講者：吳建昌醫師 (國立臺灣大學)
論文題目: Law entering the family for the health care of the elderly in Taiwan: The impact of the Family Citizens Welfare Act and the Family Affairs Act

論文摘要：

Respect for the elderly and filial piety is a norm in a traditional Confucian society. However, as the number of core family increases in a gradually individualized society such as Taiwan, the norm seems to be challenged in many perspectives, which include the health care of the elderly. Responding to the sociocultural changes, Taiwan has promulgated or revised laws related to the care of the elderly, such as the Family Citizens Welfare Act, the Family Affairs Act, the Civil Code, etc. Utilizing two difficult cases in the health care of the elderly in Taiwan, the paper aims to demonstrate what the impacts and limitations of the laws are and propose some changes in the legal policy of the elderly health care in Taiwan.

In the first section, the paper introduces the traditional ethical rules in the care of the elderly in Taiwan. Using empirical data from a social survey, it portraits the changes towards self-determination of health care. In the second section, the paper addresses the provisions of the newly promulgated and revised laws as regards the healthcare of the elderly in Taiwan. As we will see, the statutes have tried hard to maintain a balance between individualism and familism in the determination of health care and placement of the elderly. In the third section, the paper analyzes two difficult cases to demonstrate the laws’ impacts and their limitations. The cases are: (1) a vegetative elderly who is “kidnapped” by his daughter who dominates the decision making of his care using provisions of the Domestic Violence Prevention Act in Taiwan; (2) an elderly patient with schizophrenia who abandoned her family when she was around her 30s and is recognized by the health care professionals to be incompetent for the determination of her health care and placement.

In conclusion, in the two cases we witness the ambivalence of the legal system about whether the law should lead or just reflect the changes of sociocultural practices in the care of the elderly. We also witness how the charitable institutions or associations might supplement the family in the care of the elderly. The paper proposes that under the framework of relational autonomy the law plays an accessory to family mechanism and the court takes the place of family only when the family goes awry in determining the elderly health care.