소위 연명의료결정법의 법적 쟁점 및 과제 -환자중심의료를 중심으로-
= Legal Controversies and Challenges with the So Called Act on Decision for Life-prolongation Treatment of Patients
- With a Focus on the Patient-oriented Medical Care -
- 저자[authors] 이무선 ( Lee Mu Seon )
- 학술지명[periodical name] 홍익법학
- 권호사항[Volume/Issue] Vol.19No.3[2018]
- 발행처[publisher] 홍익대학교 법학연구소
- 자료유형[Document Type] 학술저널
- 수록면[Pagination] 297-325
- 언어[language] Korean
- 발행년[Publication Year] 2018
- 주제어[descriptor] 연명의료결정법, 연명의료, 존엄사, 자기결정권, 연명치료 중단, Act on Life-Sustaining Treatment Determination, Life-Sustaining Treatment Determination, Death with dignity, Patient’s Right to Self-Determination, Withdrawing Life-Sustaining
초록[abstracts]
[그간 보라매병원 사건과 세브란스병원(김 할머니) 사건에 관한 법원 판결이 세간의 관심을 집중시켰다. 이에 연명치료 중단에 대한 국민의 드높은 관심 속에 소위 연명의료결정법이 제정되어 현재 시행되고 있다. 따라서 연명의료결정법은 연명의료에 대한 기본원칙, 연명의료 결정의 관리체계, 연명의료의 결정 및 이행에 필요한 사항을 정함으로서 임종 과정에 있는 환자의 연명의료 결정을 제도화 하여 호스피스를 포함한 연명의료 환자에 대한 체계적이고 종합적인 근거 법령을 마련했다는 점에서 연명의료결정법의 가치를 찾을 수 있다. 그러나「연명의료결정법」은 환자의 자기결정권, 명칭과 정의 규정, 연명의료 중단 등 결정과 그 대리인, 의료인의 책임 면제 등으로 다양한 법률적 쟁점이 제기될 수 있다. 그리고 이 같은 법률은 효율적 법이 되어야 하는데 시행상의 문제가 제기되고 있다. 유보문제, 자기결정권 문제, 벌칙문제, 연명의료결정서문제 등을 들 수 있다. 본 논문에서는 오랫동안 입법논쟁이 있었으나 충분한 검토 없이 졸속으로 만들어진 느낌마저 주는 위 연명의료결정법의 시행에 즈음하여 위「연명의료결정법」의 주요내용, 외국의 입법례, 개선방안 등을 검토한 것이다. 이에 본 연구는 환자중심의료라는 기본틀에서 주로「연명의료결정법」의 쟁점을 검토하고, 문제점을 검토함으로써 향후 입법론에 추가사항과 개선방안을 제시함에 목적이 있다. 이를 위해 Ⅰ. 머리말 Ⅱ. 비교법적 검토, Ⅲ. 연명의료결정법 개관, Ⅳ. 연명의료결정법의 법률적 쟁점, Ⅴ. 과제, Ⅵ. 맺음말의 순서로 검토하였다. 결국 연명의료결정법은 연명치료 중단의 요건과 절차를 포함하여 관련된 문제를 해결하기 위한 중요한 법이지만 몇 가지 문제점이 있어 이를 극복한다면 좋겠다는 것이 본 논문의 결론이다.
The last court judgments on the cases at Boramae Medical Center and Severance Hospital (the case of Grandma Kim) have drawn the attention of the public in the meantime. Based on this, amidst the enhanced attention of the national public on the suspension of the life-prolongation treatment, it is very much worthwhile that the so called Act on Decision for Life-prolongation Treatment of Patients has been in effect after enactment. In this respect, we can recognize the value of the Act in that it has established the systematic and comprehensive statutory provisions for the patients subject to the life-prolongation treatment including the hospice by institutionalizing the decision of patients in the dying process on the life-prolongation treatment based on the specification of the basic principles related to the life-prolongation treatment, the administration system for the decision on life-prolongation treatment and the particulars necessary for the decision on the life-prolongation treatment and fulfillment thereof. However, a diversity of legal controversies can be raised for the 「Act on Decision for Life-prolongation Treatment of Patients」in relation to the right of patients for autonomous decisions, the provisions for the title and definitions, the decision for suspension of life-prolongation treatment and the deputy thereof, the exemption of responsibility of the medical personnel and others. Moreover, once the Act has been enacted, whereas the true value of the Act can be realized only if the effective protection devices can be enforced in the correct way, there can be identified several problems in relation to the enforcement of the Act. Among these can be included the problems related to reservation, the right for autonomous decisions, the imposition of penalty and the written decision related to life-prolongation treatment. This thesis reviews the major contents of the above 「Act on Decision for Life-prolongation Treatment of Patients」, the legislation cases in foreign countries, the plans for improvement and others on the occasion of the enforcement of the above Act on Decision for Life-prolongation Treatment of Patients which even gives the impression of being made in an awkward way without sufficient proper deliberation despite the long-time controversies surrounding the legislation. Based on these, the purpose of this study consists in the presentation of the particulars to be added in legislation in the future and the recommendations for improvement by chiefly reviewing the controversies and problems related to the 「Act on Decision for Life-prolongation Treatment of Patients」on top of the fundamental framework known as the patient-oriented medical care. To this end, the thesis has been organized in the order of I. Foreward, II. Comparative Legal Review, III. Overview of Act on Decision for Life-prolongation Treatment of Patients, IV. Legal Controversies Related to Act on Decision for Life-prolongation Treatment of Patients, V. Challenges and VI. Concluding Remarks. In summary, though the Act on Decision for Life-prolongation Treatment of Patients is a critical Act for resolution of the related problems including the requirements and procedures for suspension of life-prolongation treatment, since there are several problems in reation to the Act, it is the conclusion of this thesis that it would be desirable to overcome these limitations.]