수술 로봇의 윤리적 쟁점
= Ethical Issues in Surgical Robots
- 저자[authors] 송선영 ( Sun Young Song ) , 변순용 ( Sun Yong Byun )
- 학술지명[periodical name] 倫理硏究
- 권호사항[Volume/Issue] Vol.106No.-[2016]
- 발행처[publisher] 한국윤리학회
- 자료유형[Document Type] 학술저널
- 수록면[Pagination] 183-202
- 언어[language] Korean
- 발행년[Publication Year] 2016
- KDC[Korean Decimal Classification] 100
- 주제어[descriptor] 수술 로봇,수술 콘솔,로봇팔,도덕적 대리인,법적 책임,경제적 이익,건강과 행복,의료진 교육,surgical robots,operating console,robot arms,moral agents,legal responsibility,economic benefit,health and welfare,education for doctors
초록[abstracts]
[이번 연구의 목적은 최근에 로봇공학의 발전과 더불어 수술 로봇이 확대됨에 따라 발생할 수 있는 쟁점들을 윤리적으로 조명하는데 있다. 수술 로봇은 수술의 전 과정 또는 일부를 의사 대신 또는 의사와 함께 작업하는 로봇을 말한다. 이번 연구에서는 다음 세 가지에 주목하였다. 첫째, 도덕적 대리인(moral agent)으로서의 지위이다. 명령을 내리는 주체는 의사이지만, 그 명령에 따라 수술을 직접 시술하는 행위자(agent)는 바로 수술 로봇이기 때문에, 환자에 대한 도덕적 대리인으로서 지위를 갖는다. 둘째, 수술 로봇이 오히려 복합적인 요인에서 발생하는 합병증에 대한 책임 소재를 더 불분명하게 만들 수 있다. 셋째, 로봇 수술의 목적과 효과에 대한 윤리적 쟁점이 있다. 가령 아직 보험적용을 받지 못하는 로봇 수술을 더 많이 시술함으로써 대형 병원이 환자의 건강보다는 이익을 추구한다는 비판이 제기된다. 로봇 수술이 환자의 건강과 행복을 더욱 공고히 마련할 수 있는지에 대해서는 기술적 진보 과정에서 드러나는 윤리적 쟁점일 수밖에 없다. 마지막으로 인간의 본래적 활동으로서 의료술의 퇴보에 대한 우려이다. 이런 점에서 수술 콘솔을 조종하는 기술과 본래적인 인간 의료술의 능력을 모두 갖춘 참된 의사들로 성장하기 위한 교육적 방법들이 과제로 남아 있다.
The purpose of this paper is to explore the ethical issues that have to do with surgical robots and the risks of their employment. Robot as technological agent, Issues of legal responsibility, Inequality problems in welfare, and teaching doctors in future. The surgical robots like the Da Vinci Robot System, work with human surgeons and sometimes replaces them in the surgery. Some 35 hospitals in Korea employ about 46 surgical robots in their daily operations. And 24,207 surgeries by robot were performed in Korea between 2005 and 2012. Surgeries by robots has increased and expanded with the advent of technological development of robotics. This paper attempts to deal with the questions about the legal and the moral status of surgical robots as follows. Firstly, of fear of robots, In this paper, robots are seen as technological agent between doctors and patients. The surgical robot is not simple medical tools, but it has its own role and perform surgery directly on to human body. Secondly, we have another problem, "who is the subject of the surgery, human doctor or surgical robot?" A human doctor controls the operating console, and robot arms practice the surgery. An important feature is that the surgical robot has more precision in surgical process than a human doctor. Thirdly, of legal responsibility, there is a problem of side effects and complications. In 2011, Park, Ju-ah, Korean actress, for example, died of enterobrosia. The operation that ended the actress`s life was performed by one of 45 surgical robots. This was the first publicized case of medical accident involved with surgical robot, and this has received lots of attention. Fourthly, the surgery by surgical robots is more expensive than by human doctors. Concerning our task in future, the main question are "Should we further develop the surgical robots?" and "Can surgical robots protect the rights of patients to what extent?" The markets of medical robots are more and more expanding, and they are expected to spend 33 billion dollars in 2018. Societies must absorb the high costs of operation and maintenance of surgical robots. And it is anticipated that a very selective countries or very few global medical companies would dominate the developing scene and uses of surgical robots. It would foster the gab between the rich and the poor, resulting in discriminations. It is all too apparent that the patient would become the means for the developing robotic surgery. In particular, there is a key issue of the education of future doctors. The advent of various medical robots manifests the increased benefits by using them. The new and advanced surgical robots will expand the range of robotic surgery, and they can perform surgeries at a lesser expense, especially when the societal resources can be borrowed for their uses. The risk is that the doctors become technicians. The doctors in future need medical skills and control skills. It will be worried about the true doctor, between human doctor and technician, like as between fighter pilot and mouse-clicker.]