生前预嘱国内外实践研究进展

The current situation of Advanced Directives practice at home and abroad

生前预嘱是由患者在具有表意能力时作出临终期的治疗决定,是对患者医疗自主权的尊重,同时也是医疗和法制发展的重大进步。在世界各大洲均有立法及实践,我国起步较晚,已在台湾、香港、北京等地区进行推广实践,但尚存在概念混杂、研究集中于医护患态度调研方面等问题,且尚未立法,在此现状下,本文对生前预嘱相关概念,国外关于生前预嘱发生发展、立法、医疗实践以及生前预嘱在我国医疗实践可能存在的难点、问题及立法可行性等现状进行论述。

Advanced Directives are about decisions on the end-of-life treatment made by patients when they have the ability to express themselves. It is a respect for patients’ medical autonomy and a significant progress in the development of the medical treatment and legal system. Having been made legal and put to practice in countries throughout the world, Advanced Directives are still new to China. Although the concept has been known to several places in China, including Taiwan, Hong Kong and Beijing, problems regarding the confusion about the concept itself and researches mainly focusing on attitudes of doctors, nurses and patients remain to be solved. Besides, legislation about Advanced Directives in China still needs to take a further step, which is of vital importance. In this paper, the concept of Advanced Directives and its development including legislation and medical practice at home and abroad are described and discussed as well as the possible difficulties and problems of it being implemented in China and the feasibility of legislation under present circumstances.