신생아 치료중단의 법적 문제 - 영국 판례와 이론의 분석을 중심으로 -
Selective Non-treatment in Neonatal Medicine - Analysis of the Precedents in the U.K. -
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The massive technological advances in neonatal medicine have increased our capabilities to prolong life. But at the same time it sometimes appears to be a negative blessing. In the field of neonatal care the question arises as to whether it is justifiable to prolong the life of the newborn or infant when the treatment seems to be futile. The problem arise especially when the parents of the baby and the doctors cannot come to an agreement or the agreement between them doesn't seems to overcome the ethical concern. The legal cases in the U.K. show us the relationship between the medical opinion and value-judgment. If there exists an united medical opinion, the value-judgment in the courts tends to accept the medical opinion as it is. But if not (especially when the physical and mental damage is not so severe), the room of the discretion for the normative valuejudgment becomes wider and the courts can reach contrary decisions as R v. Arthur and Re B (a minor) case show us. Each of the proposed criteria for the decision-‘intolerability’, ‘medical futility’, ‘quality of life’ and ‘the best interest of the baby’ - seems to suggest the tendency concerning the subject of the decision. The suggestion of the criterion ‘medical futility’ implies that the value judgment is conducted especially ‘from the doctors’ point of view while the criterion ‘the baby's best interest’ which the U.K. court has been established can be understood a kind of effort to sublate the medical paternalism at least apparently and adhere to the national paternalism. Finally, concerning the legal policy for the neonatal care it seems to be the most important to establish the reasonable process the medical opinion and value judgment are made in order that the decision is neither medically arbitrary nor led only by the decision of court. To the parents the opportunity to understand the meaning of the damage of the baby should be given by the process of considering reflectively.
Abstract
The massive technological advances in neonatal medicine have increased our capabilities to prolong life. But at the same time it sometimes appears to be a negative blessing. In the field of neonatal care the question arises as to whether it is justifiable to prolong the life of the newborn or infant when the treatment seems to be futile. The problem arise especially when the parents of the baby and the doctors cannot come to an agreement or the agreement between them doesn't seems to overcome the ethical concern. The legal cases in the U.K. show us the relationship between the medical opinion and value-judgment. If there exists an united medical opinion, the value-judgment in the courts tends to accept the medical opinion as it is. But if not (especially when the physical and mental damage is not so severe), the room of the discretion for the normative valuejudgment becomes wider and the courts can reach contrary decisions as R v. Arthur and Re B (a minor) case show us. Each of the proposed criteria for the decision-‘intolerability’, ‘medical futility’, ‘quality of life’ and ‘the best interest of the baby’ - seems to suggest the tendency concerning the subject of the decision. The suggestion of the criterion ‘medical futility’ implies that the value judgment is conducted especially ‘from the doctors’ point of view while the criterion ‘the baby's best interest’ which the U.K. court has been established can be understood a kind of effort to sublate the medical paternalism at least apparently and adhere to the national paternalism. Finally, concerning the legal policy for the neonatal care it seems to be the most important to establish the reasonable process the medical opinion and value judgment are made in order that the decision is neither medically arbitrary nor led only by the decision of court. To the parents the opportunity to understand the meaning of the damage of the baby should be given by the process of considering reflectively.
참고문헌 (35)
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