Be the master of your own life, you can start by learning about the “Patient Autonomy Rights Act”!
'Patient Autonomy Rights Act' (hereafter referred to as the Patient Rights Act) was passed by the Legislative Yuan on December 18, 2015 (104th year) after three readings, and officially implemented on January 6, 2019 (108th year). It is the first Asian law that places the patient at the center and emphasizes patient autonomy rights. The legislative purpose is to respect patient autonomy, protect patients' right to a dignified end of life, and promote harmonious doctor‑patient relationships.
Regarding respect for patient autonomy, the Patient Rights Act declares that patients have the right to be informed, to choose, and to decide. The medical team must inform patients of their condition, medical options, outcomes, and risks. In addition, family members or others may not obstruct the medical institution from acting according to the patient’s decisions.
Regarding protection of end‑of‑life rights, the “Palliative Care Act” only safeguards the dignified end of life and the right to refuse futile medical treatment for terminal patients. The Patient Rights Act has a broader scope, allowing patients under five specific clinical conditions to choose to receive or refuse life‑sustaining treatment and artificial nutrition and fluid feeding, and to request palliative care and other appropriate measures from the medical team. The five specific clinical conditions include:
(1) Terminal patients
(2) Being in an irreversible coma
(3) Permanent vegetative state
(4) Severe dementia
(5) Other patient disease conditions or intolerable suffering announced by the central competent authority, where the disease is incurable and, according to current medical standards, no other suitable solutions exist.
Let's consider why such provisions were created and even led to legislation. Have you experienced any of the following?
(1) A close friend or family member suffers from a serious illness, is bedridden for a long time, and cannot take care of themselves, relying on others.
(2) You've seen in an intensive care unit many unnamed tubes and machines attached to patients and beside the beds.
(3) You've heard of vegetative patients who have been lying there for over a decade or two, with parents or family continuously caring for them; or news of people who, due to accidents or illness, remain in a persistent coma.
(4) When you see or hear about this, do you imagine whether it could happen to you in the future? At that time, would you choose to rely on advanced medical devices and various tubes to prolong a life that lacks quality, or would you choose palliative care to return naturally?
Today, with advanced medicine, many critically ill patients can extend their lives using machines, tubes, and other equipment, for periods ranging from a few days, months, to several years. However, such a life often lacks dignity and quality; it does not allow patients to recover and return to normal life, and ultimately only leads to death, placing a heavy burden on both the patients and their families. As the spirit of palliative care spreads and attitudes toward medicine change, more people recognize that futile medical treatment should be refused, allowing patients to choose a natural end of life. The Patient Autonomy Rights Act was created in response, enabling individuals to make early decisions for themselves, avoiding situations where, in critical condition and unconscious, they cannot express their wishes, leaving families feeling pressured and helpless. If one can decide in advance, whether to accept or refuse life‑sustaining treatment, it reflects the individual's values toward life, and others should respect and protect those choices.
Compared with the Palliative Care Act, where the public can directly sign a “Advance Directive for Palliative Care and Life‑Sustaining Treatment Choices,” the Patient Rights Act has a more rigorous counseling process. The public must first undergo “Advance Care Planning Counseling” before signing an “Advance Medical Decision.” By choosing the preferred medical care, they achieve a dignified end of life. Signing both documents is undoubtedly the best arrangement for one's life.
