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Hospice Palliative Care Intent of Patients with a Terminal Illness 生命末期病人善終照護意願

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Hospice Palliative Care Intent of Patients with a Terminal Illness 生命末期病人善終照護意願

2024/2/2

If you or a member of your family suffers from a serious illness or injury, the doctor has diagnosed that there is no cure, and it is inevitable that the disease will progress to death. After the doctor explains the condition, patients should consider the options of hospice palliative care.

The options available for you and your family are listed as follows:

  1. Current medical care is maintained until irresistible death.
  2. The patient chooses not to undergo cardiopulmonary resuscitation (CPR) (including endotracheal intubation, chest compression, injection of resuscitation drugs, external defibrillation, artificial cardiac pacing, and mouth-to-mouth ventilation) on their deathbed or when they have no signs of life, according to the provisions of Article 4, Article 5 and Subparagraph 2, Paragraph 1, Article 7 of the Hospice Palliative Care Act.
  3. The patient is transferred to a general ward or a hospital close to his home, accompanied by his family until the end of his life.
  4. The family applies to be discharged from hospital so that the patient could go home with his last breath and die at home.
  5. The patient is willing to spread love among the living by donating his organs.
  6. The patient is willing to donate tissue, cornea, skin and bone after death.
  7. The patient is willing to donate his body as cadaver for medical research and teaching.

The provisions of Article 4, Article 5 and Subparagraph 2, Paragraph 1, Article 7 of the Hospice Palliative Care Act are as follows:

  • Article 4: Terminal illness patients may write a letter of intent for the choice of hospice palliative care (HPC).

The letter of intent in the preceding paragraph shall at least include the following matters, and be signed by the decision maker:

  1. Name, ID no. and domicile or residence of the decision maker.
  2. The will of the decision maker on HPC choice and the specific content.
  3. Date when the letter of intent is written.

The signing of the letter of intent shall be witnessed by two or more persons with full disposing capacity. However, no staff of a medical institution implementing HPC shall be a witness.

  • Article 5: Persons with full disposing capacity may make advance decisions.

For the letter of intent in the preceding paragraph, the decision maker may designate a medical surrogate agent in advance, give details of the designation in writing. The agent may sign on his/her behalf should expression of his/her will become impossible.

  • Article 7: Non-applying CPR shall comply with the following:
  1. The patient is diagnosed with terminal illness by 2 physicians.
  2. A signed letter of intent is required. However, a letter of intent signed by a minor shall obtain the consent of his/her legal representative.

The physicians in the preceding paragraph, subparagraph 1, shall be qualified specialist physicians.

If a terminal illness patient, who has become unconscious or failed to express clearly his/her will, has not signed the letter of intent of the preceding paragraph, subparagraph 2, a consent form signed by his/her next of kin may serve as a substitute. The consent or the medical advice shall not contradict the expressed desire of the terminal illness patient before being unconscious or unable to express his/her will.

 

The next of kin in the preceding paragraph includes the following:

  1. Spouse.
  2. Adult children and grandchildren.
  3. Parents.
  4. Siblings.
  5. Grandparents.
  6. Great grandparents or third-degree collateral relative by blood.
  7. First-degree direct relation by marriage.

The consent of the next of kin in paragraph 3 may be done by one person; if there is no unanimity among several next of kin, a priority list in accordance with the listing of the preceding paragraph shall be set up. If a consent of one with lower priority is against the will of one with higher priority, the one with higher priority shall show his/her will in written before the non-application of CPR.

For those terminal illness patients who fulfill those set forth in paragraph 1 to paragraph 2 about non-applying CPR, the original CPR treatment may be terminated or withdrawn.

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