의료적 의사결정에서 자율성 역량 모델의 의의

Abstract

This article advances the Autonomy Capability Model as a new theoretical framework for understanding the concept of patient autonomy and the right to self-determination in medical decision-making. After clarifying the basic concept and approach of the Autonomy Capability Model, the article goes on to confirm the theoretical usefulness of this model and apply it to the medical decision-making process. The applicability of the Autonomy Capability Model in relation to medical decision-making at the end of life is examined. The concept of patient autonomy used in the medical field today is defined as “independent self-determination by a subject with sufficient decision-making ability,” and it is understood that anything that interferes with the subject’s inherent decision-making ability is to be excluded. However, in practice, a patient who makes a medical decision is a prescriptive subject who has the final authority to make decisions about his or her own health and body, while at the same time experiencing a dependent condition that requires medical treatment and care by others. Therefore, the patient’s autonomy cannot be reduced to the self-determination of individuals with the capacity for rational judgment. It is argued that medical decision-making should be understood as a continuous process that involves ongoing communication with medical staff.