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보건의료에서 원헬스에 대한 인식 및 적용의 필요성

The Need for a One Health Approach to Health Care

최은주
한국의료윤리학회 (The Korean Society For Medical Ethics)|2022.03|한국의료윤리학회지 (Korean Journal of Medical Ethics)|제25권 제1호|pp. 43-57|DOI 10.35301/ksme.2022.25.1.43

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기후변화인수공통감염병보건의료ecosystemclimate change생태계원헬스One Health생물다양성 상실biodiversity losszoonosishealth care
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초록

본고는 인간-동물-환경의 인터페이스 증가에 따른 사회 분야 및 학문 분과를 뛰어넘어 윤리와 소통의 필요성을 제기한 과거 연구에 대한 후속 연구이다. 코로나19(COVID-19)는 인간, 환경, 동물이 어떻게 연결되고 있으며, 인간의 무분별한 개입으로 각각의 고유 영역이 보호되지 않을 때 감염병 발생률이 증가하면서 생태적 건강이 불가능하다는 사실을 보여주었다. 20세기 인간의 감염병 60%가 동물에서 유래하며, 신종 감염병 중 약 75%가 동물에서 사람으로 전파된다. 보건의료에서 환자의 진단 시 포함되어야 하는 종간 감염의 문제가 확대된 것이다. 원헬스 접근법은 동물원성 감염증에 대해 주로 부각된 결과로, 수의학계에 비해 보건 의료학계에서 크게 고려되지 않았던 문제점이 있다. 또한 원헬스 접근법에 의한 기존의 연구 결과들이 자본의 문제에 대해 누락하고 있다는 사회과학계의 비판에서 자유롭지 않으며, 그러한 비판은 정당하다. 그러나 수의학만이 아니라 보건의료에서 본질적인 원헬스가 다루어질 필요성은 크다. 본고는 원헬스를 생태적 차원에서 살펴보고, 원헬스 개념의 접근법에 의한 연구결과들의 성과와 비판, 그리고 남아있는 과제를 논하고자 한다.

Abstract

This article builds on previous research concerning the need for ethics and communication at the expanding human-animal-environment interface. COVID-19 has shown how humans, animals, and the environment are highly inter-connected. Approximately 60% of human infectious diseases in the 20th century originated in animals, and about 75% of new infectious diseases have spread from animals to humans. Although the One Health approach to medicine clearly recognizes the interconnection between people, animals, and the environment, it is also open to criticism. The One Health approach tends to focus exclusively on zoonosis while ignoring the environmental effects caused by huge capital-based development. This article examines the concept of One Health from an ecological level and discusses its achievements, the criticisms that have been raised against it, and the tasks that remain for research based upon it.

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