俗稱渐凍人的運動神經元疾病患者，選擇氣切後仍有可能存活相 當長的時間。不過，大部分病患不願意選擇氣切。「選擇氣切仍能長 時間存活」似乎意味著病患仍未達到「近期內死亡不可避免」的「末 期」階段，那麼，拒絕氣切的選擇是否符合安寧緩和醫療條例的規 定？如果不符合，在倫理上又該如何看待這樣的選擇？這樣的選擇是 消極安樂死嗎？偷理上能接受這樣的選擇嗎？如果能接受，對安寧緩 和醫療條例又會形成怎樣的衝擊？本文將探討上述這些問題。

When facing the problem of dyspnea, patients of motor neuron disease could still expect a long term survival if they choose to accept tracheostomy and artificial ventilation. However, most patients would rather die than be kept alive on machine. Is this choice legally permissible according to the Hospice-Palliative-Care-Law in Taiwan that allows only patients in terminal phase to have the right of DNR? If it is illegal to withhold tracheostomy and artificial ventilation in the above described case, how should the case be morally judged? Is it a form of passive euthanasia? If it is morally acceptable to withdraw tracheostomy, what impacts will it exert upon the Hospice-Palliative-Care-Law? This article deals with all these issues.