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대학생들의 연명치료중지에 대한 인식 및 태도가 장기기증의사에 미치는 영향
최령(Ryoung Choi),황병덕(Byung-Deog Hwang) 한국생명윤리학회 2012 생명윤리 Vol.13 No.2
본 연구는 사회적 정의와 이상을 실천하고자하는 욕구가 강한 대학생들을 대상으로 연명치료중지에 대한 지식과 인식 및 태도가 장기기증의사에 미치는 영향을 분석하였다. 또한 앞으로 장기기증의 문제를 해소할 수 있는 단초를 마련하고 대학생들의 생명존중에 대한 가치관 형성과 생명윤리교육에 필요한 기초자료를 제공하고자 시도하였다. 대상은 부산광역시에 소재하고 있는 3개 대학교의 대학생들을 대상으로 2010년 3월 14일부터 4월 3일까지 21일간 설문지를 배부하여 자기기입식으로 작성 후 최종 303명을 대상으로 분석을 하였다. 장기기증의사와의 관련성은 종교, 윤리적 정당성, 법률제정여부, 연명치료중지 인지, 자발적 연명치료중지 태도에서 통계적으로 유의한 차이가 있었으며, 장기기증의사에 영향을 미치는 요인은 유일하게 종교가 통계적으로 유의한 차이가 있었다. 의료에 관한 전문 지식과 경험을 가지고 있지 않고, 가족 등의 임종을 많이 경험하지 못한 대학생들에게 의학적으로 회생 불가능한 환자에 대해 마지막으로 존엄하게 죽을 수 있는 권리를 인정하고 더불어 장기기증이라는 고귀한 결정을 내릴 수 있는 긍정적 신념과 태도를 가질 수 있도록 사회문화적으로 다양한 노력들이 필요할 것이다. University students have a strong desire for realizing social justice and ideals. Targeting the students of such tendency, the present study analyzed their knowledge, prejudice, recognition and attitudes to withdrawing life-sustaining treatment so that it could learn how those factors would affect the students in making organ donation. For a second purpose, the study aimed to come up with any solutions to the organ donation-related issues, providing basic data which would be used to tell the students about the respect for life and bioethics. Students from three different university in Busan were selected for the research and a survey was carried out for 21 days from March 14, 2010 to April 3, 2010. The students were asked to answer questions by themselves and answers from a total of 303 students were analyzed. According to the results, religious factors would have an influence on the organ donation. They were the one and only factors that was found statically meaningful from other factors. In terms of the recognition of the life extension treatment cease, the organ donation which is expected to be made by the students was believed to be affected as the more the students fail to understand the life extension treatment cease. For the attitudes to the life extension treatment cease. the students’ organ donation turned out to be more influenced as the more the students would go against the voluntary life extension treatment cease and the involuntary life extension treatment cease. The findings were, however, observed not to be statically significant. The students in the research were not those with professional medical knowledge nor experiences of families’ deaths. Nevertheless, they would still need to understand that patients with incurable diseases have rights to die with dignity and to live on a life of a human being. In addition, social and cultural attempts to make the students have positive ideas and attitudes to the organ donation should be conducted.
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이윤성 대한의사협회 2012 대한의사협회지 Vol.55 No.12
Although the word ‘euthanasia’, a compound word of eu- (good, well) and thanatos (death) is widely known, it is greatly misunderstood. With regard to end-of-life medicine, several phrases, including death with dignity, passive euthanasia, and natural death also need to be clarified. A review of their meanings and connotations is provided along with a brief history of the discussion in Korea on forgoing life support. Korea has no law regarding the cessation of artificial ventilation, but several judgments of law courts provide us with a general principle that cessation could be applied if the patient is in an irreversible or dying condition medically, and has presented his or her intention with something like an advance directives, or is reasonably presumed to have such a will.
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병원윤리위원회 표준운영지침 개발 : 해외 사례를 중심으로
박인경,박지용,손명세,이일학 이화여자대학교 생명의료법연구소 2011 생명윤리정책연구 Vol.5 No.2
Since the ‘Boramae Hospital’ case and ‘Severance Hospital’ case, most hospitals in South Korea have set up Hospital Ethics Committees(HECs). However, they haven’t worked well because of the absence of legislation and SOPs and a manpower shortage. Based on reviews of cases of SOPs of HECs in other countries such as the USA, Canada, and the UK, this paper will give the basic principles and contents of SOPs for HECs with a foundation of due process and independency. First, HECs must guarantee the best interests of the patients. Second, SOPs must ensure the flexibility to operate HECs according to their situations. Third, HECs must build up the ethical competences through the utilization of case consultation, policy development, and ethics education. Forth, HECs must have the professionalism to get the trust and reasoning power regarding their decisions. Fifth, HECs must be comprised of manpower that has various expertise and experiences. Sixth, HECs must operate through consistent procedures to get the due process. Seventh, HECs must try to ensure the principle of publicity and the participation of the patients to ensure transparency. Eighth, the chief of the institution has the responsibility for HECs to operate independently so that the members of HECs are able to act independently. Ninth, HECs have to maintain and improve the competences through continuous quality assessment. Tenth, all the documents of HECs have to be organized and conserved to ensure operating transparency and confidentiality. Eleventh, we propose the standard templates to promote operating effectiveness.
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허대석 대한의사협회 2009 대한의사협회지 Vol.52 No.9
There has been a controversy in Korea regarding a ‘death with dignity’ in comparison to a ‘natural death’. However, the issue of patient autonomy is often overlooked. Decision on withholding or withdrawing life-sustaining treatment should be based on the patients’ selfdetermination, prefereably in the form of advance directives. Consensus developed by the National Evidence -based Healthcare Collaborating Agency is as follows: ① a doctor should offer a detailed explanation to patients, including about hospice-palliative care and advance directives, ② when a terminally ill patient expresses reluctance regarding cardiopulmonary resuscitation or an artificial respirator in advance, such medical actions can be removed, with basic nutrition supply and pain control maintained. However, more discussions should be made in the case of a patient in “persistent vegetative state”.
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