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의료상의 자기결정권 행사와 의사의 진료업무 조화의 법적인 문제
오두진 이화여자대학교 생명의료법연구소 2010 생명윤리정책연구 Vol.4 No.2
In modern days, it has been generally accepted that medical acts should be performed in a way that is strictly based on the exercise of patient’s self-determination. Jehovah’s Witnesses refuse blood transfusion and choose to accept non-blood treatment based on their religious beliefs. Regarding this, there arises a controversy as to whether a physician is obliged to force a blood transfusion in an emergency situation. The discussion in this article deals with the issue of validity of the legal decision to force a blood transfusion, especially on a child, and the legal responsibility of a physician when it comes to the matter of emergency-related blood transfusions. In case of adults, the patient’s right to self-determination is widely recognized. In case of children, with regard to forcing a blood transfusion, in consideration of the factors, such as a problematic prejudgment viewing the refusal of blood as disrespect for life, a debate on whether a transfusion is the only remedy for survival, the necessity of a careful approach of taking legal action to force a transfusion, fragile legal grounds for the preliminary injunction and the reduced possibility of criminal prosecution against physicians, it is logically concluded that there are greater advantages for both a physician and a patient in protecting the patient’s self-determination than forcing a blood transfusion. In view of civil and criminal law, a physician would be held responsible for any damage if a surgery was performed against the patient’s will. On the other hand, the facts that a number of bloodless treatments have been successfully performed in a way that they respect the patient’s right to self-determination even in the emergent situations and for the high-risk patient groups who have been traditionally considered to be in need of a transfusion, show that a physician’s decision to perform a bloodless treatment for a patient who refuses blood transfusion should not be viewed as equal to an act of support to abandoning one's life. Therefore, an act of performing bloodless surgery in an emergency does not constitute negligence on the part of physician.