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factor, which is causing the patients’ condition to worsen,
disappears. They will not choose to go for end-of-life care.

In addition, most of the medical staff, or even hospice care
team members are usually reluctant to carry out aggressive
treatments for terminal patients. This will shorten patients’ life
span, and is also one of the reasons why terminal patients with
non-cancer chronic disease and their family hesitate to sign
hospice care documents and DNR agreement. They are worried
about “being given up” by the medical team in the event of life
threatening situations and “left to die”.

According to Mr.X, the heart transplantation patient’s
story, it is difficult for medical doctors to determine the
terminal time point of patient’s life.

Patients may or may not fear dying but are usually
worried very much about suffering. We should ensure better
care for the end-of-life patients in terms of:
(1) treating the disease routinely and continuously, and as a
result, avoid artificially shortening the life span of the patient,
and (2) minimizing the suffering. They are the principles of
end-of-life care and the core purposes and value of Hospice
Care, are they not?

Cardiac-death organ donation:

28 107 年度•醫學倫理•人文醫學•心得