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termination time point although ischemic cardiac disease is the
leading cause of death in the world. Acute myocardial event,
superimposing on the more relentless chronic cardiac allograft
vasculopathy, would make the patient’s condition quickly
deteriorate.

Could medical doctors predict a patient’s life in an
accurate way? How could we, as medical professionals, decide
when the patient should die or live? Is it beyond Medicine? Is
this a scientific issue, an ethic issue, even a religious issue, or
just an issue of no-man area, a mystery?

醫學人文倫理方面影響：

The above clinical case highlighted two issues to consider:
(1) How should hospice care in patients with non-cancer
chronic disease be done? and (2) Is cardiac- death organ
donation appropriate?

Hospice care in patients with chronic non-cancer disease:
For patients with cancer, the patient and his/her family

usually have the understanding that cancer is a relentless and
terminal disease. They are usually more open to accept hospice
care. However, patients with non-cancer chronic disease and
the family usually do not recognize the disease as terminal.
They usually believe the patients would recover if the acute

107 年度•醫學倫理•人文醫學•心得 27