Health and long-term care · Guide

How to sign an advance decision: hospice and patient autonomy in Taiwan (2026)

Taiwan has two documents that can be signed ahead of time, both recorded on the NHI card. The hospice directive covers resuscitation at the terminal stage; the advance decision is broader and requires a consultation first. As of 2025-11-24, 1,107,000 hospice wishes and more than 124,000 advance decisions had been recorded.25

Four steps to an advance decision

  1. Book an advance care planning consultation

    Find an institution offering it (285 nationwide). The person signing, at least one relative within the second degree, and the health care agent (if appointed) attend together.2627

  2. Sign the advance decision

    After the consultation, state for each of the five conditions whether to accept or refuse life-sustaining treatment and artificial nutrition and hydration. The institution stamps the document.

  3. Notary, or two witnesses

    Have it notarised, or witnessed by two or more people with full legal capacity.

  4. Scan, file and note on the NHI card

    The institution scans the document into the ministry database and records it on the NHI card. All three requirements (stamp, witnesses or notary, card note) must be met.

How the two documents differ

Hospice palliative care directiveAdvance decision
Law Hospice Palliative Care Act, in force since 7 June 2000 Patient Right to Autonomy Act, promulgated 6 January 2016, in force 6 January 2019
Applies when Terminal illness: two specialists find it incurable with death unavoidable in the near term One of five clinical conditions (below), confirmed by two specialists and at least two consultations with a palliative team
What it decides Hospice care, cardiopulmonary resuscitation and life-sustaining treatment Accepting or refusing life-sustaining treatment and artificial nutrition and hydration
Who can sign Adults with legal capacity may sign in advance; terminal patients may sign a directive Persons with full legal capacity
Before signing No consultation; two witnesses with full legal capacity An advance care planning consultation at a medical institution, which stamps the decision
Taking effect Scanned, filed and noted on the NHI card, with the same force as the original Notarised or witnessed by two people, scanned, filed and noted on the NHI card
Changing your mind Withdraw in writing at any time Withdraw or amend in writing at any time

Basis: Hospice Palliative Care Act, Articles 3 to 728; Patient Right to Autonomy Act, Articles 8, 9, 12 and 1427

The five clinical conditions for an advance decision

  1. Terminal illness
  2. Irreversible coma
  3. Permanent vegetative state
  4. Severe dementia
  5. Other conditions announced by the central authority: unbearable suffering from an incurable disease with no other suitable option at the current standard of care

When a condition is met and a decision exists, the institution or physician "may" withhold or withdraw accordingly; if they cannot carry it out for professional or personal reasons they may decline but must inform the patient or those concerned (Article 14).

Cost and NHI coverage

  • Since 2024-07-01 the NHI pays an advance care planning consultation fee once in a lifetime, 3,000 points when the decision is signed.26
  • Covered: patients meeting hospice enrollment criteria, mild dementia, conditions announced under Article 14(1)(5), and home medical care program enrollees; from 2025-05-01 also catastrophic illness patients aged 65 and over and those 65 and over with multiple chronic conditions in the family doctor or community hospital programs, in outpatient as well as inpatient settings. The ministry estimates 1.8 million people benefit.26
  • Others pay out of pocket. We found no official summary of self-pay prices; ask the institution when booking.

Frequently asked questions

Is an advance decision the same as euthanasia?

No. It lets a person refuse or accept life-sustaining treatment and artificial nutrition and hydration under five clinical conditions; when treatment is withheld or withdrawn the institution must provide palliative care. It does not include a physician administering drugs to end life.

Can I change it later?

Yes. Article 8 of the Patient Right to Autonomy Act allows withdrawal or amendment in writing at any time. A hospice directive can likewise be withdrawn in writing.

Is the consultation mandatory?

For an advance decision, yes: consultation and stamp, plus notary or two witnesses, plus the NHI card note. A hospice directive needs no consultation, only two witnesses.

What if my family disagrees?

At least one relative within the second degree must join the consultation so the family understands the wishes. Once valid, institutions follow the person's decision; an appointed health care agent speaks for the person, in line with the decision, when they cannot.

Will the hospital always follow it?

The statute says institutions "may" act on the decision. If they cannot carry it out for professional or personal reasons they may decline but must inform the patient or those concerned.

Sources and cut-off dates

  1. 衛福部新聞稿：器捐病主中心 114 年度聯合頒獎典禮（累計註記人數，計至 2025-11-24） （2025-11）
  2. 衛福部新聞稿「強化自主醫療決策 健保擴大預立醫療照護諮商給付」 （2025-04-30）
  3. 全國法規資料庫《病人自主權利法》 （2021-01-20 修正）
  4. 全國法規資料庫《安寧緩和醫療條例》 （2021-01-20 修正）

Rules as of 2026-11-10

Keep reading

Calculator Long-term care subsidy calculator Allowances and copay ceilings by level, category and county. → Calculator NHI premium calculator Salary, category, dependents, plus the supplementary premium. → Calculator Long-term care eligibility check Five questions against the current rules. → Guide Hospice and advance decisions Four steps from consultation to the note on your NHI card, and how the two laws differ. →

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