Implementing Patient Autonomy in Medical Substitute System

Abstract

SUMMARY Medical decision-making is not a judicial act and does not have the characteristic of a contract Sufficient flexibility and freedom to allow individuals to express autonomic medical decisions is important in law The core elements of medical decision capacity include understanding reasoning appreciation and expressing a choice An individual is presumed to be capable before it is proven not It cannot mechanically deprive one’s medical decision-making right and the law should develop the supported decision-making system to respect one’s residual mental capacity The process of medical decision-making is more important than the decision itself because individuals could change the preferences and choices and we should engage in respecting them all the time The function of health care agent is quite limited in Hospice Palliative Care Act and Patient Right to Autonomy Act only similar to a messenger This article suggests that their role should be like a witness and need to act as a facilitator in order to express the patient’s value preference and belief In addition to advocate the supported decision-making system this article recommends that the law gives the room to medical professionals to develop guidelines instead of legislation Respecting patient autonomy principle should be shown in legal practices and the judicial system need to be more familiar with it Key words: medical decision-making autonomy medical substitute system supported decision-making Hospice Palliative Care Act Patient Right to Autonomy Act mental capacity

Date of Award	2020
Original language	English
Supervisor	Ing-Ling Hou (Supervisor)