연명치료중단 결정에서 의학적 무의미함(medical futility)
Medical Futility in Decision-making concerning the Withdrawal of Life-Sustaining Treatment
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Most discussions about medical futility focus on the determination of when continued medical treatment is futile. However, there are no simple answers to this question, despite best efforts to define medical futility. Decisions concerning medical futility should involve not only physicians,but also patients and their family members, since value judgments are also relevant to the determination of medical futility. This raises the question of who actually holds the authority to make final decisions concerning medical futility. In this article we argue that shared decisionmaking should occur between patients, physicians, and family members. Even if disagreements arise in the decision-making process, each party’s opinions should be voiced and taken into consideration in reaching a resolution. Furthermore, we argue that, for the purposes of establishing a futility standard, what is needed is not a fixed and invariable law, but a process, which assists patients, physicians, and family members to debate, consult, and reach a resolution. In other words, communication skills as well as policy guidelines are required in order to optimize decision-making concerning medical futility.
Abstract
Most discussions about medical futility focus on the determination of when continued medical treatment is futile. However, there are no simple answers to this question, despite best efforts to define medical futility. Decisions concerning medical futility should involve not only physicians,but also patients and their family members, since value judgments are also relevant to the determination of medical futility. This raises the question of who actually holds the authority to make final decisions concerning medical futility. In this article we argue that shared decisionmaking should occur between patients, physicians, and family members. Even if disagreements arise in the decision-making process, each party’s opinions should be voiced and taken into consideration in reaching a resolution. Furthermore, we argue that, for the purposes of establishing a futility standard, what is needed is not a fixed and invariable law, but a process, which assists patients, physicians, and family members to debate, consult, and reach a resolution. In other words, communication skills as well as policy guidelines are required in order to optimize decision-making concerning medical futility.
참고문헌 (18)
- 김소윤, "연명치료중단과 유보 결정에 대한 한국 중환자 전담의사 인식과 실행", 한국의료윤리학회지, 12(1), pp.15~28 (2009), 한국의료윤리학회
- 최지윤, "안락사와 연명치료중단에 관한 우리나라의 최근 동향", 한국의료윤리학회지, 12(2), pp.127~142 (2009), 한국의료윤리학회
- Robert AB, "The Medical Futility Debate: Patient Choice, Physician Obligation, and End-of-Life Care", Journal of Palliative Medicine, 5(2), pp.249~ (2002)
- Eric G, "Does Professional autonomy protect futility judgment?", Bioethics, 20(2), pp.94~ (2006)
- Futility and Hospital Policy, "Tom T", Hastings Center, 31~ (1995)
- Baruch AB, "Is Futility a Futile Concept?", The Journal of Medicine and Philosophy, 20, pp.127~128 (1995)
- Robert DT, "The Problem with Futility", The New England Journal of Medicine, 326(23), pp.1561~ (1992)
- Edwin H, "A Confucian Ethic of Medical Futility. in Confucian Bioethics", pp.129~ (1999), Kluwer Academic Publisher
- Robert H, "Medical futility and the social context", Journal of Medical Ethics, 23, pp.149~ (1997)
- John PS, "Medical Futility in the Post-modern context", HEC Forum, 19(1), pp.70~71 (2007)
- Nancy MPK, "Making Sense of Advance Directives", pp.16~29 (1996), Georgetown University Press
- Lawrence JS, "Medical Futility: Response to Critiques", Annals of Internal Medicine, 125(8), pp.669~ (1996)
- Ian MK, "The Karen Quinlan case: Problem and proposal", Journal of medical ethics, 2, pp.6~ (1976)
- George JA, "Reconcciling Quinlan and Saikewicz: Decision Making for the Terminally Ill Incompetent", American Journal of Law & Medicine, 4(4), pp.372~ (1978)
- 이상목, "생명의료윤리에 대한 비교문화적 접근: 의학적 의사결정을 중심으로", 한국의료윤리학회지, 10(1), pp.23~32 (2007), 한국의료윤리학회
- What About the Family?, "John H", The Hasting Center, ~ (1990)
- Jeffrey PB, "Futility: A Concept in Evolution", Chest, 132(6), pp.1991~ (2007)
- Hospital Ethics Committees: Is There a Role?, "Robert MV", Hasting Center, 23~24 (1977)
