Korean Journal of Medical Ethics
The Korean Society for Medical Ethics

우리나라 일부 병원에서 환자, 보호자, 의료진의 연명치료 중지 관련 의사결정에 관한 태도*

권복규1,*, 고윤석2, 윤영호3, 허대석4, 서상연5, 김현철1, 최경석1, 배현아1, 안경진1
Ivo KWON1,*, Younsuck KOH2, Yun Young Ho3, Dae Seog HEO4, Sang Yeon SEO5, Hyeonchul KIM1, Kyungsuk CHOI1, Hyuna BAE1, Kyungjin AHN1
1이화여자대학교 생명의료법연구소
2울산의대 호흡기내과
4서울의대 내과
5동국의대 가정의학과
1Institute for Biomedical Law & Ethics, Ewha Womans University
2University of Ulsan College of Medicine
3National Cancer Center
4Seoul National University College of Medicine
5Dongguk University School of Medicine
*교신저자: 권복규. 이화여자대학교 생명의료법연구소. 02-2650-5758. kivo@ewha.ac.kr

ⓒ Copyright 2010 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.

Published Online: Mar 31, 2010


A survey was conducted from September to December 2008 to examine the attitudes of patients, family members, and physicians toward the withdrawal of medical treatment for terminal patients and other related issues. The subjects for the study were 91 cancer patients, 96 family members of cancer or other terminally ill patients, and 140 physicians. Most subjects acknowledge the need for an appropriate regulatory framework for the withdrawal of treatment for terminal patients. However, some discrepancies were found among the different groups (patients, family members, physicians) in this study. Patients showed a stronger preference for the withdrawal of treatment than did family members. Also, most patients claimed they wanted to receive the diagnosis of a terminal illness from their physician, while most family members seem to think it is their own duty to convey such a diagnosis to the patient. Both groups prefer co-decision-making about the withdrawal of treatment over individual decision-making by the patient. However, most family members admit that they do not know much about the patient’s wishes and lack the time for sufficient conversation with the patient. Physicians are skeptical of the authenticity of the decisions made by family members, and some physicians also regard hospital ethics committees as being ineffective for resolving these issues. The results of this study paint a unique picture of clinical culture in Korea, where family members still exert strong influence on clinical decision-making and little information is shared between patients, family members, and physicians. The study points to a need for greater public education in Korea on the practical and ethical issues surrounding the withdrawal of treatment for terminal patients.

Keywords: 말기환자; 연명치료중단; 사전의료지시서
Keywords: terminal patients; treatment withdrawal; advance directives