| 摘要: | 全球已邁向高齡化的趨勢，臺灣將在2025 年成為老年人口占比大於20%的國家之
一，並進入「超高齡社會」，根據衛生福利部健康署的「癌症登記報告」，自民國 71
年起，癌症高居十大死因之首，因此，從這些資料反映出大規模人口老年化和癌症病
人逐年的增加，醫療照護的需求也相對地增加，而臨終準備與權利的保障也愈加受到
重視。醫療科技的日新月異，為許多無法痊癒的臨終病人，提供了許多解決的治療方
式以達成延長生命為目的，但相對地也延長了死亡的過程，這期間病人不僅要承受著
難以忍受的病痛折磨，雖延續了生命的長度，但生活沒有了品質，存在對於生命價值
又有何意義？因此，如何面對死亡是一生最大的考驗，終究當生命走向謝幕的階段，
每個人都希望能有個善終、圓滿的結局。
台灣社會對於死亡議題這幾年有更多地關注，其實死亡有許多複雜的情境題，關
於死亡的議題有的道德兩難，時至今日歧見仍然持續不斷地在辨明著。本文分析臨終
病人死亡方式的選項包括自然死、醫助自殺、安樂死、臨終鎮靜，及《安寧緩和醫
療條例》和《病人自主權利法》所提供的方法。而亞洲第一部《病人自主權利法》已
在台灣正式上路。這是以病人為主體，是一部保障病人自主權利的法案，因此本文對
於《病主法》分析與探討，並且提出修訂建議。期盼能支持並提供臨終病人更多的選
項，對於化解臨終病人善終所面臨的醫療困境所幫助。
生命總會有走向終點的一天，如果有機會死得有尊嚴，平靜、安詳而圓滿地結束，
能達到「養生送死無憾」，就是一種善終。關於善終的詮釋是涵蓋身、心、靈與社會
的層面，涵意甚廣，本文意指的善終，只是狹義臨終病人的善終權，因此本文認為善
終的意境，如同印度詩人泰戈爾《飛鳥集》的詩句：「生，如夏花般絢爛。死，若秋
葉之靜美。」。;The world has been moving towards an ageing trend. Taiwan will become one of the countries
with an elderly population of more than 20% by 2025, and will enter a "super old society".
According to the "Cancer Registry Report" of the Department of Health and Welfare,
cancer has been among the top ten causes of death since 1971. Therefore, these data reflect
the massive aging of the population and the yearly increase of cancer patients, and the demand
for medical care has increased correspondingly, and the preparation of end-of-life and
rights to die have become more and more important. The rapid advancement of medical technology
has provided many solutions for many terminal patients who cannot be cured to
achieve the goal of prolonging life, but it also prolongs the process of dying. Therefore, how
to face death is the biggest test of life. In the end, when life comes to an end, everyone hopes
to have a good and satisfactory ending.
In fact, there are many complex issues regarding death, and some moral dilemmas regarding
death are still unsolved today. This thesis treats in details the options for terminally ill patients
today including natural death, physician assisted suicide, euthanasia, terminal sedation
and the solutions provided by the Hospice and Palliative Care Act, and the Patient Right to
Autonomy Act. The first Patient Autonomy Act in Asia has been officially launched in Sixth
January 2019 in Taiwan. This thesis gives a more or less complete analysis of the Act and
proposes some amendments for it. It is hoped that it can support and provide more options for
terminally ill patients and solves some of the issues of medical dilemma faced by hospice patients.
If one has to die with dignity, to end peacefully, quietly, and satisfactorily, and to achieve
"no regrets for those alive as well as those died", and this is a good death. The meaning of
good death covers issues including the body, mind, spirit and society, and has a wide range of
meanings. In this paper I deal only with the good death for the terminally ill in a narrow sense.
This is why we believe that the meaning of a good death is like the poem of Tagore′s Stray
Birds: ?Let life be beautiful like summer flowers and death like autumn leaves. |
