生前预嘱的民法权利基础和规范构造之研究

Study on the Civil Law Rights Basis and Normative Construction of Living Will

生前预嘱制度仍需在立法层面进行完善,深圳的地方立法作了初步尝试,但其辐射效应有限,且法理、制度规范乃至伦理观诸端均尚待完善。完善该制度需要克服生前预嘱内容的易变性,并调和儒家生死观、孝道与医学伦理之间的矛盾;澄清生前预嘱在民法上的权利基础,确保其与《民法典》中生命尊严权的理念相符;生命尊严原则、明确性及利益平衡原则是制度构建的核心;只有具备完全民事行为能力的主体才能制定生前预嘱,特殊情况下可设代理人决策;预嘱形式应严格,内容以“我的五个愿望”--我要或不要什么医疗服务、我希望使用或不使用生命支持治疗、我希望别人怎样对待我,我想让我的家人和朋友知道什么以及我希望谁帮助我等为基础。此外,建立生前预嘱登记制度以监督其生效、执行及撤销等流程,确保制度透明度和公信力。

The living will system still needs to be perfected at the legislative level.Shenzhen's local legislation has made a prelimi⁃nary attempt,but its radiation effect is limited,and the aspects of legal theory,institutional norms and ethical view are still to be per⁃fected.To perfect the system,it is necessary to overcome the variability of the contents of living will,and to reconcile the contradictions between the Confucian view of life and death,filial piety and medical ethics,and clarify the rights basis of living will in civil law to en⁃sure that it is consistent with the concept of the right to dignity of life in The Civil Code.The principle of life dignity,the principle of clar⁃ity and the principle of interest balance are the core of the system construction.Only subjects with full capacity for civil conduct can make living wills,and agents can make decisions under special circumstances.The form of a living will should be strict and based on"my five wishes"-what medical services I do or do not want,I want to use or not to use life support treatment,how I want to be treated,what I want my family and friends to know,and whose I want.In addition,a living will registration system will be established to monitor the process of its entry into force,enforcement and revocation to ensure transparency and credibility of the system.