Legal Research on the Improvement of the Subject System of Advance Directives in China 

Li Yuchen  Chen Chunqin

School of Law, Southwest Medical University, Luzhou, Sichuan, China，646000；

Abstract：As China's aging population intensifies (projected to reach 402 million people aged 60 and above by 2040, accounting for 28% of the total population), the issue of safeguarding autonomy in end-of-life medical decisions has become increasingly prominent. Article 78 of the Shenzhen Special Economic Zone Medical Regulations, which took effect on January 1, 2023, marks the first legislative confirmation of the advance directive system in China, representing a "breakthrough" in this field. However, significant deficiencies exist at the level of subject norms: ambiguous criteria for subject qualification, absence of mechanisms for assessing mental capacity, and undetermined subject status for special groups such as minors and individuals with cognitive impairments. These issues severely constrain the practical effectiveness of the system. This paper focuses on the core proposition of "improving the institutional subject," aiming to construct a normative framework for advance directive subjects that aligns with China's legal system and cultural context.

Keywords: Advance Directive; Subject Qualification; Medical Decision-Making Capacity; Shenzhen Medical Regulations

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