目標。 / This study investigates the methods of analyzing and planning competitive strategies, with a case study of a technology startup company – “L Company” in the 3D sensor industry. Based on strategy analysis and Strategic Matrix Analysis, this study developed a new analytic framework – “Value Unit Expansion Analysis” which is a systematic model integrated into Strategic Matrix Analysis. By verifying the systematic model through the case, this study proposed a more precise and optimization–capable method to form a company’s future competitive strategies. Value Unit Expansion Analysis is a clarifying, quantifying, and standardizing method for the company to pave the path for factor condition analysis and strategic optimization. The structure was designed with a high flexibility in correspondence to different considerations and changing aspects; it is compatible and can be built within Strategic Matrix Analysis. The systematic model is liable for communication and synchronization during the process of strategy planning and, therefore, setting higher efficiency, benefit, and utility for pertinent strategies that fit into companies’ goals.

近幾年來，有一些研究提出了只用單一一個管制圖即可同時偵測平均數和變異數。根據此目的，我們提出了加權平均損失管制圖，此管制圖是利用加權平均損失所建立的，在一個製成的目標值和平均數不一定相等時，它可同時監控一個製成的平均數和變異數。此加權平均損失統計量是應用一個加權因子，去調整製程平均和目標值的平方差和變異數的損失比重，所以此管制圖的效能比未經由加權因子調整過的管制圖還好。我們不只建立了固定管制參數(FP)加權平均損失管制圖，也建立了適應性加權平均損失管制圖，包括變動抽樣間隔(VSI)、變動樣本數與抽樣間隔(VSI)、變動管制參數(VP)；我們利用平均連串長度(ARL)來衡量固定管制參數管制圖的偵測績效，利用馬可夫鏈的方法計算偵測出異常訊息所需的平均時間(ATS)來衡量適應性管制圖的績效，並且做比較，我們發現適應性管制圖比固定管制參數管制圖的效能還要好。我們也利用最佳化技術建立最加適應性管制圖，當製成失控時，此最佳化管制圖能使ATS1最小。此外，當平均數和變異數的偏移幅度很小時，我們利用指數加權移動平均法(EWMA)建立EWMA加權平均損失管制圖，使其有較好的偵測力。這些我們所提出的管制圖，是只根據單一一個統計量所建立的，和X bar-S管制圖相比，有較好的效能，且和使用兩個管制圖同時偵測平均數和變異數相比，比較輕易理解且容易執行。 / In recent years, a few researchers had proposed different types of single charts that jointly monitor the process mean and the variation. In this project, we use the weighted average loss (WL) to construct WL control charts for monitoring the process mean and variance simultaneously while the target value may be different from the in-control mean. This statistic WL applied a weighted factor to adjust the weights of the loss due to the square of the deviation of the process mean from the target and the variance change. So the WL charts are more effective than unadjusted loss function charts. We not only construct the fixed parameters (FP) WL chart but also the adaptive WL charts which included variable sampling interval (VSI) WL chart, variable sample size and sampling interval (VSSI) WL chart and variable parameters (VP) WL chart. We calculate the average run length (ARL) for FP WL chart and using Markov chain approach to calculate the average time to signal (ATS) for adaptive WL charts to measure the performance and compare each other. From the comparison, we find the adaptive WL charts are more effective than the FP WL chart. We also proposed the optimal adaptive WL charts using an optimization technique to minimize ATS1 (ARL1) when the process was out-of-control. In addition, in order to detect the small shifts of the process mean and variance effectively, we construct the WL charts using the EWMA scheme. The proposed charts are based on only one statistic and are more effective than the X bar-S chart. And the WL charts are easy to understand and apply than using two charts for detecting the mean and variance shifts simultaneously.

本論文針對隨機數位網路提出一套可行的計算機制，以提供網路管理者進行資源分配與壅塞管理的分析工具。我們研究兩種利潤最佳化模型，探討在預算控制下的頻寬分配方式。因為資源有限，網路管理者無法隨時提供足夠頻寬以滿足隨機的網路需求，而量測網路連結成功與否的阻塞機率(Blocking Probability)為評估此風險之一種指標。我們利用頻寬分配、網路需求量和虛擬端對端路徑的數量等變數，推導阻塞機率函數，並證明阻塞機率的單調性(Monotonicity)和凸性(Convexity)等數學性質。在不失一般性之假設下，我們驗證阻塞機率是(1)隨頻寬增加而變小；(2)在特定的頻寬分配區間內呈凸性；(3)隨網路需求量增加而變大；(4)隨虛擬路徑的數量增加而變小。 本研究探討頻寬分配與阻塞機率之關係，藉由推導單調性和凸性等性質，提供此兩種利潤模型解的最適條件與求解演算法。同時，我們引用經濟學的彈性概念，提出三種模型參數對阻塞機率變化量的彈性定義，並分別進行頻寬分配、網路需求量和虛擬路徑數量對邊際利潤函數的敏感度分析。當網路上的虛擬路徑數量非常大時，阻塞機率的計算將變得複雜難解，因此我們利用高負荷極限理論(Heavy-Traffic Limit Theorem)提供阻塞機率的估計式，並分析其漸近行為(Asymptotic Behavior)。本論文的主要貢獻是分析頻寬分配與阻塞機率之間的關係及其數學性質。網路管理者可應用本研究提出的分析工具，在總預算限制下規劃寬頻網路的資源分配，並根據阻塞機率進行網路參數的調控。 / This thesis considers the problem of bandwidth allocation on communication networks with multiple traffic classes, where bandwidth is determined under the budget constraint. Due to the limited budget, there exists a risk that the network service providers can not assert a 100% guaranteed availability for the stochastic traffic demand at all times. We derive the blocking probabilities of connections as a function of bandwidth, traffic demand and the available number of virtual end-to-end paths for all service classes. Under general assumptions, we prove that the blocking probability is directionally (i) decreasing in bandwidth, (ii) convex in bandwidth for specific regions, (iii) increasing in traffic demand, and (iv) decreasing in the number of virtual paths. We also demonstrate the monotone and convex relations among those model parameters and the expected path occupancy. As the number of virtual paths is huge, we derive a heavy-traffic queueing model, and provide a diffusion approximation and its asymptotic analysis for the blocking probability, where the traffic intensity increases to one from below. Taking the blocking probability into account, two revenue management schemes are introduced to allocate bandwidth under budget control. The revenue/profit functions are studied in this thesis through the monotonicity and convexity of the blocking probability and expected path occupancy. Optimality conditions are derived to obtain an optimal bandwidth allocation for two revenue management schemes, and a solution algorithm is developed to allocate limited budget among competing traffic classes. In addition, we present three elasticities of the blocking probability to study the effect of changing model parameters on the average revenue in analysis of economic models. The sensitivity analysis and economic elasticity notions are proposed to investigate the marginal revenue for a given traffic class by changing bandwidth, traffic demand and the number of virtual paths, respectively. The main contribution of the present work is to prove the relationship between the blocking probability and allocated bandwidth under the budget constraint. Those results are also verified with numerical examples interpreting the blocking probability, utilization level, average revenue, etc. The relationship between blocking probability and bandwidth allocation can be applied in the design and provision of broadband communication networks by optimally choosing model parameters under budget control for sharing bandwidth in terms of blocking/congestion costs.

本論文的研究目標是建構一個由多標記複合成的最佳疾病診斷工具，所考慮的評估準則為操作者特徵曲線在特定特異度範圍之線下面積(pAUC)。在常態分布假設下，我們推導多標記線性組合之pAUC以及最佳線性組合之必要條件。由於函數本身過於複雜使得計算困難。除此之外，我們也發現其最佳解可能不唯一，以及局部極值存在，這些情況使得現有演算法的運用受限，我們因此提出多重初始值演算法。當母體參數未知時，我們利用最大概似估計量以獲得樣本pAUC以及令其極大化之最佳線性組合，並證明樣本最佳線性組合將一致性地收斂到母體最佳線性組合。在進一步的研究中，我們針對單標記的邊際判別能力、多標記的複合判別能力以及個別標記的條件判別能力，分別提出相關統計檢定方法。這些統計檢定被運用至兩個標記選取的方法，分別是前進選擇法與後退淘汰法。我們運用這些方法以選取與疾病檢測有顯著相關的標記。本論文透過模擬研究來驗證所提出的演算法、統計檢定方法以及標記選取的方法。另外，也將這些方法運用在數組實際資料上。 / The aim of this work is to construct a composite diagnostic tool based on multiple biomarkers under the criterion of the partial area under a ROC curve (pAUC) for a predetermined specificity range. Recently several studies are interested in the optimal linear combination maximizing the whole area under a ROC curve (AUC). In this study, we focus on finding the optimal linear combination by a direct maximization of the pAUC under normal assumption. In order to find an analytic solution, the first derivative of the pAUC is derived. The form is so complicated, that a further validation on the Hessian matrix is difficult. In addition, we find that the pAUC maximizer may not be unique and sometimes, local maximizers exist. As a result, the existing algorithms, which depend on the initial-point, are inadequate to serve our needs. We propose a new algorithm by adopting several initial points at one time. In addition, when the population parameters are unknown and only a random sample data set is available, the maximizer of the sample version of the pAUC is shown to be a strong consistent estimator of its theoretical counterpart. We further focus on determining whether a biomarker set, or one specific biomarker has a significant contribution to the disease diagnosis. We propose three statistical tests for the identification of the discriminatory power. The proposed tests are applied to biomarker selection for reducing the variable number in advanced analysis. Numerical studies are performed to validate the proposed algorithm and the proposed statistical procedures.

因為醫病互動關係的改變，病患自主權在經過歐美數十年來的覺醒與詮釋，並定位於不論是人性尊嚴或是隱私權內涵中之憲法層級，以及在告知後同意於近二十年來引進國內並蓬勃發展之後，病患的自主決定權在現今醫療過程中已經受到相當的重視。青少年也因接近成人的年齡及成熟度，在法律及臨床實務上也逐漸肯認其對於自身的醫療決定擁有自主決定權。然而，兒童不論在法律或是社會觀念之中，均被認定為能力尚未成熟，傳統上認為必須由父母代替其做醫療決定。可是在作者身為一位臨床兒科醫師的臨床實務經驗當中，許多病童往往能表達自己對於醫療決定甚至是臨終決定的自主意見，卻不受到父母或其他成年代理人的採納。 因此，本文將從臨床經驗出發，將所發現許多兒童有能力決定、以及父母無法做出符合兒童利益決定的案例，提出作為本文探討的思考起源。本文主要鎖定未成年人中未滿12歲的兒童進行討論，排除許多文獻早已熱烈討論的青少年人；另外因為立法例上並未賦予未成年人擁有「自主權」，故本文暫不深究兒童法律上的自主權利，而是以探討兒童實質上的「自主性」作為探討的主軸，並以此為未來法律發展的基礎。 本文將首先從「醫病關係的演進」開始，探討一般性「病患自主決定權」之倫理與法律。醫學倫理上涉及包括「生物醫學倫理四原則」以及「告知後同意」；多數國家也將「自主決定權」在法律上定位為憲法層級之人權保障。聯合國兒童權利公約則為現今國際上兒童人權維護的重要指引，也是對於兒童一般自主權正當性的重要依據。至於兒童的自主決定與其決定能力相關，也涉及父母代理決定的討論，故從法律上對於父母子女關係及未成年人保護的討論出發，探討代理決定時的最佳利益判斷，思考兒童醫療決定的問題及衝突，以及在不同年齡適合該年齡得以決定的事項。 在兒童醫療決定上，難題包括為何要重視兒童自主、何人有權決定、如何決定等等，在此議題受到各國重視並不斷發展之下應如何運作。在本文中主要參考了美國以及英國的發展經驗以及建議，提出對於臨床操作的看法。本文認為，可以用兒童醫療「表意權」的行使作為對兒童自主性的肯認，從兒童決定能力的判斷開始，對於具有決定能力的兒童表達其合理意見應充分尊重；若是缺乏決定能力的兒童，則在考量其最佳利益後由父母代理其做出醫療決定。醫療人員基於必須對於病童負責的角色及責任，亦應檢視父母決定是否合理，適時地介入決定以維護兒童最佳利益。 至於在兒童的最佳利益的判斷上，除了要考慮所面對的病況以外，還需要針對兒童未來生理發育和心智發展的影響，整體考量其未來的生活品質；對於臨終的兒童，則應考量是否得到有尊嚴的死亡，此與成年人的思考並無相左。最後，本文將進一步探討較為特殊的臨床狀況，包括面對重症以及急症的病童應如何操作及思考，並重新檢視本文所提出之實際臨床困難案例，建議較為適合的做法，以作為更多臨床個案判斷的參考指引。 / Patients' awareness of self-determination has raised and their rights have been taken into account in clinical consideration because of the change of doctor-patient relationship in recent decades. The right to autonomy was highly positioned at the constitutional level no matter it is contained in the concept of human dignity or the right of privacy. It is also highly valued after “the doctrine of informed consent” was introduced into our country with vigorous development in recent years. Because adolescents’ age and maturity approach adults, they have been recognized to have sufficient ability and right to make their own medical decisions as well as adults. Children, in the general idea of the society, are concerned not to have sufficient decision making ability and therefore need their parents’ help to make their own medical decisions. However, from clinical experiences, many children could not only express their autonomous opinions but even have the ability to consent to their medical treatments, including life-saving treatments. Unfortunately, children’s opinions were usually ignored, and sometimes their parents could not make decisions in their best interest. This study will discuss the patient autonomy of children whose ages are under 12 years old. We acknowledge that children do not have legal “right” to autonomy but they still have their own autonomous expression. The ethical and legal bases of patient autonomy are firstly illustrated, including “the four principles approach to bioethics”, “the doctrine of informed consent”, the legal status of “the right to autonomy” at the constitutional level, and the United Nations Convention on the Rights of the Child which is an international guide to children’s human right. Children’s autonomy is closely related to their decision-making capacity or competence and their age. Furthermore, surrogate decision making plays an important role in children’s affairs. When there is a conflict between the parents and children, the principle of best interest of children should be the leading concern. Regarding the medical decision of children, difficult problems are: why children’s patient autonomy is vital, who has the right to decide, and how to make a decision. I have reviewed the experiences and suggestions from concept leading countries such as the United States and the United Kingdom. I proposed my own viewpoint and suggest some guidelines on the clinical decision process. My opinion is that children’s right to express should be taken as the confirmation of children’s autonomy. For the children with decision making capacity, we should fully respect his rational decision; for the children without it, parents could make the decisions according to the children’s best interest. Medical staffs, including doctors and nurses, also need to reexamine the parents’ decisions suitable for children’s best interest. At the end of the thesis, I re-examine the clinical cases proposed at the beginning of this thesis, to present my resolution to the cases as guides for future clinical situation.