장기기증에 있어서 순환정지 후 사망의 합리적 도입방안
A reasonable Proposal for Introduction of Donation after Circulatory Death in Organ Transplantation
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이 논문은 우리나라에서는 최초로 순환정지후장기기증의 법적ᆞ제도적 도입방안에 관하여 검토하고 있다. 순환정지후장기기증(DCD, Donation after Circulatory Death)이란 사망의 개념이 아니라 뇌사가 아닌 경우 심장사에 대한 새로운 판단기준을 의미하는 것으로 이해되고 있다. 그 동안의 심장사 또는 심폐사는 심박을 기준으로 사망을 판정해왔지만, 새롭게 등장한 순환정지후장기기증에 있어서의 순환사는 순환을 기준으로 사망을 판정하기 때문이다. 순환정지후장기기증은 뇌사기증자의 고갈로 이식용 장기의 수급차이를 줄이기 위하여 서구에서는 이미 10여년 전부터 활발히 시행되어 오고 있는 제도이다. 우리나라에서도 이식용 장기의 수급차이가 점점 심화되고 있을 뿐만 아니라 이식의료와 관련된 기술의 발달과 연명의료중단등에 대한 법률의 제정과 시행으로 변화된 환경은 DCD의 도입가능성을 더욱 높게 하고 있는 상황이다. 여기서 이 논문은 목차를 Ⅰ. 서언, Ⅱ. DCD의 개념, Ⅲ. 외국의 입법례, Ⅳ. DCD의 허용요건 및 Ⅴ. DCD의 도입방안으로 구성한다. 끝으로 Ⅵ. 결어에서는 DCD의 도입방안으로서 제1안 장기이식법의 개정안과 제2안 연명의료결정법의 개정안 및 제3안 양법 모두의 체계적 정비를 위한 개정안이라는 3가지의 방안을 제시하고 있다.
Abstract
This paper is the first discussion about introduction of Donation after Circulatory Death(DCD) in korean legal system. It is understood that DCD is not a concept of death, but a new criterion for determining cardiac death if it is not Brain Death(BD). Because a traditional cardiopulmonary death or a cardiac death is determined based on heart beating, but a newly emerged DCD is determined based on circulation. DCD has become an acceped strategy to reduce the shortage of organs for transplantation in many european countries. In Korea, the difference in supply and demand of organ for transplantation is getting deeper, and the legal environment changed by the enactment and enforcement of so-called ‘Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life’ is raising the possibility of introducing DCD. This Paper consists of Ⅰ. Introduction, Ⅱ. The concept of DCD, Ⅲ. Foreign legislation, Ⅳ. The acceptance requirements of DCD and Ⅴ. The introduction for DCD. Finally, Ⅵ. The conclusion suggests three ways to introduce DCD, such as the amendment to so-called ‘Internal Organs, etc. Transplant Act’(organtransplantation act) in the first proposal, the amendment to so-called ‘Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life’ and the amendment for systematic reorganization of both acts in the third proposal.
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