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우리 사회의 의사조력자살 법제화

Legislation concerning Physician-assisted Suicide in Korea

고윤석
한국의료윤리학회 (The Korean Society For Medical Ethics)|2022.12|한국의료윤리학회지 (Korean Journal of Medical Ethics)|제25권 제4호|pp. 313-323|DOI 10.35301/ksme.2022.25.4.313

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키워드

자율성의사조력자살autonomy완화의료palliative careend-of-life care연명의료결정법physician-assisted suicide임종 돌봄end-of-life act
주제분류의학일반

초록

최근 12명의 국회의원이 발의한 소위 ‘조력존엄사법안’에 대한 토론회가 국회에서 열렸다. 이는 많은 논란 끝에 의료 현장에 적용되고 있는 ‘연명의료결정법’이 불과 4년밖에 경과되지 않은 점 등을 고려해보면 빠른 사회 변화라고 할 수 있다. 이 논문은 우리 사회에서의 의사조력자살 법제화에 대하여 임종 방식과 시기를 선택할 환자의 권리, 발의된 ‘조력존엄사’ 법률안의 내용, 의사조력자살을 보조하는 의료 행위의 정당성, 의료계의 의사조력자살에 대한 준비, 현행 ‘연명의료결정법’의 보완 및 좋은 죽음에 관한 논의를 이어갈 사회 기구의 측면을 살펴본 것이다. 무엇보다도 환자가 원하지 않는 연명 혹은 집중치료의 거절이 ‘임종 과정’에서만 존중되는 현행 ‘연명의료결정법’을 보완하여, 말기부터 환자의 자율성이 존중될 수 있게 하는 것이 시급하다.

Abstract

In 2011 Korean Medical Association proposed guidelines concerning the withdrawal of life-sus-taining medical treatment, but in the years that followed, the proposal and the issue it addressed failed to receive any significant public attention. However, Korean legislators have recently held discussions on the so-called “Aided Dignity Death Act” (i.e. the Partial Amendment to the “Act On Hospice And Palliative Care And Decisions On Life-sustaining Treatment For Patients At The End Of Life”). Public discussions such as these are evidence of the rapid social changes that are taking place in Korean attitudes towards end-of-life care. In light of these recent changes, efforts should now be made to build a social consensus on the rights of patients at the end of life. This article contributes to that consensus-building process by analyzing the following six aspects of the proposed legalization of physician-assisted suicide (PAS): a patient’s right to choose the manner and timing of their death, the contents of the proposed act, the legitimacy of medical practices to support PAS, how prepared the Korean medical community is for the implementation of PAS legislation, the complement of the current legislation on end-of-life care, and the necessity of an organization for facilitating social discussions on PAS. The article argues for extending the right of patients to decline any intensive care from the “period of imminent death” that is mentioned in the current legislation on end-of-life care to the “terminal stage of life.”

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