关于预先医疗指令书的相关问题探讨

Issues of Advance Medical Directive

预先医疗指令书表达了患者在有自主能力时做出的对丧失自主能力后拒绝或接受治疗的决定,其包括生存意愿书和预指医疗代理两种形式。通过借鉴预先医疗指令书的提出依据和国际上存在的争议,针对我国目前医疗紧急状况时往往因为没有预先准备,医疗处理决定不能充分尊重患者意愿的普遍现象,分析了我国在采用预先医疗指令书的过程中,普遍存在传统文化障碍和缺乏规范宣传等诸多问题,提出我国推广预先医疗指令书的必要性,同时提出在实际应用中应当注重引导和尊重传统文化习俗。

Advance medical directive is a statement made by a patient,which indicates patient＇s acceptable or unacceptable treatments, when he or she is not competent to make a medical decision. There are two types of ad- vance directive, which are living will and durable power of attorney for healthcare. The paper will briefly introduce advance directive＇s history and analyse its controversies throughout the world. In China, most people don＇t own an advance directive. When these patients are faced with medical emergency, their desires can not be known by their relatives, and not to mention let their relatives respect their desires. Cultural barrier and the lack of regulation and propaganda on advance directive are the main reasons cause the current situation of advance directive in china. Based on the analyses above, the paper offers a suggestion that it is necessary to widely promote advance directive in China. During the process of promoting advance directive, should pay attention to guide and respect traditional culture.