From November 21st to 23rd, 2024,Support for sustainable decision-making and arrangements that preserve dignity for everyone during and after life" project, I conducted a survey in Taiwan. In this article, I will provide an overview of the survey.
Survey Objective
台湾は、高齢期の身じまい（生活の面倒を見ることや亡くなった後の弔いなど）を家族が支える文化が根強いとされています。また、ボランティア活動も盛んです。日本と同様に高齢化が進む中、どのように身じまいを支えているのかを調査することで、日本の社会のあり方への示唆を得ることが期待できます。また、意思決定の観点では、台湾で２０１６年に設立され２０１９年から施行されている法律である患者自主権利法(*1)が注目されます。この法律は延命治療の差し控えや中止の判断について患者本人の意思決定を重視するもので、東アジアでは数少ない、患者の自己決定権を明確に確立した法律と言われています。
By investigating Taiwan's systems and culture, focusing on the medical field where progress is being made, and comparing it with Japan, the goal was to gain insight into the future shape of Japanese society.
(*1) The translation of Taiwan's "Patient Autonomy Act" isHere(Redirects to Kyoto University's website)
Places visited and survey contents
November 21st
国立台湾大学病院 倫理センター（Ｔｈｅ ＮＴＵＨ Ｅｔｈｉｃｓ Ｃｅｎｔｅｒ）（*２）
The Ethics Center was established in 2024 and is divided into three departments: research ethics, clinical ethics, and research integrity, and studies ethical, legal, and social issues arising from the development of medicine and science and technology. We exchanged opinions with researchers, doctors, social workers, and others affiliated with the Ethics Center on topics such as end-of-life care, palliative care, and treatment discontinuation.
(*2) For details,Here(Redirects to the Ethics Center homepage)
The Ethics Center is located on the campus of the University Hospital.
November 22nd
Buddhist Tzu Chi Foundation
The Buddhist Tzu Chi Foundation (hereafter referred to as "Tzu Chi") is a Buddhist NGO established in Hualien City in 1966. It conducts charitable activities to help the underprivileged and provides disaster relief to victims after disasters. A volunteer introduced us to the activities and history of Tzu Chi.
The inside is spacious and includes an exhibition space and a cathedral.
Buddhist Tzu Chi General Hospital
仏教慈済総合病院は慈済会が運営する病院です。緩和ケア病棟の様子や台湾におけるＡＣＰ（アドバンス・ケア・プランニング）（*３）We investigated the development of
(*3) ACP (Advance Care Planning): Discussions between an individual and their family, medical professionals, etc. regarding future medical care and treatment options.
Institute of Religion and Humanities, Buddhist Tzu Chi University
仏教慈済大学は慈済会が運営する大学です。宗教と人文研究所の研究者より、台湾における意思決定の法律や埋葬習慣の変化、また仏教慈済大学病院への献体（*４）He explained about this to us. We had a discussion focusing on the comparison between Taiwan and Japan.
(*4) Body donation: The provision of a body after death as teaching material for anatomical or surgical training.
November 23
Taipei General Hospital
Taipei General Hospital is a large public hospital in Taipei City. We spoke about ACP in Taiwan and at Taipei General Hospital. From 2022 onwards, in Taiwan, patients' wishes regarding treatment plans will be digitized and shared to support end-of-life decision-making. We investigated the specific mechanisms and their dissemination to the public.
Gyoichi Clinic
Gyoichi Clinic is a home care facility in Taipei City that provides in-home medical care for terminally ill patients with chronic diseases. We were introduced to the efforts of the facility, including how to help terminally ill patients have a "good death."
Veterans General Hospital
Veterans General Hospital is a national hospital for veterans in Taipei City. Veterans are veterans who came to Taiwan with the Kuomintang after losing the civil war with the Chinese Communist Party in 1949, and in Taiwan, medical and nursing care services for veterans are provided separately from those for the general public. We asked about the circumstances of veterans and the system for supporting elderly people without relatives in Taiwan.
From next time onwards, we will be publishing articles with dialogue between Professor Kodama and Researcher Sawamura about what they learned and what suggestions they gained from their research at each of the locations they visited.
