安宁疗护的立法基础与规制进路

Journal of Nanjing Medical University(Social Sciences)Legislative basis and regulation approach of palliative care

在医疗卫生事业中,安宁疗护日渐受到关注,而我国法律法规鲜有规定,有碍安宁疗护的现实实施。安宁疗护立法具有正当性基础,法理基础在于人的尊严属性,生命权、医疗自主权是安宁疗护的重要权源,宪法、民法典、基本医疗卫生与健康促进法的相关内容是安宁疗护的主要法律依据。考察安宁疗护立法的现实维度,一方面,预先医疗指示在知情同意规则下的适用可能产生权利冲突,需要完善相关规则以加强现实适用性;另一方面,协调安宁疗护多方主体,有助于解决安宁疗护的立法难题。安宁疗护的规制框架应包括规范的安宁疗护预先医疗指示制度、严格的审查制度以及双重监督机制。

In the healthcare industry,palliative care has gained increasing attention.There is a lack of legal regulations on palliative care in China,which hinders its practical implementation.The legitimacy of legislation has a justified basis and lies in the attribute of human dignity.The rights to life and medical autonomy are important legal sources of palliative care with relevant provisions in the constitution,civil code,and law on the promotion of basic healthcare.On the one hand,the application of advance medical directives under informed consent rules may lead to conflicts of rights,stress the need to improve regulations for practical applicability.On the other hand,coordinating multiple subjects of palliative care is helpful in solving the legislative challenges.The regulatory framework of palliative care should include a standardized system for advance directives,a strict review system and a dual supervisory mechanism.