| Summary: | 碩士 === 國立中央大學 === 哲學研究所碩士在職專班 === 94 === Abstract
Improvements in advanced medical technologies have increased and lengthened the lifespan of human beings and changed the way of life. In addition, the issue of rapid aging population certainly affects people’s attitude about their facing death, approaching the point of death and making decision for certain medical treatment.
Taiwan’s “Hospice Palliative Care Act” was promulgated on December 11th, 2002. Its distinguishing features are to return the right to self-determination back to the patients and expand it to cover the scope of medical treatments from birth, aging, sickness to death, as well as assists the patients in facing death. The main point of this Act is to allow terminal patients to refuse to undergo the cardiopulmonary resuscitation (CPR), to make a living will, and to appoint the durable power of attorney.
This study first reviews the principles and bases of the advance directives in bioethics, in particular the relationship between advance directives, the principle of automony and the principle of informed consent, as well as the competence that advance directives involved, and the authorization of the durable power of the attorney.
Advance Directives usually are those directives that patients made due to their expectations or assumptions on the future medical conditions. These directives announce the decisions of the patients with respect to their future. However, the use of these directives overlook the fact that directives based on assumptions can sometimes lead to regretful decisions when the actual outcome differs from the assumptions and leads to moral risks. Hence, this essay analyses the challenge of the personal identity to the moral authority of the advance directives. Basically, this study indicates that even with a change in personal identity, advance directives are still effective. Therefore, the author supports the use of the sliding scale strategy for competence.
It is critical that whether informed consent was well taken care of in the advance directives, advance directives made by patients that may lead to controversy: 1) Questions in execution. 2) The issue of the criteria of incompetence. 3) Difficulty in judgment made by the durable power of attorney.
This dissertation also investigates the risks involved in advance directives, the effectiveness of verbal directives, and the establishment of a valid example for advance directives. At last it will analyze the problems and solutions on the judgments made by the durable power of the attorney.
Key words: advance directives,living will,durable power of the attorney,
autonomy,informed consent,self-determination,competence,personal identity
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