從刑法釋義界定重症新生兒 的治療界限


韓政道

中文摘要

自1970 年代起,日本陸續導入了具備先端治療設施的重症 新生兒集中治療室(NICU)。醫療技術設備的精進,明顯改善了 重症新生兒的存活機率。不過,先進的治療技術,雖能及時拯救 病童生命,但面對重大後遺症的殘存,反倒會讓病童父母陷入救 與不救的兩難境地。 因此,如何確保父母的決策符合病童的最善利益最佳利益, 除需仰賴醫療專業人員的建議外,較棘手的是,當父母做出凌駕 於醫療專業的不理性決策,進而可能侵害新生兒的相關權利時, 有無較為周全的處理或應對方式。同樣的問題,在我國現行法未 有特別著墨的情況下,應有深入探討的必要性。 日本發生的現實案例是,某新生兒之父母拒絕醫師為其進行必要的手術,導致新生兒因延誤病情而死亡。藉此案例,本文的 探討將聚焦於:其一,說明日本NICU 臨床指引如何形塑重症新 生兒的最佳利益;其二,從刑法之觀點,思索如何避免父母做出 違背新生兒利益的醫療決策後造成的不幸結果。 類似於齋藤事件,也會發生在我國新生兒的臨床治療現況 中。一旦刑法秉持國家保護義務的精神,作為醫師執行業務的後 盾,當下強行拯救了重症新生兒之生命,但在未來,家屬必須成 為日後主要照顧者的前提下,從「事前機制」介入調整所衍生的 後續效益中,我們必須思考,往後可能耗費的治療成本與家庭失 去的生活品質。

 

Defining the Decisions to Limit Treatments of Critically Ill Neonates from the Interpretation of Criminal Law

Cheng-Tao Han

abstract

Since the 1970s, Japan has introduced a Neonatal Intensive Care Unit (NICU) with advanced treatment facilities. Medical technology and equipment of the sophisticated, significantly improved the survival rate of critically ill neonates. However, the advanced treatment technology, although the timely rescue of severe neonatal, but the face of major sequelae of the remnants of the parents will fall into the rescue and not save the dilemma. Therefore, how to ensure that parents make decisions in line with the best interests of the critically ill neonate, in addition to relying on the recommendations of medical professionals, the more difficult is that when parents make irrational decisions over the medical profession, which may infringe the neonatal related Rights, there is no more comprehensive treatment or coping style. The same problem, in our current law is not particularly in the case of ink, there should be the need for in-depth discussion. Japan has occurred in the reality case, a newborn's parents refused to physicians for the necessary surgery, resulting in neonatal death due to delay in the disease. In this case, this paper will focus on: First, explain how the Japanese NICU clinical guidelines to shape the best interests of critically ill neonates; Second, from the criminal point of view, thinking about how to avoid parents make against the interests of the critically ill neonates medical decision-making, resulting in unfortunate results. Cases similar to the Saito incident would also occur in the clinical treatment of neonates in our country. Once the criminal law upholds the spirit of the protective obligation of the state and support the doctors in practice to save current lives of those critically ill neonates forcibly, we will have to consider the possible cost of the treatment and the quality of life lost by the family afterwards under the follow-up effectiveness derived from the adjustment of the prior mechanism on the premise that family members must become main caretakers in the future.