从深圳医疗条例颁布展望我国安宁疗护立法

Prospect of legislation for hospice care in China as implied by newly issued medical regulations in Shenzhen

生前预嘱是维护个人临终医疗决策权,实现善终的重要途径。深圳医疗条例首次将生前预嘱纳入法律规范的举措能够改善生前预嘱订立少、执行难的现状,且具有保护患者自主权、缓解家属压力、整合医疗机构资源和树立社会理性死亡观等现实意义。同时,生前预嘱法律规则的广泛实践仍需要通过澄清宣导相关观念、开展生前预嘱咨询指导等方式提高公众认知,并从生前预嘱形式要件、格式文本、变更撤销、存放方式、医学判断程序等角度制定严谨的、可操作性强的生前预嘱相关配套规范,从而完善生前预嘱制度。从生前预嘱制度出发,补充医疗代理人制度形成完整的预先指示制度,并以此为突破口逐步建立安宁疗护法律体系,是安宁疗护立法努力营造个人、家庭、医疗机构、国家等主体多赢局面,实现全面依法治国的具体路径。

Living will serves as an important way to guard an individual′s right to make end-of-life medical decisions and die a natural death. Shenzhen took the initiatives by including living will in its medical regulations as legal norms, which can improve the current situation of low signature rate and difficult execution and has practical significance in protecting the patient′s autonomy, alleviating family burden, integrating institutional medical resources, and establishing a rational concept of death in the society. At the same time, the extensive practice of the legislation pertinent to living warrants enhanced public awareness with conceptual clarification and publicity, and consultation and guidance on living will, and improved policy of living will by establishing the rigorous and operable supporting norms in the respects of the formal requirements, formatted texts, revision and revocation, storage method, procedures for medical judgment, etc. Starting from the establishment of a system for living will, a complete legal system for advance directives may be formed with supplementary medical agency system. Taking this as a breakthrough, a legal system of hospice care is expected to be gradually established, featuring a win-win situation of all parties including the individuals, families, medical institutions and state, and serving as a specific pathway of comprehensive rule of law.