人口老化趨勢是全球性的事實，也是你我都不可避免的過程，根據統計2017年底中國之65歲以上人口即佔2.2億人，失能人口也佔3500多萬人。依此數據中國面臨人口高齡化，有迫切面對龐大長期照護之需求。依剛出台之長期照護政策，是否足以滿足這些失能者與照顧者。研究者極為關心此問題，期盼藉由研究建構中國高齡化社會長期照護之倫理實踐進路，首先考察高齡化之社會現況，其次檢視中國長者長期照護衍生之失能者照護問題，最後確認從養老機構的制約性（臥床約束尿布）照顧模式發生之三大問題：一、社會弱勢族群(失能殘疾者)之照護模式，二、醫療保障分配不均涉及失能者，三、失能者因醫療照護不當而產生廢用症候群等合併症問題。依此反思納斯邦(Martha C. Nussbaum)所提出之能力進路原則，檢討目前失能者照護實施中面臨之倫理議題。依其理論主張能力對人類生存基準點的影響，強調「值得人性尊嚴的生活」(a life worthy of human dignity)，當透過正義概念中的「照護」(care)概念可以提升人類的「能力」。其「能力進路」對弱勢者的觀照，正是失能者在長期照護所需求的倫理生命本質，故本文藉由台灣實施自立支援之經驗：探討採能力回復之原則，就桌進食，定期如廁之成效，企圖解決中國養老機構之三大問題。最後，本文證實養老機構自力支援之實踐模式，經由提升失能者生活機能，可以增進生命尊嚴減少就醫降低醫保之需求。建議中國政府當局應積極推動自力支援照顧模式，提供失能者之長期照護品質。 The aging population trend is a global fact. According to the statistics, by the end of 2017, China's population aged over 65 is 220 million people, and disability also accounts for more than 35 million people. According to this data, China faces an aging population and there is an urgent need for large-scale long-term care. However, the newly released long-term care policy is sufficient to meet these disabled and caregivers. This article is extremely concerned about this issue and looks forward to researching and constructing ethical practices for long-term care of China aging society. let's examine the current situation of the aging society and examine the level of care of disabled people with long-term care and the elderly in China. We have identified three major problems that arise from the care of nursing homes' restrictive (bed-constrained diapers) model: Unequal distribution of medical insurance involves socially disadvantaged people and the elderly. Improper care of doctors leads to complications such as disuse syndrome. In accordance with the principle of the ability approach proposed by Martha C. Nussbaum, and to review the current ethical issues faced by the disabled persons in their implementation. In accordance with the influence of the claim ability on human survival benchmarks, emphasizing, the care in the concept of justice can enhance human ability. Its capabilities approachis a reflection of the disadvantaged people. It is precisely the nature of the ethical life that disabled people need in long-term care. Therefore, this article uses Taiwan's experience of independence support: to explore the principle of ability recovery, to eat at the table, and to be able to go to toilet by himself/herself was an attempt to solve the three major problems of China's pension institutions. Finally, this article confirms that the practice model of self-supporting by the old-age care institutions can enhance the dignity of life and reduce the need for medical treatment to reduce medical insurance. It is suggested that the Chinese government authorities should actively promote the independence support care model and provide the long-term care quality of the disabled.
