Article

연명의료결정법 1주기 평가와 종양내과 의사로서 느끼는 법과 임상현장의 괴리

안희준 1 , 2 , * https://orcid.org/0000-0002-7075-7565
Heejoon AHN 1 , 2 , * https://orcid.org/0000-0002-7075-7565
Author Information & Copyright
1울산대학교 의과대학, 강릉아산병원 내과학교실 혈액종양내과 부교수
1Associate Professor, Division of Hematology and Oncology, Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine
2Visiting Researcher, The Kennedy Institute of Ethics, Georgetown University, Washington D.C.
*교신저자: 안희준. 울산대학교 의과대학, 강릉아산병원 내과학교실 혈액종양내과. Tel: 033-610-3134. Fax: 033-641-8050. e-mail: anijune@daum.net

ⓒ Copyright 2019 The Korean Society for Medical Ethics. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: May 11, 2019; Revised: May 22, 2019; Accepted: Jun 13, 2019

Published Online: Jun 30, 2019

요약

연명의료결정법이 통과되고 실시된 지 1년이 경과했다. 환자의 자기결정권을 존중하는 취지의 이 법은 법적절차를 위한 복잡한 서식 등의 문제로 초기정착에 어려움이 있었으나 기대보다 많은 수의 환자와 일반국민의 참여가 이루어지고 있다. 하지만 의료현장에서 실제로 이 법의 취지가 잘 반영되어 시행되고 있는지, 그러한 환경이 우리사회에서 조성이 되었는지는 진지하게 돌아보아야 할 시점이다. 우리사회 각계의 토론과 합의, 그리고 성급한 법제화 과정들을 돌아보며 이 법이 원래 가지고 있는 목적과취지에 부합하는 법이 될 수 있도록 지속적인 의문의 제기와 토론이 요구된다.

ABSTRACT

More than a year has passed since the implementation of the “Act on Decisions on Life-sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life” (hereafter the “Life-Sustaining Treatment Decisions Act”) in South Korea. Although there have been complaints about the complicated legal documents that the law requires patients to complete when choosing to end life-sustaining treatment, overall this new law has been well received and more patients than expected have made use of the provisions of this law since it was implemented. However, it is now time to reconsider whether the law is serving the purpose for which it was originally designed. I argue in this article that while the expressed purpose of the Life-Sustaining Treatment Decisions Act is to respect and enhance patient autonomy, in practice the law seems to do more to reduce socio-economic burden than to protect patient autonomy. Furthermore, this law is transforming the ethical culture within the practice of medicine into a bureaucracy. Greater public debate on this matter is needed to ensure that the Life-Sustaining Treatment Decisions Act serves the purpose for which it was originally designed.

Keywords: 연명의료결정법; 법제화; 자기결정권
Keywords: Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life; legislation; self-determination