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2020 한국의 의사상을 통해 바라 본 국내 의과대학에서의 호스피스·완화의료 및 연명의료결정 관련 교육현황

Current Status of Hospices, Palliative Care and Life-Sustaining Treatment Decision-Making Education in Korean Colleges of Medicine: based on the 2020 Korean Doctor’s Role

박소연|방관욱
(재) 국가생명윤리정책원 (Korea National Institute For Bioethics Policy)|2024.10|생명, 윤리와 정책 (Bio, Ethics and Policy)|제8권 제2호|pp. 27-55|DOI 10.23183/konibp.2024.8.2.002

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키워드

교육과정curriculummedical educationmedical ethicslife-sustaining treatment decision연명의료결정의학교육의료윤리한국의 의사상Korean Doctor’s Role
주제분류학제간연구

초록

한국은 매우 빠르게 고령화가 진행됨에 따라 초고령사회가 임박하였다. 이에 호스피스·완화의료 및 연명의료결정에 대한 수요도 많아지게 되었다. 고령인구의 증가로 말기 환자나 임종기환자들이 직면하는 의료적 결정이 복잡해지고, 이에 따라 의료인들이 환자의 존엄성과 자기결정권을 존중하며 적절한 의료적, 윤리적 판단을 내릴 수 있는 역량이 더욱 중요해지고 있다. 이러한 변화에 대비하여 의료인의 호스피스·완화의료 및 연명의료결정 관련 교육의 체계적 점검이필요한 시기가 되었다. 이에 본 연구는 2020 한국의 의사상에 따라 국내 의과대학에서 시행되고있는 호스피스·완화의료 및 연명의료결정 관련 교육과정의 현황을 조사하고자 한다. 국내 40개의과대학에서 교육과정 자료를 수집하고, ‘죽음’, ‘호스피스’, ‘임종기’ 등의 키워드를 기반으로 관련 교과목을 분류하였다. 해당 교과목들은 ‘환자·의사·사회’, ‘의료윤리학’, ‘의료법규’, ‘의사소통기술’, ‘의료인문학’, ‘호스피스·완화의료’의 7가지 범주로 구분하였다. 그리고 교육내용, 교수학습법, 평가 방법 등을 확인하여, 한국의 의사상의 5대 핵심역량과 비교하였다. 분석 결과, ‘환자·의사·사회’ 과목은 40개 의과대학 중 31개교(77.5%)에서 개설되어 있었으며, ‘의료윤리학’ 은 28개교(70.0%), ‘의사소통기술’ 20개교(50.0%), ‘호스피스완화의학’ 4개교(10.0%)에서 운영되었다. 대부분의 교과목들이 환자와의 소통, 윤리적 판단, 사회적 책임 등의 역량을 포괄적으로 다루고 있었으나 과목의 특색에 따라 강조하여 교육하고 있는 역량이 조금씩 달랐다. 본 연구는 연명의료결정제도 시행됨에 따라 의과대학에서 운영되는 호스피스·완화의료 및 연명의료결정 관련 교육을 조사하고, 이를 한국의 의사상과 비교하였다. 모든 대학에서 관련 교과목이 개설되어 있었으나, ‘호스피스’, ‘완화의료’, ‘연명의료’가 명확히 구분되지 않고 부분적으로 교육이 이루어졌다. 한국은 초고령 사회로 진입 중이며, 이에 따른 의학교육에서의 교육과정 재정비가 필요하다. 따라서 각 의과대학은 본 연구의 자료를 기초자료로 하여 기초의학과 임상의학을 통합한교육과 시뮬레이션을 통해 임상적·윤리적 문제 해결 역량을 강화하는 등의 방안을 마련할 수 있을 것이다.

Abstract

As South Korea rapidly approaches the status of a super-aged society, there is a growing demand for hospices, palliative care, and life-sustaining treatment decisions. The increasing elderly population complicates medical decisions for terminally ill patients, rendering it essential for healthcare professionals to make ethical judgments while respecting patient dignity. This study examines the current status of education related to hospices, palliative care, and life-sustaining treatment decisions in South Korean medical schools, based on the 2020 Korean Doctor’s Role. Data were collected from 40 colleges of medicine, and relevant courses were categorized into seven groups: ‘Patients, Doctors, and Society,’ ‘Medical Ethics,’ ‘Medical Law,’ ‘Communication Skills,’ ‘Medical Humanities,’ ‘Hospices and Palliative Medicine,’ and ‘Life-Sustaining Treatment.’ The analysis showed that ‘Patients, Doctors, and Society’ was offered at 31 colleges (77.5%), ‘Medical Ethics’ at 28 (70.0%), ‘Communication Skills’ at 20 (50.0%), and ‘Hospices and Palliative Medicine’ at 4 (10.0%). While most courses addressed patient communication, ethical decision-making, and social responsibility, distinctions between ‘hospices,’ ‘palliative care,’ and ‘life-sustaining treatment’ were often unclear. As Korea transitions into a super-aged society, the reorganization of medical curricula is crucial to enhance clinical and ethical decision-making competencies through integrated education and simulation-based training.

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관련 논문AI추천

우리나라 의과대학의 호스피스 완화의료 교육김도연, 이순남연세대학교 의과대학 · 의학교육논단2020 · 제22권 제3호연명의료결정법 시행 이후 일반인과 의대생 대상 죽음교육 개선을 위한 예비연구김정아, 안경진연세대학교 의과대학 · 의학교육논단2022 · 제24권 제2호예비의료인을 위한 효과적 호스피스 교육컨텐츠 구성김현주, 배성권, 서영준보건의료산업학회 · 보건의료산업학회지2010 · 제4권 제2호의과대학생을 위한 죽음교육이 말기환자 돌봄 태도에 미치는영향에 대한 예비연구김혜원, 박중철연세대학교 의과대학 · 의학교육논단2018 · 제20권 제3호한의과대학에서 죽음학 교육 필요성에 대한 인식조사 및 교과목 설계김선경, 이해웅, 진명호한국의료윤리학회 · 한국의료윤리학회지2023 · 제26권 제3호임종기 환자 의료 결정에 대한 의사의 태도: 완화적 진정을 중심으로김영훈, 김평만, 박미현, 오승민한국의료윤리학회 · 한국의료윤리학회지2016 · 제19권 제1호

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