• 의료법학
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• 제23권2호
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• pp.67-96
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• 2022

인간의 존엄성과 환자의 자율성에 터잡아 연명의료의 중단이 제도화된 이래, 최근에는 스스로 존엄하게 죽음에 이르기 위해 환자가 자기 생명을 단축시키고자 의료적 도움을 받을 권리가 있는지, 그러한 행위가 어느 범위에서 정당화될 수 있는지의 문제가 활발하게 논의되고 있다. 우리나라에서는 2016년 연명의료결정법의 제정으로 연명의료중단이 제도화된 이래 여러 차례 개정을 거쳤는데, 최근에는 '조력존엄사'를 합법화하기 위한 내용의 연명의료결정법 개정안이 발의되었다. 이번 개정안에서는 조력존엄사를 '환자의 의사로 담당의사의 조력을 통해 스스로 삶을 종결하는 것'으로 정의하고 있는데, 이는 네덜란드, 벨기에 등의 유럽 국가와 미국 일부 주에서 시행되고 있는 조력사망(Aid in Dying)에 해당하는 내용으로 보인다. 조력사망이란 의사결정능력이 있는 환자가 치료가 불가능한 질병으로 고통을 받고 있을 때 환자가 사망을 앞당길 수 있는 약물을 의사로부터 처방받아 이를 이용하여 사망에 이르는 것을 의미한다. 존엄사에 대한 논의는 연명의료중단에서 조력사망의 순서로 진행되는 것이 세계적 추세인데, 2000년대에 이르러 일부 국가에서는 조력사망, 나아가 적극적 안락사까지 합법화하였다. 미국에서는 오리건 주를 필두로 여러 주에서 조력사망을 인정하는 법률을 두고 있지만 적극적 안락사에 대해서는 금지하고 있다. 이 논문에서는 일찌기 존엄한 죽음에 관한 논의를 시작하여 환자의 자기결정권을 제도화한 미국의 일부 주에서 조력사망의 입법화가 어떤 과정을 거쳐 이루어졌는지를 살펴보고 캘리포니아의 임종선택법의 주요 내용과 법시행 이후의 결과를 분석하였다.

• 의료법학
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• 제25권1호
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• pp.193-222
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• 2024

세계적 추세에서 볼 때, 환자의 존엄사에 대한 논의는 연명의료중단의 문제에서 점차 조력사망의 허용 여부와 그 요건에 대한 문제로 진행되고 있다. 미국의 여러 주와 캐나다, 벨기에, 네덜란드 등 서구유럽 국가에서는 의사의 조력을 통하여 사망시기를 앞당기는 치료를 제도화하였다. 프랑스에서는 오랜 시간 동안의 문제 제기와 검토 끝에, 다른 유럽 국가에 비해서는 완만한 속도로 관련 법제에 대한 논의가 이루어지고 있다. 프랑스에서는 20세기 후반부터 존엄사에 대한 사회적 논의와 입법적 시도가 활발히 이루어져 왔다. 2005년의 레오네티 법에 의해 환자의 의사에 반하는 무의미한 치료의 지속이 금지되었고 2016년 클레이-레오네티 법 이후 환자에게 강도 높고 지속적인 진정제를 사망시까지 투여하는 것을 합법화하였다. 그러나 이웃하는 다수의 유럽국가와 달리 프랑스에서는 사망 시기 자체를 앞당기는 처치는 환자가 원한다고 하여도 여전히 금지되고 있다. 임종기의 환자가 의사의 조력을 받아 고통 없이 사망에 이르는 것을 허용할 것인가에 대한 실존적이고 보편적인 질문이 최근 중요한 문제로 부각되면서 다수의 국회의원들이 조력사망을 합법화하는 내용의 법률안을 제출하였다. 이 논문에서는 프랑스에서 존엄한 죽음에 대한 환자의 권리(droit de mourir dans la dignité)와 관련하여 전개된 입법과정을 살펴보고 최근 조력사망의 합법화를 시도하는 프랑스의 법률안들을 우리 연명의료결정법 개정안과 비교·검토하고자 한다.

• 지역사회간호학회지
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• 제18권3호
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• pp.400-409
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• 2007

Purpose: This study was performed to investigate the level of subjective health status, religiosity and the fear of death of the elderly and to identify the relationships among them. Methods: This study was a cross-sectional descriptive study using a questionnaire. Fear of Death Scale that was made by Loo & Shea (1996) and translated and revised by Kim(2003) was used to measure the fear of death. The data was analyzed using SPSS. Results: The subject was 128 community dwelling elders who had a religion. Of the respondents, 50% felt 'not healthy', and 69.5% was moderately religious. The mean score of FODS was 3.18 (out of 5). The mean score of each subcategory of FODS was as follows: Death anxiety about the death of self was 3.00. Death anxiety about the dying of self was 3.18. Death anxiety about the death of others was 3.31 and death anxiety about the dying of others was 3.23. There was a statistically significance correlation between the level of religiosity and FODS (F=3.29, p= .040). Conclusion: Health professionals may make efforts to learn about healthy attitudes toward death and aid for the elderly and to comfort them. Death education programs are needed for the elderly.

• 보건교육건강증진학회지
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• 제7권2호
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• pp.89-102
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• 1990

The research is a comparative study of death attitudes between male and female elderly people. There is no doubt as to the inevitability of death. And yet, there is a vast conspiracy involved in the word of dead or death. The aged are considered to be nearer death than are people in other age groups. Kalish(1976) emphasized that for the aged two meanings of death have significance for evaluating their life ; first, that older people are known to have a limited life time and face death ; second that older people are known to have suffered many death-imposed losses that are often associated with the dying process. In considering these implications, the level of anxiety regarding death and dying is a crucial factor in determining mental health. In the study, 152 male elderly and 145 female elderly residing in Seoul, Korea was compared on the four dimensions of death anxiety and assigned personal variables. Therefore, the purpose the research was (1) to examine the characteristics of subjects on the independent variables(age, marital status, family relationship, social activities, religiousity etc.) ; (2) to examine the relationship between the independent variables and each dimension of death axniety ; (3) to determine the proportion of variance in the respective of death anxiety which is accounted for by the respective independent variables ; (4) to examine whether a significant difference between the respective independent variables and each dimension of death anxiety has ; (5) to determine the combination of variables which is the most successful in explaining the variance in death anxiety. Finding from this study support the following conclusions; 1. There was a significant differences between the male and female subjects in the level of death anxiety. In turn, the male older adults had lower death anxiety than did the female elderly. This implies that male tend to look forward to death rather than deny it. 2. As there was evidences from several studies, this research found that fear of death decreases as age increases. 3. The following two variables that correlate best with dying anxiety of others in both male and female older adults : 'marriage life', 'social interaction'. 4. The variables 'age' and 'children' for both female and male elderly accounted for the most variance in death anxiety of self. The findings of the study lend this investigator several suggestions, implications and recommendations for future research. There can be no death without life, and conversely, no life without death. Psychologists and health-related professionals may be learn as much about death as they can in order to develop more healthy attitudes and in order to be able to better aid and comfort dying people and their familities. Perhaps most importantly, professionals may be help those who are not faced with death at present to develop an understanding of it and healthy attitudes toward it. The programs of death education are needed for dedication to the evitability of death and the preparation of life for the older adults. More seminars, symposiums and research on death attitudes are needed. Finally, study for female older adults has been negelected topic in the areas of women's study and health education. Future study, for female elderly, have to deeply investigate where those problems come from and how to cope with in order to the female elderly segment can live the rest of their lives in satisfaction with well-being.

• 기본간호학회지
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• 제12권1호
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• pp.91-100
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• 2005

Purpose: This research used quantitative research to identify differences in death consciousness between pre and post education. The study was also designed to further understanding of the effects of nursing education by using a qualitative analysis to examine hospice education experience. Method: This study a one group pre-post test design. Results: 1 The mean score for the students' death consciousness before the hospice education averaged $2.15{\pm}\;.33$, a medium level for death Consciousness. The Score after education was $2.25{\pm}\;.36$, that is, there was higher score for death consciousness after education. 2. The result of classification, giving their names and categorizing the experience of being in a coffin shown to be self-reflection, regret, recognition to death, death as discontinuation of life, the last closing from everything, death as a sad and cruel event, death as another world, specialist intuition of nursing. Conclusion: This research provided an opportunity for nursing students to consider death earnestly and realistically through hospice nursing education. We also discovered affirmative changes in the students' viewpoint of death, students who in future clinical practice may work with elders. We also found increases in motives to develop ability to present effective aid to dying patients.

• 대한간호학회지
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• 제40권6호
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• pp.872-881
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• 2010

Purpose: This study was done to evaluate the formal education program provided by the Korean government for care workers for frail elderly people. Methods: This study was a cross-sectional survey in which 438 certified care workers who had completed the education program participated. Data were collected from June to October 2009, using a self-report questionnaire consisting of satisfaction with, and understanding of the education program. Results: The participants had a mean age of 46.7 yr, 87.9% were female and 58.2% were high school graduates. For the theory part of the education, the highest score for understanding was for 'supporting household & activities of daily living' while the lowest score for understanding was for 'care for death and dying'. For the practical education, the highest score for understanding was for 'talking with the client' and the lowest score was for 'first aid & basic life support'. There was a significant difference in satisfaction and understanding of the theoretical and practical parts according to educational level. Conclusion: Continuing education programs are needed for care workers for elders, both in the theoretical and practical areas. Also the content of programs should address the weak points of this formal education program.

• 한국아프리카학회지
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• 제29권
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• pp.27-53
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• 2009

At the start of the new century, South Africa probably had the largest number of HIV-infected people of any country in the world. The only nation that comes close is India with a population of one billion people compared to South Africa's figure of 57 million. The tragedy is that this did not have to happen. South Africa was aware of the dangers posed by AIDS as early as 1985. In 1991, the national survey of women attending antenatal clinics found that only 0.8percent were infected. In 1994, when the new government took power, the figure was still comparatively low at 7.6 %. The 2004 figure which has been published is 26.5%. This article tracks the epidemic globally, in the region and in South Africa. I explain some of the basic concepts around the disease and look at what may happen with respect to numbers. The situation is bad, and the number of people falling ill, dying and leaving families will rise over next few years. This will impact on South Africa in a number of important ways. This article assesses the demographic, economic and social consequences of the epidemic. It disposes of a number of myths and present the real facts. The AIDS in South Africa is not related to individuals only. It warns that AIDS in Africa is becoming a community and systemic problem. The acuteness of the problem does not stem merely from the fact that communities are affected, or could even be wipe out by the end of this decade, but from the fact that AIDS will place incredible burdens and obligations upon medical services, health care and religious communities such as churches. The facts confront churches' mission with the important question: who is going to take care of all the patients and where? The reality is that people dying of AIDS will have to be cared for at home by relatives and friends. A further question that arises is whether our people are prepared for this. AIDS was considered to be a homo-plague and the hunt was on for a scapegoat in the light of the fatal implication of the disease. At present we are in the strategic phase where we all realize that it will be of no avail to scare people with the ominous threat of AIDS AIDS destroys the optimism of our achievement ethics. This exposure of the culture of optimism is also an exposure of the so-called 'human basic fear which accuses Christianity that their concept of sin is a damper on man's search for liberation and basic need to be freed from all Imitation. AIDS is also a test for our ecclesiastical genuineness and the sincerity of our mission sensibility. It poses the question: How unconditional is Christian love? Is there room for the AIDS sufferer in the community of believers, despite the fact he is an acknowledged homosexual? The question to put to the church is whether the community of believers is an exclusive to put to the koinonia which excludes homosexuals. They may be welcome on principle, but in actual fact are not acceptable to the church community. As South Africa enters the new century, it is clear that the epidemic is not having a measurable impact. However, the impact of AIDS is gradual, subtle and incremental. The author's proposal of what is currently most needed in South Africa is that the little things will make a difference. It's about doing lots of little things better at grassroots level, with the emphasis on doing. There are so many community, churches and NGOs initiatives worth building on and intensifying. One must not underestimate the therapeutic value of working together in small groups to overcome a problem