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12:44:09","會議時間":"2026-07-30T09:00:00+08:00","會議名稱":"立法院第11屆第5會期社會福利及衛生環境委員會第21次全體委員會議（事由：一、審查委員陳冠廷等18人擬具「安樂死法草案」案。\n二、審查台灣民眾黨黨團擬具「尊嚴善終法草案」案。\n三、邀請衛生福利部部長及教育部次長就「近期幼兒園及托育兒虐頻傳：責任通報、兒少保護及跨部會合作機制檢討」進行專題報告，並備質詢。\n【專題報告及法律案綜合詢答，法律案僅詢答】\n【7月29日及30日，二天一次會】）","transcript":{"pyannote":[{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":7.92846875,"end":10.493468750000002,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":10.56096875,"end":11.57346875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":15.218468750000003,"end":45.01971875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":45.407843750000005,"end":59.04284375,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":59.312843750000006,"end":75.12471875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":75.74909375,"end":132.12846875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":132.49971875,"end":163.97159375,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":164.41034375,"end":231.99471875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":232.50096875000003,"end":263.87159375000005,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":264.09096875,"end":269.20409375,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":269.67659375,"end":287.02409375,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":287.53034375000004,"end":302.12721875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":302.27909375,"end":308.32034375,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":308.42159375,"end":332.55284375,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":333.00846875,"end":367.83846875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":368.42909375000005,"end":376.24221875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":376.69784375,"end":378.30096875000004,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":378.89159375,"end":421.63596875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":422.09159375,"end":426.88409375000003,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":427.59284375000004,"end":434.56221875000006,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":434.78159375,"end":460.73534375,"speaker_score":0.972},{"speaker":"SPEAKER_01","speaker_name":"石部長崇良","start":460.11096875000004,"end":460.58346875,"speaker_score":0.851},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":461.07284375,"end":475.83846875,"speaker_score":0.972},{"speaker":"SPEAKER_01","speaker_name":"石部長崇良","start":463.58721875000003,"end":463.99221875,"speaker_score":0.851},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":476.12534375,"end":484.78221875,"speaker_score":0.972},{"speaker":"SPEAKER_01","speaker_name":"石部長崇良","start":484.78221875,"end":484.90034375000005,"speaker_score":0.851},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":484.90034375000005,"end":484.96784375000004,"speaker_score":0.972},{"speaker":"SPEAKER_01","speaker_name":"石部長崇良","start":484.96784375000004,"end":517.90784375,"speaker_score":0.851},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":518.02596875,"end":537.19596875,"speaker_score":0.972},{"speaker":"SPEAKER_01","speaker_name":"石部長崇良","start":518.5828437499999,"end":519.0047187499999,"speaker_score":0.851},{"speaker":"SPEAKER_01","speaker_name":"石部長崇良","start":522.41346875,"end":523.0209687500001,"speaker_score":0.851},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":537.5503437500001,"end":548.89034375,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":549.0422187500001,"end":553.2947187500001,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":554.22284375,"end":565.44471875,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":565.6472187500001,"end":638.7834687500001,"speaker_score":0.972},{"speaker":"SPEAKER_01","speaker_name":"石部長崇良","start":638.7834687500001,"end":719.1084687500002,"speaker_score":0.851},{"speaker":"SPEAKER_01","speaker_name":"石部長崇良","start":719.6147187500001,"end":783.7565937500001,"speaker_score":0.851},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":736.9622187500001,"end":738.8015937499999,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":749.4834687500002,"end":749.8715937500001,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":782.86221875,"end":786.22034375,"speaker_score":0.972},{"speaker":"SPEAKER_00","speaker_name":"王委員正旭","start":786.3047187500001,"end":800.6653437500001,"speaker_score":0.972},{"speaker":"SPEAKER_00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謝謝主席 我們還是請石部長"},{"start":10.5,"end":11.5,"text":"有請石部長"},{"start":11.5,"end":16,"text":"好 王委員好"},{"start":16,"end":21,"text":"部長好 今天就是要針對很重要的主題"},{"start":21,"end":25,"text":"就是有關於安樂死的部分的研究 病毒"},{"start":25,"end":29,"text":"跟安寧緩和醫療政策這兩點來跟部長討論"},{"start":29,"end":34,"text":"大家一直在討論 我想所有委員都很關心"},{"start":34,"end":38,"text":"就是民眾他是對安樂死有高的期待"},{"start":38,"end":41,"text":"或者是很希望能夠趕快立法"},{"start":41,"end":45,"text":"我相信大家都講得非常清楚 就是很怕痛苦"},{"start":45,"end":48,"text":"不知道將來怎麼樣去掌握痛苦"},{"start":48,"end":52,"text":"那如果根據世界衛生組織對痛苦的定義的話"},{"start":52,"end":56,"text":"他是認為只要任何身心設靈"},{"start":56,"end":61,"text":"這四大部分 四大面向不平安 那就是痛苦"},{"start":61,"end":63,"text":"那其實痛跟苦是分開的"},{"start":63,"end":68,"text":"痛的話 身體上的一些不舒服 不平安我們就稱為痛"},{"start":68,"end":73,"text":"那更難的是苦 任何心理上的 或者是靈性上"},{"start":73,"end":78,"text":"包括我們上次所提到的這些可能很擔心成為其他人的負擔"},{"start":78,"end":83,"text":"他覺得生命沒有意義 這些苦如何能夠有效的去處理"},{"start":83,"end":87,"text":"如果能夠把痛跟苦做有效處理"},{"start":87,"end":92,"text":"那是不是平安了以後 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當然這個主責單位還是在部裡面"},{"start":830,"end":833,"text":"由這個醫事司來主責"},{"start":833,"end":837,"text":"不過這個涉及到這個安寧整個政策的推動"},{"start":837,"end":840,"text":"那也會破阻到長照"},{"start":840,"end":843,"text":"我們現在也希望這些長照的對象"},{"start":843,"end":846,"text":"也能夠有這個ACPAD的簽署"},{"start":846,"end":849,"text":"所以這個是目前長照3.0裡面在規劃的"},{"start":849,"end":852,"text":"那健保的部分也有政策進來的"},{"start":852,"end":854,"text":"剛剛我提到65歲以上"},{"start":854,"end":858,"text":"都從慢性病或重大傷病者都可以簽"},{"start":858,"end":861,"text":"除了安寧符合條件的之外"},{"start":861,"end":865,"text":"那只是把這個可信性如何再擴大"},{"start":865,"end":868,"text":"這個是我們接下來會持續的努力"},{"start":868,"end":869,"text":"好 謝謝部長"},{"start":869,"end":871,"text":"好 謝謝王振旭委員發言"},{"start":871,"end":874,"text":"接下來請盧憲毅召委發言"}],"gazette":[{"speaker":"王委員正旭","start":"2026-07-30T12:29:37+08:00","guessed":false,"end":"2026-07-30T12:29:46.692308+08:00","text":"好，謝謝主席，我們還是請石部長。","quality":1},{"speaker":"主席","start":"2026-07-30T12:29:47.500000+08:00","guessed":false,"end":"2026-07-30T12:29:48.300000+08:00","text":"有請石部長。","quality":1},{"speaker":"石部長崇良","start":"2026-07-30T12:29:49.400000+08:00","guessed":false,"end":"2026-07-30T12:29:52.100000+08:00","text":"王委員好。","quality":1},{"speaker":"王委員正旭","start":"2026-07-30T12:29:53+08:00","guessed":false,"end":"2026-07-30T12:29:53.625000+08:00","text":"部長好。","quality":1},{"speaker":"王委員正旭","start":"2026-07-30T12:29:53.937500+08:00","guessed":false,"end":"2026-07-30T12:30:24.769231+08:00","text":"針對今天重要的主題，就是有關於安樂死的研究、病主及安寧緩和醫療政策這兩點來跟部長討論，大家一直在討論，所有的委員都很關心，民眾對於安樂死有高度的期待，或者是很希望能夠趕快立法，相信大家都講得非常清楚，就是很怕痛苦，不知道將來怎麼樣去掌握痛苦。","quality":0.937},{"speaker":"王委員正旭","start":"2026-07-30T12:30:25.631579+08:00","guessed":false,"end":"2026-07-30T12:30:56.818182+08:00","text":"根據世界衛生組織對痛苦的定義，認為只要任何身、心、社、靈這四大面向不平安就是痛苦，其實痛跟苦是分開的，生理上的一些不舒服、不平安，我們就稱為痛；更難的是苦，任何心理上或者是靈性上，包括我們上次所提到的可能很擔心成為其他人的負擔，他覺得生命沒有意義。","quality":0.973},{"speaker":"王委員正旭","start":"2026-07-30T12:30:57.045455+08:00","guessed":false,"end":"2026-07-30T12:30:59.772727+08:00","text":"這些苦如何能夠有效的去處理？","quality":1},{"speaker":"王委員正旭","start":"2026-07-30T12:31:00+08:00","guessed":false,"end":"2026-07-30T12:31:08.761905+08:00","text":"如果能夠把痛跟苦做有效處理，那是不是平安了以後，對安樂死的觀點又會不一樣？","quality":1},{"speaker":"王委員正旭","start":"2026-07-30T12:31:09+08:00","guessed":false,"end":"2026-07-30T12:31:16.761905+08:00","text":"這就是大家必須共同努力來討論，也希望未來針對死亡議題社會有更多的共識。","quality":0.939},{"speaker":"王委員正旭","start":"2026-07-30T12:31:17.173913+08:00","guessed":false,"end":"2026-07-30T12:31:41.750000+08:00","text":"身為一個腫瘤科醫師，對死亡議題真的感受特別深刻，所以很期待未來不管是主管機關或者是社會能夠針對這個議題，包括我們看到民眾黨本身所提出來的法案或者是陳委員所提出來的法案，真的是值得大家共同努力來討論。","quality":0.957},{"speaker":"王委員正旭","start":"2026-07-30T12:31:42.230769+08:00","guessed":false,"end":"2026-07-30T12:31:44.538462+08:00","text":"安樂死是不是等同善終？","quality":1},{"speaker":"王委員正旭","start":"2026-07-30T12:31:44.769231+08:00","guessed":false,"end":"2026-07-30T12:31:58.736842+08:00","text":"我想這也是大家共同要去了解的，剛剛講過善終的意思，很平安的離開就是善終，剛剛也提到什麼是不平安、痛苦？","quality":0.978},{"speaker":"王委員正旭","start":"2026-07-30T12:32:00.428571+08:00","guessed":false,"end":"2026-07-30T12:32:17.760000+08:00","text":"針對安樂死，如果將來經過大家討論以後，真的有辦法做到善終，這是非常完美的，要跨到這個部分之前，我們如何能夠有好的討論模式，我相信這是今天所有委員和部長大家要共同來討論的。","quality":0.897},{"speaker":"王委員正旭","start":"2026-07-30T12:32:18.300000+08:00","guessed":false,"end":"2026-07-30T12:32:40.809524+08:00","text":"今天我先引用立法院法制局所做的研究，在2015年5月份立法院法制局的研究針對安樂死的類型做了一些區分，第一個就是所謂的積極安樂死，另外一個就是消極的安樂死，這是從醫療行為作為判斷的標準。","quality":0.867},{"speaker":"王委員正旭","start":"2026-07-30T12:32:41.307692+08:00","guessed":false,"end":"2026-07-30T12:32:55.750000+08:00","text":"積極安樂死是指醫療人員或他人採取積極行動，直接促成病人死亡，這就稱為積極安樂死。","quality":1},{"speaker":"王委員正旭","start":"2026-07-30T12:32:56.266667+08:00","guessed":false,"end":"2026-07-30T12:33:32.722222+08:00","text":"這個部分又分為兩個目的跟方式，一個是直接安樂死，一個是間接安樂死，我們從螢幕上可以看得出來，所謂直接安樂死就是透過注射藥物或者其他方式，直接造成病人的死亡；如果是間接安樂死的話，就是在緩解病人痛苦的醫療過程當中，使用可能具有縮短生命效果的藥物或是措施，其主要目的還是在減輕痛苦，而不是直接造成死亡，也就是積極安樂死再分為這兩個大部分。","quality":0.974},{"speaker":"王委員正旭","start":"2026-07-30T12:33:33.238095+08:00","guessed":false,"end":"2026-07-30T12:33:53.785714+08:00","text":"所謂消極安樂死，是指停止或是不施行無效、無益的延命醫療措施，例如目前已經實施的撤除維生設備、拒絕接受維生治療或讓疾病自然發展至死亡，這也是安樂死的一種形式。","quality":0.875},{"speaker":"王委員正旭","start":"2026-07-30T12:33:54.250000+08:00","guessed":false,"end":"2026-07-30T12:34:13.700000+08:00","text":"另外第三個就是協助自殺，協助自殺就是我們剛剛聽到的病人自行執行結束生命的行為，但是必須要由他人提供必要的協助，這樣的提供大部分都是與醫療相關，由醫師開立處方以後提供。","quality":0.923},{"speaker":"王委員正旭","start":"2026-07-30T12:34:14.461538+08:00","guessed":false,"end":"2026-07-30T12:34:27.818182+08:00","text":"如果我們將來要討論的話，大家可能要針對這些名詞或者是概念上需要有比較好的立論基礎，不然的話，恐怕會混為一談。","quality":0.96},{"speaker":"王委員正旭","start":"2026-07-30T12:34:28.263158+08:00","guessed":false,"end":"2026-07-30T12:34:43.812500+08:00","text":"針對這部分，另外也提供加拿大10年的經驗再供大家參考一下，我想部長應該很清楚，剛剛林淑芬委員也花了很多時間，針對加拿大的經驗也提供了一些說法。","quality":0.859},{"speaker":"王委員正旭","start":"2026-07-30T12:34:44.250000+08:00","guessed":false,"end":"2026-07-30T12:35:20.769231+08:00","text":"這邊的例子是加拿大在2016年將醫療協助死亡合法化以後，到現在已經將近10年的時間，根據加拿大衛生部最近公布的官方年度報告，2024年透過安樂死而死亡的人數占全國死亡人口的5.1%，所以的確他們也執行到將近5.1%，人數是不是跟他們當初所預期的有落差，這個還需要後續了解。","quality":0.974},{"speaker":"王委員正旭","start":"2026-07-30T12:35:21.210526+08:00","guessed":false,"end":"2026-07-30T12:36:01.714286+08:00","text":"意思就是說，關於合法化10年的安樂死，看起來在加拿大安樂死所占的比例還不是多數人臨終的選擇，只有5.1%，大部分的人還是依靠既有的醫療跟長照體系走完最後一程，他們在報告裡面也另外直接點出非末期的病患申請者當中，有一半左右（占49.2%）表示是因為自己覺得是家人的負擔，想要減少或者是免除這樣的負擔而申請了安樂死。","quality":0.899},{"speaker":"王委員正旭","start":"2026-07-30T12:36:02.200000+08:00","guessed":false,"end":"2026-07-30T12:36:24.818182+08:00","text":"另外，安大略省首席驗屍官辦公室的審查報告也多次揭露，有個案是在長照或者是安寧床位不足的情形之下，經過數個小時就被核准，並且執行安樂死，這代表如果有足夠醫療資源的話，也許選擇就會不一樣。","quality":0.965},{"speaker":"王委員正旭","start":"2026-07-30T12:36:25.857143+08:00","guessed":false,"end":"2026-07-30T12:36:43.818182+08:00","text":"在這份報告當中也有委員指出少數醫師會集中執行大多數的案例，這代表著把關的寬嚴不一，這是未來我們在討論的時候或是立法的過程裡面也要非常非常注意的地方。","quality":0.93},{"speaker":"王委員正旭","start":"2026-07-30T12:36:44.300000+08:00","guessed":false,"end":"2026-07-30T12:36:57.750000+08:00","text":"這些都代表著安樂死合法化在加拿大實施10年以後，官方自己的報告點出來的問題就是安樂死的執行或者是處理還是要更多的討論，這才是未來我們要處理的重點。","quality":0.912},{"speaker":"王委員正旭","start":"2026-07-30T12:36:58.214286+08:00","guessed":false,"end":"2026-07-30T12:37:10.750000+08:00","text":"當然，如果我們把現有的病主法、安寧緩和條例跟長照做好、做完整的話，是不是就能夠讓這樣的需求做不同的考量？","quality":0.979},{"speaker":"王委員正旭","start":"2026-07-30T12:37:11+08:00","guessed":false,"end":"2026-07-30T12:37:31.750000+08:00","text":"所以面對安樂死政策的建議有兩點請部長來考量：第一個，衛福部不應該只是被動回應，必須要主動把這個議題拋出來以後，看看如何請社會上所有的民眾以及專家學者一起共同來討論。","quality":0.935},{"speaker":"王委員正旭","start":"2026-07-30T12:37:32+08:00","guessed":false,"end":"2026-07-30T12:37:39.714286+08:00","text":"第二個，衛福部也應該儘速啟動跨國比較研究，讓討論的過程可以更為周詳。","quality":1},{"speaker":"王委員正旭","start":"2026-07-30T12:37:40+08:00","guessed":false,"end":"2026-07-30T12:37:41.777778+08:00","text":"請問部長，您的意見怎麼樣？","quality":0.818},{"speaker":"石部長崇良","start":"2026-07-30T12:37:42.750000+08:00","guessed":false,"end":"2026-07-30T12:38:14.750000+08:00","text":"跟委員說明，事實上我們過去也有蒐集過其他國家的資料，不過這些年過去之後，這些實施的國家也有更進一步的討論，所以我剛剛也說我們一年內會完成這樣的研究，除了跨國比較之外，還要開啟國內各個焦點團體或者是透過討論的方式，把這些重要的議題跟大家盡可能取得的共識，把它逐步的點出來。","quality":0.921},{"speaker":"王委員正旭","start":"2026-07-30T12:38:15.823529+08:00","guessed":false,"end":"2026-07-30T12:38:42.727273+08:00","text":"OK，這是非常需要大家共同來努力的方向，其實目前透過病人自主權利法及安寧緩和醫療條例，也已經提供病人在特定條件之下，可選擇不接受無效醫療，讓病情自然發展到死亡，目前在執行過程裡面，其實是有這樣可以依據的法令。","quality":0.927},{"speaker":"王委員正旭","start":"2026-07-30T12:38:43.222222+08:00","guessed":false,"end":"2026-07-30T12:38:55.800000+08:00","text":"當然，落實方面就會有現況跟困境，針對這些現況跟困境，也正在修病主法，希望能夠擴大範圍。","quality":0.868},{"speaker":"王委員正旭","start":"2026-07-30T12:38:56+08:00","guessed":false,"end":"2026-07-30T12:39:32.750000+08:00","text":"可是我們也了解目前病主法跟安寧緩和的現況問題首先就會包括ACP的服務量能不足；再過來就是制度性的障礙需要趕快突破，以及啟動標準模糊難行，導致AD架空；第三個是跨場域資訊斷鏈，病人意願在轉銜中遺失，第一線人員權責界線不明，承受巨大風險壓力，社會端生命識能匱乏，決策被推遲至最後一刻才會去考慮怎麼用。","quality":0.877},{"speaker":"王委員正旭","start":"2026-07-30T12:39:33.545455+08:00","guessed":false,"end":"2026-07-30T12:39:41.625000+08:00","text":"這些困境我們也都了解，所以在病主法的修法過程裡面，還有待更多的共識。","quality":0.871},{"speaker":"王委員正旭","start":"2026-07-30T12:39:42.200000+08:00","guessed":false,"end":"2026-07-30T12:40:02.714286+08:00","text":"在還沒有完成這些修法之前，是不是能夠考慮以下幾點：第一個是直接修正，提供預立醫療照護諮商之醫療機構管理辦法來加強執行；第二部分，是不是能夠納入大家醫等家庭或社區醫師照護計畫來提高量能？","quality":0.872},{"speaker":"王委員正旭","start":"2026-07-30T12:40:03+08:00","guessed":false,"end":"2026-07-30T12:40:05.800000+08:00","text":"還有，能不能夠持續擴大健保的給付範圍？","quality":0.765},{"speaker":"王委員正旭","start":"2026-07-30T12:40:06+08:00","guessed":false,"end":"2026-07-30T12:40:15.750000+08:00","text":"早上部長在口頭報告裡面也有把這些人數做了說明，似乎我們需要再加把勁，部長目前有沒有什麼想法？","quality":1},{"speaker":"石部長崇良","start":"2026-07-30T12:40:16+08:00","guessed":false,"end":"2026-07-30T12:40:41.800000+08:00","text":"跟委員說明，其實我們一開始起步真的是很困難，不過去年我們已經把65歲以上的多重慢性病、重大傷病及符合安寧緩和醫療條例條件者納入健保給付ACP，所以現在的人數看起來已經有明顯的成長。","quality":0.94},{"speaker":"石部長崇良","start":"2026-07-30T12:40:42.444444+08:00","guessed":false,"end":"2026-07-30T12:41:06.692308+08:00","text":"今年到現在為止，過去安寧簽的人數比較多，因為不需要ACP的過程，比較容易，AD是比較不好簽的，但是從今年的統計來看，已經明顯拉近差距，簽安寧的大概是四萬五千多人，而已經簽了AD的是兩萬六千多人，跟過去的落差已經慢慢在追趕。","quality":0.931},{"speaker":"石部長崇良","start":"2026-07-30T12:41:07+08:00","guessed":false,"end":"2026-07-30T12:41:53.714286+08:00","text":"所以我們透過大家醫計畫……您這邊提到大家醫計畫，在大家醫計畫裡面，對於65歲以上多重慢性病的，我們有給付ACP，只是醫師本身還是要符合ACP機構的條件，剛剛提到它需要醫師、要有相關專科、要有護理人員及心理社工人員，有些診所可能比較不好完備這些人力，所以如何用支援的方式，不見得都要在一個診所裡面才能夠做，剛剛您提到的辦法，我們來研議、來修……","quality":0.921},{"speaker":"王委員正旭","start":"2026-07-30T12:41:53.714286+08:00","guessed":true,"end":"2026-07-30T12:41:54.714286+08:00","text":"來精進。","quality":0},{"speaker":"石部長崇良","start":"2026-07-30T12:41:54.250000+08:00","guessed":false,"end":"2026-07-30T12:42:07.600000+08:00","text":"目前也在討論未來還可以放寬更多樣態的機構也可以協助做ACP，這樣就會讓可近性更高，這是第一個。","quality":0.977},{"speaker":"石部長崇良","start":"2026-07-30T12:42:08.200000+08:00","guessed":false,"end":"2026-07-30T12:42:39.750000+08:00","text":"第二個，執行面的部分，當然，慢慢、慢慢地，我們也是從做中學，包括怎麼去啟動、團隊要照會、怎麼執行，我們都會定期委託做一些推廣，我們的病主中心也在做這些推廣，我來看看是不是有需要再制定一些像handbook或者是指引之類的東西，讓大家在執行上能夠更有參考的依據。","quality":0.957},{"speaker":"王委員正旭","start":"2026-07-30T12:42:40+08:00","guessed":false,"end":"2026-07-30T12:42:48.846154+08:00","text":"好，那就請部長儘速提高諮商服務的可近性，如果費用的負擔能夠再做好的處理的話會更好。好。","quality":0.923},{"speaker":"王委員正旭","start":"2026-07-30T12:42:49+08:00","guessed":false,"end":"2026-07-30T12:42:55.823529+08:00","text":"最後一點點的時間，我想提出如何強化剛剛我們所提到的，如何讓所有的人平安？","quality":0.879},{"speaker":"王委員正旭","start":"2026-07-30T12:42:56+08:00","guessed":false,"end":"2026-07-30T12:42:59.692308+08:00","text":"如何強化長照、安寧政策的銜接？","quality":1},{"speaker":"王委員正旭","start":"2026-07-30T12:43:00.263158+08:00","guessed":false,"end":"2026-07-30T12:43:06.846154+08:00","text":"目前是不是有司署整合相關的政策規劃或者明確的政策指引？","quality":0.923},{"speaker":"王委員正旭","start":"2026-07-30T12:43:07+08:00","guessed":false,"end":"2026-07-30T12:43:23.833333+08:00","text":"因為劉司長也很擔心，這個部分如果沒有整體設計制度的話，未來在執行上還是會有困難，這部分部長有沒有一個期程，或者是什麼時候可以給我們一個書面報告？","quality":0.97},{"speaker":"石部長崇良","start":"2026-07-30T12:43:24.200000+08:00","guessed":false,"end":"2026-07-30T12:43:45.812500+08:00","text":"當然，主責單位還是在部裡面，由醫事司來主責，不過這個涉及整個安寧政策的推動，也會跨足到長照，我們現在希望這些長照的對象也能夠有ACP、AD的簽署，這個是目前長照3.0裡面在規劃的。","quality":0.963},{"speaker":"石部長崇良","start":"2026-07-30T12:43:46.230769+08:00","guessed":false,"end":"2026-07-30T12:44:04.785714+08:00","text":"健保的部分也有政策進來，剛剛我提到65歲以上多重慢性病、重大傷病者都可以簽，除了符合安寧條件的之外，只是如何把可近性再擴大，我們接下來會持續地努力。","quality":0.864},{"speaker":"王委員正旭","start":"2026-07-30T12:44:05+08:00","guessed":false,"end":"2026-07-30T12:44:05.800000+08:00","text":"好，謝謝部長。","quality":1},{"speaker":"石部長崇良","start":"2026-07-30T12:44:05.800000+08:00","guessed":true,"end":"2026-07-30T12:44:06.800000+08:00","text":"謝謝委員。","quality":0},{"speaker":"主席","start":"2026-07-30T12:44:06.200000+08:00","guessed":false,"end":"2026-07-30T12:44:07.800000+08:00","text":"謝謝王正旭委員發言。","quality":0.889},{"speaker":"主席","start":"2026-07-30T12:44:08+08:00","guessed":false,"end":"2026-07-30T12:44:10.727273+08:00","text":"接下來請盧縣一召委發言。","quality":0.818}]}},"supported_relations":[],"relations":[]}