의사조력자살에 대한 형법적 고찰 = (A) study of criminal law on physician-assisted suicide

다국어 초록 (Multilingual Abstract)

Medical technology is to help patients to be alive with new methods that the patients might once die in earlier times without it. However, the medical technology may bring about negative effects to the patients, For example, new medicine can allow patients to extend the chronic and terminal phases of illnesses. However, the patients may have a hard time of suffering from the loss of useful function well before death. Medicine is thus indirectly responsible for the predicament of many patients who are suffering from terminal or chronicle illness. In such a case, the patients may request a relief from the dragged lives even if shortening their life, especially in patients being in extreme situation. As a way of vanishing the terminal, painful, debilitating illness, the patients may prefer dying to living.
In recent years, there have been periodical upsurges of public and medical concerning about physician-assisted suicide around the Anglo-American nations. Even though the physician-assisted suicide elicited an extensive and enormous public reverberation, some patients were willing to request it to end their life. Therefore, the main goal of this study is to seek a positive way to permit physician-assisted suicide with certain obvious questions: 1) Is there any fundamental difference between physician-assisted suicide and voluntary active euthanasia. 2) Whether the difference is legal or moral. 3) Whether physicians should be exempt from legal structures that others must obey. If nations legally permit such physician actions, we have to ask what safeguards adequately prevent from abuse and whether the professional ethics of the physicians preclude certain mistreated actions even when the patients request it.
To answer these questions, the following was preformed: 1) The historical, legal, and ethical dimensions of suicide assistance were surveyed in contrast to the voluntary active euthanasia. 2) The current legal status of the actions and its justification were considered to critically analyze traditional arguments that were offered for and against to legalize physician-assisted suicide. 3) Historical treatment of assisted suicide was discussed. 4) Some factors were provided to consider those who favor physician assisted suicide legislation.
Physician-Assisted Suicide occurs when a physician facilitates a patient's death by providing the necessary means or information to enable the patient to perform the life-ending act. For example, the physician provides sleeping pills and information about the lethal dose, so that the physician may notice that the patient may commit suicide sooner or later. On the other hand, Euthanasia (here meaning the voluntary active Euthanasia) is the administration of a lethal agent by doctor or another person to a patient for the purpose of relieving the patient's intolerable and incurable suffering.
Similarly, when a doctor prescribes or leaves a lethal drug dosage for a patient to take later, it has traditionally fallen under the rubric of physician-assisted suicide. Because the patient intentionally brings about her own death by her own decision, the patient commits suicide, or self-murder. The physician simply provides the means for the patient to do so. Such suicide assistance, even coming from the beneficent motives, has generally been distinguished from the direct physician's action. In suicide, the patients kill themselves, but in euthanasia, the physician helps to perform the killing. Nevertheless, permitting physician-assisted suicide is not free from the penalty of assisting suicide, Section 252 (2) of the criminal code in our nation.
This study takes two approaches in ethical and legal aspects to explain why physician-assisted suicide should be permitted. First, we examined the traditional arguments that were offered against legalizing physician-assisted suicide in the two aspects. Physician-assisted suicide is fundamentally incompatible with the physician's role as a healer, so it would be impossible to control the abuse and it would pose serious social problems. Instead of participating in assisted suicide, physicians may forcefully respond to the needs of the patients at the end of life, which the physicians may not abandon once curing is not possible. In addition, permitting physician-assisted suicide infringes on the criminal law. Second, we investigated the objections against physician-assisted suicide, which feed on the fear that physician-assisted suicide may be abused by unscrupulous doctors and family members of the patients. In response to the objective arguments from the inalienability of the right to life rights and the righs that there is no constitutional right to suicide, we criticized it on the basis of the arguments from personal autonomy.
This study comes to the conclusion that physician-assisted suicide should be permitted and decriminalized by laws, because we should respect the preferences of competent patients who are severely suffering from a painful illness. In the other words, personal liberty about a private matter, such as controlling over one's own death, should be accorded with great respect. Although the general rule that assisted suicide may have been proscribed, specific exceptions should be allowed for physician-assisted suicide that could be justified. This could be helped to assist the terminally ill patients at the end of their lives to take their fate into their own hands, which is the most fundamental and supreme right the human being can have. Through physician-assisted suicide, patients would attain a help to have a humane death and be free from unbearable pains.
From now on, we expect to provide a sufficient basis and direction on the further research and arguments in this area and in case a nation decide to permit Physician-Assisted Suicide.
Finally, I am very grateful to my professor, Kim, Seong-don, for his invaluable guidance, support, and encouragement throughout this study.

목차 (Table of Contents)

• 목차 = ⅰ
• 제1장 서론 = 1
• 제1절 문제의 제기 = 1
• 제2절 연구의 범위와 방법 = 3
• 제2장 의사조력자살의 개념 및 적극적 안락사와의 구분 = 6
• 제1절 의사조력자살의 개념 = 6
• 제2절 의사조력자살과 적극적 안락사와의 구분에 대한 검토 = 9
• Ⅰ. 의사윤리지침의 구분 = 9
• Ⅱ. 문헌상의 구분 = 9
• 1. 의사조력자살과 적극적 안락사의 차이점 = 9
• 2. 의사조력자살과 적극적 안락사의 유사점 = 12
• 제3절 소결 = 13
• 제3장 우리나라에서의 의사조력자살 논의 상황 및 형법적 고찰 = 15
• 제1절 국내 논의 상황 = 15
• Ⅰ. 사회적 분위기 = 15
• Ⅱ. 의사윤리지침의 공포 = 16
• 1. 의사윤리지침의 내용 = 16
• 2. 의사윤리지침의 사회적 반응 = 18
• Ⅲ. 적극적 안락사의 허용론 대두 = 18
• 1. 적극적 안락사 불허론과 허용론 = 22
• 2. 적극적 안락사의 허용근거와 허용요건 = 28
• 제2절 의사조력자살의 형법적 고찰 = 35
• 1. 의사조력자살과 자살관여죄와의 관계 = 36
• 2. 의사조력자살의 해결책의 일환으로의 적극적 안락사의 고려 = 38
• 제3절 소결 = 38
• 제4장 외국에서의 의사조력자살 논의상황 및 입법현실 = 41
• 제1절 의사조력자살에 관한 논의상황 = 41
• Ⅰ. 의사조력자살의 역사적 개관 = 41
• Ⅱ. 의사조력자살의 현주소 = 50
• 제2절 외국의 의사조력자살의 입법현실 = 57
• Ⅰ. 미국 = 57
• 1. 미국에서의 의사조력자살의 입법현실 = 57
• 가. 자살방조법령 = 57
• 나. 조력자살에 대한 주들의 취급 = 58
• 다. 자살방조와 관련된 근본적인 사실 : 6가지 다른 사실의 유형 = 60
• 라. 자살방조를 위한 새로운 입법 모델:모형자살방조법령(A Model Suicide Assisted statute) = 66
• 2. 의사조력자살에 대한 법원의 입장 및 그 밖에 제기되는 문제점 = 72
• 가. 법원의 입장 및 판례 = 72
• 나. 의사조력자살의 정당화 근거 = 81
• 다. 의사조력자살의 정당화의 문제점 = 83
• 라. 의사조력자살에 관한 법률정책의 목적과 범위 = 84
• 마. 의사조력자살에 있어서의 의사의 의무 = 85
• Ⅱ. 캐나다 = 89
• Ⅲ. 영국 = 91
• Ⅳ. 독일 = 92
• Ⅴ. 네덜란드 = 94
• 제5장 의사조력자살에 대한 불허론과 허용론 = 97
• 제1절 의사조력자살의 허용여부 = 97
• Ⅰ. 윤리적 측면에서 바라본 의사조력자살 불허론과 허용론 = 97
• 1. 의사조력자살 불허론 = 97
• 2. 의사조력자살 허용론 = 102
• Ⅱ. 법적인 측면에서 바라본 의사조력자살 허용여부 = 108
• 1. 실정법적인 측면에서 바라본 의사조력자살 불허론과 허용론 = 108
• 가. 실정법에 기반을 둔 의사조력자살 불허론 = 108
• 나. 의사의 법적 지위 논쟁에 있어서 의사조력자살 허용론 = 109
• 2. ‘헌법상 자살할 권리는 없다’는 권리 논쟁 = 110
• 3. 개인의 자기결정권에 대한 논쟁 = 110
• Ⅲ. 검토 =111
• 제2절 의사조력자살의 비범죄화를 위한 해석론 및 입법론 = 113
• Ⅰ. 의사조력자살의 해석상 비범죄화 = 114
• 1. 미국의 의사조력자살의 비범죄화 = 114
• 2. 우리나라의 의사조력자살의 형법 해석상 비범죄화 = 116
• Ⅱ. 의사조력자살의 입법상 비범죄화 = 117
• Ⅲ. 우리나라에서의 의사조력자살의 허용요건과 입법례 = 119
• 1. 우리나라에서의 의사조력자살의 허용요건 = 119
• 2. 의사조력자살특별법 = 120
• 제6장 결론 = 121
• 참고문헌 = 124
• ABSTRACT = 131