Taiwan, Like USA, Delegates Too Much Power to Physicians

Yi-Chen Su recently published a critique of 2013 amendments to Taiwan's Hospice Palliative Care Law in the Journal of Medical Ethics.  I want to focus on his comments on Article 7.



Article 7 of the revised Hospice Palliative Care Law, effective since January 2013, authorised the palliative care team, namely the physicians, to take medical decisions on behalf of incompetent terminally ill patients who did not express their wishes while still competent and who have no family member, regarding the termination of life-sustaining treatment in accordance with the patient’s best interests. . . .



[T]he team could be composed solely of the two physicians who had previously confirmed that the patient was terminally ill.  . .  It is clear from the legislative history that the new law intended the treating doctors to take the decision to withdraw or withhold treatment if the patient was incompetent and no family members were available.



As I argue in a new Perspective column in this week's New England Journal of Medicine, many healthcare facilities in the United States similarly authorize physicians (with no oversight) to make treatment decisions on behalf of incapacitated patients without surrogates.  This unnecessarily exposes these patients to decisions that are corrupt, biased, arbitrary, and careless.