我国首部生前预嘱地方性法规已正式施行，关于生前预嘱的研究必须更加 审慎和严格。存在于生命和尊严博弈中的“态度”决定了生前预嘱能否真正落地。在生 前预嘱中，反应态度和客观态度的内部矛盾难以消除，知情同意面临着家庭态度的挑战， 而个体认知甚至会导致自主态度的不自主。从生前预嘱的成立和启动出发，可以在解决 内部态度矛盾的基础上完善生前预嘱体系的内部路径，而外部路径的完善则要尽力消除 家庭、医院和社会的态度对生前预嘱的多重影响。

China′s first local law of living will has been formally implemented, and the research on living will must be more prudent and strict. The ″attitude″ existing in the game of life and dignity deter mines whether living will really land. In living will, the internal contradiction between reactive attitude and objective attitude is difficult to eliminate. Informed consent faces the challenge of family attitude, and individual cognition may even lead to the non-autonomy of autonomous attitude. Starting from the establishment and launch of living will, we can improve the internal path of living will system on the basis of solving the internal attitude contradiction, while the improvement of external path should try to eliminate the multiple effects of family, hospital and social attitudes on living will.