隨著醫學科技的進步,越來越多病患無法自主進行醫療決定的情況發生。西方國家受病人自主權的概念啟發,發展出預立醫囑(living will)及醫療代理人制度(durable power of attorney for health care)。醫療代理人制度提供個人預先指定醫療代理人,當事人無法自主做出醫療決定時,可由醫療代理人代替當事人作出醫療決定,以補足無預立醫囑或預立醫囑的不足。
我國同志伴侶於目前仍缺乏法律上的實質身分保障,伴侶相關的醫療權利正迫切且無預警的影響許多打算共組家庭而無法受法律上的婚姻制度保障的同志伴侶。雖有論者認為,可適用醫療法上「關係人」以及安寧緩和醫療條例之「醫療委任代理人」,即可滿足同志伴侶於醫療上的需求。然由於關係人的定義模糊,且實務上為避免醫療糾紛,往往要求病患的親屬到場,而不接受其他不具配偶、親屬身分關係者進行醫療行為的同意,「關係人」一詞於實務上難以適用。
本文試圖從醫療代理人制度的角度,期能另闢蹊徑,除強化並保障病人自主權外,提供同志伴侶在與生死攸關的醫療議題上更可能且直接的保障,也為不論是同志或其他愛的關係尋求更多可能,提供在婚姻以外的選擇能有更多彈性。本文除了介紹西方的醫療代理人制度並借鏡美國同志伴侶使用醫療代理人制度的經驗外,也探討醫療代理人制度對於我國家庭觀念、傳統醫療上家屬父權主義以及家庭中心式的醫療決策文化的影響與衝擊。同時更深入討論,同志伴侶必須面臨來自醫療院所、醫護人員對於同志是否友善;以及來自病患原生家庭對於醫療代理人及同志身分的壓力。 / With the advances in medical technology, the situation that patients couldn't determine their medical decisions increasingly occurs in our society. Inspired by the concept of patient autonomy, Western countries developed living will and durable power of attorney for health care, which is as known as health care proxy. Individuals can appoint a trustworthy person as their health care proxy. When the patient is incompetent, the health care proxy can make medical decisions for the patient to complete the inadequacy of living will.
Same-sex couples can’t make medical decisions for their same-sex partners because same-sex marriage is currently illegal in Taiwan. Moreover, family members play an important role in the process of medical decision in Taiwan. Therefore, this article introduces the development of durable power of attorney for health care in Western countries, tries to address the medical issue of Taiwanese same-sex couples, and discusses the impact of durable power attorney for health care on Chinese traditional family values and family-centered medical decision making. While as a health care proxy, same-sex partner has to face the medical staff’s attitude toward homosexual, also has to confront the pressure from the patient’s family-of-origin.
Identifer | oai:union.ndltd.org:CHENGCHI/G0100652018 |
Creators | 林芳伃, Lin, Fang Yu |
Publisher | 國立政治大學 |
Source Sets | National Chengchi University Libraries |
Language | 中文 |
Detected Language | English |
Type | text |
Rights | Copyright © nccu library on behalf of the copyright holders |
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