109 年度高屏澎醫療區域輔導與醫療資源整合計畫協助辦理醫事人員及非醫事人員繼續教育訓練-預立醫療照護諮商在基層醫療推展的利基與挑戰與相關跨文化研究

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  Ageing has been recognized as one of the most critical political and healthcare issues worldwide. It is relevant to Asia, where the increasing number of older population has drawn attention to the paramount need for healthcare investment, particularly in end-of-life care. The advocacy of Advance Care Planning (ACP) is a mean to honor patient autonomy. Since most East Asian countries are influenced by the Confucianism and the concept of “filial piety”, patient autonomy is consequently subordinate to family values and physician authority. The dominance from family members and physicians during a patient’s end-of-life decision-making is recognized as a cultural feature in Asia. Physicians often disclose the patient’s poor prognosis and corresponding treatment options to the male, family member, rather to the patient him/herself. In order to address this ethical and practical dilemma, the concept of ‘relational autonomy’ and the collectivism paradigm might be ideally used to assist Asian people, especially older adults, to share their preferences on future care and decision-making on certain clinical situations with their families and important others.