Research On Advance Directive For Health Care

According to modern medical and legal values,patients have autonomy in their own medical affairs.The premise of the patient's independent decision is to have sufficient decision-making ability.For those who have insufficient ability to make decisions,the law generally provides that their close relatives,guardians and other related persons shall make decisions on their behalf.However,the substitutive decision of others may not meet the patient's true wishes,because each person may have different life pursuits because of different religious beliefs,living habits,educational background,etc.In order to deal with this problem,advance directive for health care system was created,which confirmed that individuals can plan ahead and make decisions about health care matters in advance when they still have sufficient decisionmaking capacity,or entrust their power of attorney for health care affairs to others who fully understand their true wishes to make decisions on their behalf after they become incapable.In this way,individuals can own autonomy across time and realize their own unique pursuit of life.The first chapter of this paper gives an overview of the advance directive for health care.The advance directive for health care system originated in the United States.The establishment of the system is the result of the synergy of objective factors and subjective factors.People mainly regard the advance directive for health care system as a means of pursuing die with dignity.According to different forms of expressing will,advance directive for health care can be divided into instructional and agency types.Instructional advance directive for health care is a written record of the individual's wishes in advance.As an act of expression,referring to the discussion on the legal nature of the victim's consent in theory,it should be regarded as a "quasi-juristic act." Agency advance directive for health care is that individuals choose an agent in their own medical affairs to express their medical wishes and choices on their behalf.This is a breakthrough in the principle of no agency of personal affairs.The advance directive for health care of patients are based on their medical decision-making ability.When identifying the patient's medical decision-making ability,Physicians need to specifically examine a patient's ability to understand,measure,and communicate information.The second chapter of this paper introduces the justified basis of advance directive for health care,namely the medical autonomy.According to modern philosophy,autonomy is the core value of human dignity.Medical autonomy is the embodiment of the principle of autonomy in the relationship between doctors and patients.The patient's refusal to life-sustaining medical treatment is essentially the exercise of his right to refuse special medical treatment.The right to refuse special medical treatment is a type of medical autonomy.Its exercise means the surrender of the survival of life,which will lead to conflicts between autonomy and the right to life.German legislation chose to give priority to the protection of autonomy,arguing that the willingness of patients is more important than their health.The Taiwan region adheres to the "absolute protection of life principle",which does not allow patients to exercise their right to refuse special medical treatment at will,but under certain clinical conditions,the above principle can be loosened.In U.S.law,the conflict between autonomy and the right to life is reflected in the conflict between the right to privacy and the state interests in protecting life.The U.S.court believes that specific cases should be analyzed in detail,depending on the prognosis of the patient and the degree of intrusion of medical measures.Although autonomy has become a universal value,it is rarely discussed as an independent right,and China 's Civil Code(Draft)does not stipulate the right of self-determination as an independent right.However,self-determination should be the core connotation of the general personality right of civil law.We should use the practice of judicial protection of the general personality right of civil law to protect the self-determination of individuals from the law of tort liability.In the third chapter of this paper,through the discussion of the current legal system in China,it is found that the relevant provisions of China's medical law and guardianship law are flawed and cannot guarantee that the patient's wishes will be respected and enforced after their disability.In addition,the advance directive for health care involves a breakthrough in the constitutional principle of "prohibition of insufficient protection",follows the spirit of strict exceptions,and it is appropriate for legislation to make detailed provisions for this system.This constitutes the necessity of establishing the advance directive for health care system in China.Chapter 4 of this paper looks forward to China's future legislation.There are two legislative ideas.First,after examining the logic of the civil capacity system,it is found that because the field of medical behavior does not involve transaction security,and the case review is not unrealistic,so in the medical decision-making area,in order to better protect the medical autonomy of minors and people with cognitive disabilities,"medical decision-making ability" should be used instead of " civil capacity ".Second,considering that medical autonomy is actually a relational autonomy,and based on the concept of Chinese culture,legislation should guarantee the participation of family members of patients in the medical decision-making process,so we should establish an advance health care planning system.On the one hand,the conduct of planning is conducive to the legality and accuracy of health care directives,on the other hand,it is conducive to the prevention of medical disputes.