Research On Advance Directives System In China

The development of medical technology has extended human life,but the extension of life by various life-sustaining treatments at the end of life has not only increased suffering,but also undermined human dignity.With the improvement of patients’ autonomy in the doctor-patient relationship and people’s pursuit of life quality,the demand of refusing treatment at the end of life gradually emerged,and the advance medical directive system came into being.With medical autonomy as the core of rights,advance medical directives can be divided into acceptance type and rejection type,and can also be divided into directive type and agency type.The refusal type is the research subject of this paper.The essence of the directive type is that individuals perform unilateral legal acts to show their will,while the agency type is divided into agency and transmission according to whether the agent needs explanation.The right basis of advance medical directive is the right of personality,in which the right of body is the basis of the justification of refusing medical treatment,prior autonomy can indicate the equal validity of prior will,and personal dignity indicates the significance of establishment,which is also in line with the concept and principle of medical ethics.At present,there is no special law in China,and only Shenzhen has issued relevant regulations to allow the establishment of living wills.However,from the perspective of relevant medical laws and regulations in China,patients’ autonomy is gradually expanding,but medical "paternalism" still exists,leading to patients’ rights easily being ignored.However,living wills have been promoted by civil society.According to the research of scholars,advance medical directives are not well recognized in China,but oncology doctors have a high degree of recognition and recognition of advance medical directives.Meanwhile,the objective situation of low death quality of the elderly in China indicates that advance medical directives are in need of legislation.Research by scholars shows that traditional filial piety and family-centered traditions are impeding advance medical directives,which also pose a legislative dilemma: the autonomy priority advocated by advance medical directive conflicts with our traditional concept of the right to life first,and our paternalistic model conflicts with the patient autonomy model.In foreign countries,there are both special legislation and general law on the legislation of advance medical directives.In the process of judicial judgment and legislation,the interests of the subjects involved are measured and selected,and the obligations and requirements of different subjects are clearly specified in the specific system.According to foreign experience and our national conditions,the legislative model of special law can be adopted.The legislative dilemma can be solved from two aspects: from the expression of intention made by the person,after careful consideration by the person and strict application requirements,the exercise of autonomy can be restricted;Between family members and patients,patient autonomy is given priority,and the plan is set up for family members to participate in.Clarifying the requirements of different subjects,the establishment person should have the ability to make medical decisions.The agent shall exercise the power of agency in accordance with the "three criteria" rules.Doctors have the obligation to transfer and may not implement advance medical directives in case of emergencies and uncertainty in advance medical directives.In addition,doctors shall be liable for non-compliance with advance medical directives,and patients and their families may resort to breach of contract and infringement for relief.