论精神疾病患者的“预先指示权”

The Right of Advance Directives for Patients with Mental Illness

对患者“预先指示”权的尊重意味着当患者丧失决定能力时对其自我决定权和知情同意权的尊重。患者的预先指示是患者就医疗干预和代理人问题上所事先表达的一种意愿,是患者对医疗行为行使控制权的表现。精神疾病患者在行使预先指示权时会遇到许多法律问题。应本着患者利益最佳化的原则去善待预先指示,包括其消极指示和积极指示,以保护患者本人真实的主观意志。我国对患者(包括精神疾病患者)的预先指示权尚缺乏认识和规定,应引入这一法律设计,以彰显对精神病患者权利的切实保障。

Respect for patient's right of advance directive means respect for patient's rights of self determination and informed consent when a patient loses his/her competence. Patient's advance directives are their previously expressed wishes about medical interventions and proxy. It reflects a patient's further control over medical treatment. There exist many legal issues when people with mental illness exercise their right of advance directive. We should treat advance directives, including negative and positive ones, in the best interests of patients so as to protect patient's real subjective will. There is no knowledge and regulation on patients' (including people with mental illness) right of advance directive in China. We should borrow this legal design and effectively safeguard rights of individuals with mental illness.