Less than 1 percent of 19.6 million adults in Taiwan have signed a living will, the Patient Autonomy Research Center (PARC) said yesterday as it marked the fifth anniversary of the enactment of the Patient Right to Autonomy Act (病人自主權利法).
The legislation was the first special act in Asia to protect patient autonomy and dignity of life, allowing adults of sound mind to go through a process of advance care planning (ACP) and sign an advance decision for instructions for treatment or refusal of treatment when facing medical situations including terminal diseases, irreversible comas and dementia.
Even though in fewer than 360 days, Taiwan is expected to become a super-aged society, only 68,000 people have signed an advance decision as of last year, which includes about 24,000 people last year, showing that there is a lot of room for improvement, PARC marketing division head Chiu Yu-chen (邱宇晨) said.
Photo: Chiu Chih-jou, Taipei Times
ACP teams consist of physicians, nurses, psychologist and social workers, and each team has different working methods, Chiu said, adding that heavy administrative work is one of the obstacles that is keeping the coverage rate low.
Regardless of whether consultations are conducted in groups or one-on-one, the team must make sure the individual has communicated with their family and clearly understand the contents of the documents they are to sign, so they usually take one to two hours.
For special cases, such as when people with dementia give inconsistent decisions, it might take even longer, she said, adding that as the outpatient sessions take a long time and so few people go through them, they do not garner a lot of National Health Insurance (NHI) points and income for health workers, so physicians are less willing to do them.
If there were greater incentives for ACP teams, they would be more motivated to provide high-quality services, which would boost the coverage rate, Chiu said.
Fees of NT$2,000 to NT$3,500 for the process also deter people, she added.
NHI Administration Director-General Shih Chung-liang (石崇良) said that people who are terminally ill, have mild dementia or an “unbearable or incurable disease” and are under home-based medical care would be eligible for a one-time NHI-funded ACP outpatient visit.
Many people are unwilling to go through the process because they must pay extra fees, so NHI funds this year would be reserved to cover ACP, with the policy taking effect from the middle of the year at the earliest, Shih said.
People with terminal illness have NHI coverage for hospice and palliative care, and family medical consultations, and the one-time ACP consultation would be covered as a family medical consultation, he said.
People with profound dementia cannot undergo the process, so the second eligible group are those with mild dementia who have some independence and a clinical dementia rating of 1 or below, he said.
Another group to be eligible for the coverage is those in the Home-based Medical Integration Program, including those with reduced mobility or disabilities, but who clearly have the awareness to undergo the process, he said.
South Korea has adjusted its electronic arrival card system to no longer list Taiwan as a part of China, a move that the Ministry of Foreign Affairs said would help facilitate exchanges between the two sides. South Korea previously listed “Taiwan” as “Taiwan (China)” in the drop-down menus of its online arrival card system, where people had to fill out where they came from and their next destination. The ministry had requested South Korea make a revision and said it would change South Korea’s name on Taiwan’s online immigration system from “Republic of Korea” to “Korea (South),” should the issue not be
Tainan, Taipei and New Taipei City recorded the highest fines nationwide for illegal accommodations in the first quarter of this year, with fines issued in the three cities each exceeding NT$7 million (US$220,639), Tourism Administration data showed. Among them, Taipei had the highest number of illegal short-term rental units, with 410. There were 3,280 legally registered hotels nationwide in the first quarter, down by 14 properties, or 0.43 percent, from a year earlier, likely indicating operators exiting the market, the agency said. However, the number of unregistered properties rose to 1,174, including 314 illegal hotels and 860 illegal short-term rental
Both sides of the Taiwan Strait share a political foundation based on the “1992 consensus” and opposition to Taiwanese independence, Chinese Nationalist Party (KMT) Chairwoman Cheng Li-wun (鄭麗文) today said during her meeting with Chinese President Xi Jinping (習近平). Both sides of the Strait should plan and build institutionalized and sustainable mechanisms for dialogue and cooperation based on that foundation to make peaceful development across the Strait irreversible, she said. Peace is a shared moral value across the Strait, and both sides should move beyond political confrontation to seek institutionalized solutions to prevent war, she said. Mutually beneficial cross-strait relations are what the
ECONOMIC COERCION: Such actions are often inconsistently applied, sometimes resumed, and sometimes just halted, the Presidential Office spokeswoman said The government backs healthy and orderly cross-strait exchanges, but such arrangements should not be made with political conditions attached and never be used as leverage for political maneuvering or partisan agendas, Presidential Office spokeswoman Karen Kuo (郭雅慧) said yesterday. Kuo made the remarks after China earlier in the day announced 10 new “incentive measures” for Taiwan, following a landmark meeting between Chinese President Xi Jinping (習近平) and Chinese Nationalist Party (KMT) Chairwoman Cheng Li-wun (鄭麗文) in Beijing on Friday. The measures, unveiled by China’s Xinhua news agency, include plans to resume individual travel by residents of Shanghai and China’s Fujian
RSS