Research On Advance Medical Directive System

The advance medical directive is a written or oral statement designed for people to pre-express their personal positive or negative health care decisions,in case they cannot make such decisions in the event of future incapacity due to illness.The concept of advance medical directive stems from the principle of autonomy in medical ethics.The US Supreme Court has derived its rights base through a series of jurisprudence,and finally established its right to the principle of informed consent and privacy.In addition,the emergence of advance medical directive is also closely related to the reality that human life is continually extended by medical technology and the further interpretation of medical practitioners'practice.Subsequently,the common law countries(regions)tried to construct the system around the concept of advance medical directive firstly,and explored two different regulatory models.For countries(regions)that adopt non-specialized legislative model,their regulation relies mainly on the common law principles,that is,binding advance medical directive must has three elements,“conscious adults”and“developed when it is protected from undue influence”and“expected implementation”;for countries(regions)that adopt a special legislative model,the legislative purpose is to define common law principles and form a certain system around the above-mentioned“three elements”,generally,it includes“subject qualifications”,“witness and supervision procedures”and“execution procedures”.In China,the protection of patient autonomy is mainly reflected in the legal recognition of the right to informed consent,but there are still some shortcomings in relevant legislation.The consequence of this is that once a patient is at the end of the disease and loses his or her ability to perform,all medical decisions are carried out in accordance with the wishes of the close relatives,and such willingness is largely unregulated and restricted.At this point,if the advance medical directive system is attempted in an appropriate manner,it should be able to improve the protection of patient autonomy in such situations.Since China does not currently have the realistic basis for formulating specific legislation,it cannot directly copy the existing principles and precedents in the practice of common law,either.Therefore,the author puts forward the non?legislative model promotion path of"step-by-step piloting and gradual improvement"and envisions the core parts of the system,including the development,entry into force,implementation and supervision of advance medical directive.