카렌 케이스를 통해 본 인간답게 죽을 권리와 치료중단의 책임

Abstract

It was obvious that because the stoppage of respiration and heart would cause brain death in a few minutes, no heart beat and respiration can be recognized as death. With the developments in medical technology, the definition of death has been obscured. Under circumstances that patient is in a persistent vegetative state, is maintained by respirator, and shows no reasonable possibility to emerge from her comatose condition to a cognitive state, is it right to discontinue the life-support apparatus for the good of patient? Because human life is priceless and cannot be restored once it is lost, discontinuance of the life-support apparatus should be extremely cautious. In the matter of Karen Quinlan, an incompetent under the circumstances mentioned above, the Supreme Court of New Jersey held that the life-support system may be withdrawn by physicians without any civil or criminal liability upon the concurrence of the guardian and family of patient, and preferably with the consultation with hospital ethics committee, even though it was expected that patient’s death would follow soon after its removal. The court determined that under such physical and medical conditions, Karen’s right of privacy may be asserted in her behalf by her guardian and family. In deciding the constitutional right of privacy that was the most crucial concern of the court, the court believed that if Karen were miraculously lucid for an interval and perceived of her irreversible condition, she would decide to discontinue the life-support apparatus even though she knew that it would definitely cause her death. This case has important implications on withdrawing of medical treatment for an incompetent as follows. The doctor can act only with the direct or indirect, explicit or implicit permission of the patient. When vital procedures of patient’s life is maintained by extraordinary medical procedures and mechanisms, prolongation of his life is meaningless, only to expand the enormous pain of patient who has no hope of recovery, and not to help the patient to manage his life as a duty given by God. It would be desirable to constitute ‘hospital ethics committee’ consisting of doctors, lawyers, law professors, ministers, social workers, university students, etc to examine ethical issues involved in such cases and provide suggestions to the doctor in charge and the family of patient. This would reduce and disperse the responsibility for, difficulty in, the decision to suspend the life-support mechanism.