A Study On The Scope Of Application Of Advance Medical Directives

The advance medical instruction system is a new kind of medical decisionmaking system,which takes the medical autonomy as the core and points to the medical affairs after the patients lose their capacity of will(decision-making ability).The system ensures that the patients control over their medical destiny won't be destroyed due to the loss of their capacity of will in the long struggle against medical paternalism and medical familism,and responds to the real needs of the majority of patients.Living Will,as the origin and typical representative of advance medical instruction,has been well known in practice and theory at home and abroad,but this has also led to a misunderstanding of the system of advance medical instruction itself.Most scholars in China's mainland even equate living will with advance medical instruction.A part is a part of the whole,and no part,no matter how important,can replace the whole.Therefore,it is necessary to restore the original system and find the application of advance medical instructions in other personal medical fields.Starting from the basic theory of advance medical instruction,this paper presents the concept and classification of advance medical instruction from a more macroscopic perspective,and thus preliminarily reveals its application scope and form far beyond the field of end-stage disease and Living Will.Secondly,it establishes the legitimacy for the advance medical instruction system from the core of the right of pre-medical instruction--the establishment and extension of the patient's medical autonomy,the principle of non-agency of medical decision and its exceptions.However,the core of this paper is to explore the practical application scope of premedical instruction,which needs to cast eyes on the countries and regions that have established the system.The advance medical instruction system,which originated in the United States,has taken root in Europe,Asia and other countries after nearly a century of development.The field of medicine is no longer limited to end-stage diseases,and it no longer takes the form of Living Will.Through the efforts of the above,this paper holds that the application scope of advance medical instruction should include all the areas of individual medical treatment,and especially in several areas,including Living Will in the field of terminal diseases,advance mental health instructions in the field of mental diseases,advance organ donation instructions in the field of organ donation,advance human test instructions in the field of human trials and Birth Preference in the field of child birth.The good intention of the advance medical instruction system and its wide applicable scope just meet the needs of the patients with meaningless ability in our country.Hong Kong and Taiwan have established the system of advance medical instruction,but the mainland is still at the stage of legislative wait-and-see and folk promotion.The need of reality,the achievement of theory and practice,and the multiple meanings that the system can bring urge our country mainland must establish the system of advance medical instruction as soon as possible.Among the issues to be addressed are the discovery of the patient's ability to make medical decisions and the establishment of basic principles of advance medical instruction.In general,introducing the system of advance medical instruction into the legal procedure of medical decision of patients in China and forming a complete process of "full protection of patients' medical autonomy--recognition of the legal effect of advance medical instruction--legal agency without advance medical instruction",which is the due content of medical construction in the new period of China.