생애말기 의학적 돌봄 향상을 위한 연명의료결정법의 개정방안
Amendment Proposals for the Act on Decisions on Life-Sustaining Treatment to Improve End-of-Life Care
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초록
연명의료결정법은 생애말기에 환자의 자기결정권과 존엄을 보호하는 목적으로 제정되었다. 그러나 아직 이 법이 규율하는 연명의료결정제도는 그 활용도가 40% 전후로 개선의 필요성이 대두되고 있다. 본 논문은 그 개선의 방향을 제시하고자 유사한 방식으로 연명의료를 규율하는 대만, 독일, 미국, 영국 및 일본의 법률과 현행 연명의료결정법을 비교하고, 연명의료결정법의 개정 방향을 수립, 이에 대한 국 내 전문가 의견을 수집한 결과를 제시하였다. 이 개정안의 목표는 환자의 자기결정권이 적합한 방식으 로 존중될 수 있도록 하는 법률 근거를 마련하는 것이며, 이를 위해 법의 규율 범위, 사전연명의료의향 서 및 연명의료계획서 등 환자의 의사가 반영되는 사전지시 제도의 활성화 등을 고려하였다. 논문의 말 미에 개정안을 제시했다.
Abstract
The Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life (ELDA) was passed by the Korean National Assembly in 2016 and came into effect in 2018. Although the stated purpose of the act is to uphold patient autonomy and dignity in the context of end-of-life (EOL) care, its utilization remains low, with only some 40% of EOL decisions reflecting patients’ direct opinions. This study aims to pinpoint areas for enhancing ELDA by comparing it with similar systems in other countries and gathering expert opinions. To achieve this, we reviewed ELDA, compared it with EOL care systems in Taiwan, Japan, the UK, the US, and Germany, and surveyed Korean medical experts to collect their thoughts on how ELDA might be improved. On this basis, we make several recommendations, including broadening the scope of ELDA, bolstering the role of advance directives, and providing education for healthcare professionals. These recommendations are expected to increase the utilization rate of ELDA and enhance the quality of EOL care in South Korea.
참고문헌 (17)
- Survey on public opinion for the improvement of end-oflife culture through the life-sustaining treatment decision system, "National Health Insurance Service", National Health Insurance Service, ~ (2022)
- Statistics Korea, "Yearbook of life-sustaining treatment decision system, 2022" (2023), National Agency for Management of Life-Sustaining Treatment
- Goswami P, "Advance care planning: advanced practice provider-initiated discussions and their effects on patient-centered end-of-life care", Clin J Oncol Nurs, 24(1), pp.81~87 (2020)[DOI]
- Park HJ, "Experience of healthcare providers participating in life-sustaining treatment decision making for end-of-life cancer patient", Korean J Bioethics, 24(2), pp.47~68 (2023)[DOI]
- Kim C, "Issues of interpretation and direction of revision of Korean act of decision-making in life-sustaining medicine focused on decision of holding-off or discontinuation of lifesustaining medicine", SungKyunKwan Law Rev, 31(4), pp.257~304 (2019)[DOI]
- Jeon H, "Experiences with a lifesustaining treatment decision system : focus group interview", Bio Ethics Policy, 7(1), pp.25~47 (2023)[DOI]
- Choi JY, "Institutional ethics committees for decisions on life-sustaining treatment in Korea : their current state and experiences with their operation", Korean J Med Ethics, 22(3), pp.209~233 (2019)[DOI]
- Analysis of the outcomes of the operation of the life-sustaining treatment decision system project (3 years) and study report on mid- to long-term development plans, "Ministry of Health and Welfare", Ministry of Health and Welfare, ~ (2021)
- Study report on improvement measures for the life-sustaining treatment decision system, "Ministry of Health and Welfare", Ministry of Health and Welfare, ~ (2023)
- National public opinion survey on the life-sustaining treatment decision system for the improvement of end-oflife culture, "National Health Insurance Service", National Health Insurance Service, ~ (2022)
- Clinical guidelines for the diagnosis of clinical criteria for determining end-of-life and terminal stages, "Korean Association of Medical Societies", Korean Association of Medical Societies, ~ (2016)
- Hui D, "Concepts and definitions for"actively dying, ""end of life, ""terminally ill, ""terminal care, "and"transition of care" : a systematic review", J Pain Symptom Manag, 47(1), pp.77~89 (2014)[DOI]
- Lee SB, "Das deutsche patientenverfügungsgesetz", J Law Res, 26(4), pp.337~357 (2010)
- "End of life care strategy:promoting high quality care for all adults at the end of life" (2008)[URL]
- "FAQs for EMS providers" (2024)[URL]
- Development of a consultation and care plan manual based on the survey of the status of life-sustaining treatment decisions in medical institutions, "Ministry of Health and Welfare", Ministry of Health and Welfare, ~ (2020)
- Phua J, "Withholding and withdrawal of life-sustaining treatments in intensive care units in Asia", JAMA Intern Med, 175(3), pp.363~371 (2015)[DOI]