生前预嘱选择缓和医疗的伦理法律问题探讨

从自由意志与生命权之处置两个角度入手，探讨生前预嘱与缓和医疗相关的伦理与法律问题。发现自由意志系生前预嘱的生效基础，对于不涉及生命权处置的预立医疗计划依现行法律“当然有效”；而对于选择缓和医疗、放弃治疗等涉及生命权消极处置的生前预嘱，则需严格限定其生效条件，且医院应当建立一套机制对此予以审查。此外，亦探讨了生前预嘱确定的消极治疗所带来的其他问题，有助于相关领域的继续深入与补充立法，并对医生选择绝症患者的治疗方案及减小医院法律风险具有实际意义。

Discussion on Ethical and Legal Issues Related to Palliative Care Selected by Living Will

From the perspectives of free will and right to life, this paper discusses the ethical and legal issues related to living wills and palliative care. It is found that free will is the basis for the validity of living will, and advanced medical plans that do not involve the disposal of right to life are "ex facto valid" under current law. For living wills involving passive treatment of right to life, such as choosing palliative care or abandoning treatment, the conditions for their validity need to be strictly limited, and hospitals should establish a mechanism to review this. In addition, the implications of palliative treatment determined by living wills are also discussed, which is conducive to the continued deepening and supplementary legislation in related fields, and has practical significance for doctors to choose treatment options for terminally ill patients and reduce the legal risks of hospitals.