• 제목/요약/키워드: The death with dignity act

검색결과 13건 처리시간 0.02초

중화민국(타이완) "안녕완화의료조례(安寧緩和醫療條例)"의 연혁과 내용 (Taiwan's Palliative and Hospice Care Act - Legislative Background and Controversial Issues -)

  • 석희태
    • 의료법학
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    • 제9권2호
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    • pp.77-107
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    • 2008
  • In Republic of Chaina (Taiwan), Natural Death Act named "Anning Huauhe Yiliao Tiaoli" which means palliative and hospice care act was enacted in year of 2000. And enforced in the same year. Many scholars say that Taiwan's Act took Many U.S.A.'s acts such as 'Federal Patient Self-Determination Act 1990', 'California Natural Death Act 1976' and 'Washington Natural Death Act 1979' for a model. Taiwan's Act adopts a few outstanding systems - 'advance declarations' including 'living will' and 'durable power of attorney for health care', 'family-determination system' for a patient who is in a persistent unconscious state. This paper disusses this Act. 'The content is as follow: 1. A background of legislation. 2. The purpose of legislation. 3. The concept of terms. 4. Patient's self-determination. 5. Subrogated determination by family. 6. Keeping documents. 7. Punitive provision. 8. The relationship with euthanasia. 9. Controversial issues.

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존엄사에 대한 미국의 법제 (The Legal Framework of the Death with Dignity in U.S.A.)

  • 김장한
    • 의료법학
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    • 제9권2호
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    • pp.53-75
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    • 2008
  • The end of life problem in the United States has been evolved from the development of concept of brain death over last 50 yr. The invention of ventilator and the development of emergency medicine also played a key role to elongate the end stage of life and which caused the American people to ask a question about the patients self determination and refusing the unwarranted medical treatment in the view of the death with dignity. With regard to the patient unable to self determination, surrogate decision was also considered. To guarantee the self determination, The patient self determination act also enacted on the level of Federal regulation in 1990s. But no law has effectively dealt with the situation when medical treatment became futile. Along with the significant debates on literature and court cases. The American Medical Association's Council on Medical and Judical Affairs presented formal opinion and the Texas was the first states to regulate the medical futile situation in 1999. Even though that definition was in controversy, the concept of medical futility mainly focused on the doctors' right to refuse the treatment.

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생명권과 자기결정권, 그리고 의사의 진료의무 (Death with Dignity and the Right to Decide)

  • 유승룡
    • 의료법학
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    • 제9권2호
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    • pp.11-52
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    • 2008
  • Based on foreign examples and past debates, the minimal conditions for passive euthanasia can be suggested as following; (1) The patient is incurable by modem medical practice and his death is impending (less than 6 months), (2) Euthanasia is practiced solely to relieve physical pain of the patient, (3) If the patient can express his will, there should be a clear and sincere request or consent, (4) More than 2 doctors including doctor in charge should consent, (5) Euthanasia should be practiced in ethical way, (6) Patient family should agree(when the patient will is assumed.) It is hard to resolve issues regarding euthanasia based on past rulings and cases without concrete law. As in United States and Germany, clear and objective provisions of euthanasia and definitive method for patient's advanced directive should be legislated to resolve medical conflict and to relieve patient and family from agony. And death with dignity debate will not be able to proceed if it is only substantively approached because of unclear definition of euthanasia and benefit comparison way of thinking. Thus it is important to establish definitive process to decided legislation of euthanasia act and resolving conflicts arising from each step of the process among interested parties exchanging medical/ethical opinions.

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연명의료의 중단 - 대법원 2009.5.21. 선고 2009다17417 판결과 관련하여 - (Legal Grounds for Withholding or Withdrawal of Life-Sustaining Treatment)

  • 석희태
    • 의료법학
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    • 제10권1호
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    • pp.263-305
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    • 2009
  • Is it lawful to withhold or withdraw life-sustaining treatment applied to a patient in a terminal condition or permanent unconscious condition? In Korea, there are no such laws or regulations which control affairs related to the withholding or withdrawal life-support treatment and active euthanasia as the Natural Death Act or the Death with Dignity Act in the U. S. A. And in addition there has had no precedent of Supreme Court. Recently Supreme Court has pronounced a historical judgment on a terminal care case. The court allowed the withdrawal of life-sustaining treatment from a patient in a permanent unconscious state. Fundamentally the court judged that the continuation of that medical treatment would infringe dignity and value of a patient as a human being. And the court required some legal grounds to consider such withdrawal or withholding of medical care lawful. The legal grounds are as follow. First, the patient is in a incurable and irreversible condition and already entered a stage of death. Second, the patient executed a directive, in advance, directing the withholding or withdrawal of life-support treatment in a incurable and irreversible condition or in a terminal condition. Otherwise, at least, the patient's will would be presumed through his/her character, view of value, philosophy, religious faith and career etc. I regard if a patient is in a incurable and irreversible condition or in a terminal condition, the medical contract between a patient and a doctor would be terminated because of the actual impossibility of achievement of it's purpose. So I think the discontinuation of life-sustaining care would be legally allowed without depending on the patient's own will.

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조력사망에 관한 프랑스의 입법 동향 (Legislation on Aid in Dying in France)

  • 이지은
    • 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.

생전유언, 의료지시서, 자연사법(natural death act) 입법의 사회적 함의 (Social Implication of Living Wills, Advance Directives and Natural Death Act in Korea)

  • 이인영
    • 의료법학
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    • 제9권1호
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    • pp.413-459
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    • 2008
  • The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.

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성년후견과 의료 -개정 민법 제947조의 2를 중심으로- (The Adult Guardianship and Medical Issue According to the Amendments of Civil Code)

  • 박호균
    • 의료법학
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    • 제13권1호
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    • pp.125-153
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    • 2012
  • The adult guardianship system has been introduced through amendments of Korean Civil Code for the first time in the March 2011(Act No. 10429, 7. 1. 2013. enforcement). The adult guardianship system has the main purposes to provide a lot of help vulnerable adults and elderly, and protect them on the welfare related with property act, treatment, care, etc. There could be a controversy about whether the protection Legal Guardian's consent(formerly known as the Mental Health Act) or permission of the Family Court(revised Civil Code) are required to, or the Mental Health Act should be revised, when mental patient will be hospitalized forcibly. The author proposes that mental patient with Adult guardians should be determined by Legal Guardian's consent and approval of the Family Court, but mental patient without Adult guardians could be determined by Legal Guardian's consent. The issue of Withdrawing of life-sustaining treatment could be occurred due to the aging society and the development of modern medicine, and this has provided difficult, various problems to mankind in Legal, ethical, and social welfare aspects. The need of Death with dignity law or Natural death law has been reduced for a revision of the Civil Code. Therefore, on the issue of Withdrawing of life-sustaining treatment, in the future, intervention of the court is necessary in accordance with the revised Civil Code Section, and Organ Transplantation Act and the brain death criteria may serve as an important criterion.

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조력사망(Aid in Dying)에 대한 고찰 (A Study on Aid in Dying)

  • 이지은
    • 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.

연명의료결정법의 법적 고찰 (A Legal Study on 「the Act on Decision on Life-sustaining Treatment for Patient's in Hospice and Palliative Care or at the End of Life」)

  • 박광현
    • 한국컴퓨터정보학회:학술대회논문집
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    • 한국컴퓨터정보학회 2019년도 제60차 하계학술대회논문집 27권2호
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    • pp.195-198
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    • 2019
  • 연명의료결정법의 정식 명칭은 '호스피스 완화의료 및 임종 과정에 있는 환자의 연명의료 결정에 관한 법'이다. 이 법은 호스피스 완화의료에 대한 것과 환자의 연명의료 결정에 대한 것을 규정하고 있다. 특히, 후자의 연명의료결정에 관한 부분은 법제정 과정에서 법 종교 의료 윤리 등 다양한 분야에서 논박이 있었지만 2018년 2월 4일부터 시행되고 있다. 법학에서는 이 법이 생명이라는 법익과 관련되어 있어 형사법적, 민사법적으로 중요한 의미를 갖는다. 이 법이 탄생되기 위해 두 번의 변곡점이 있었다. 첫째, 1997년 '보라매병원 사건'에서 의사를 작위에 의한 살인방조죄로 판결한 사건 둘째, 2009년 '김 할머니' 사건에서 회생할 수 없을 경우 가족 등이 진술한 환자 의사에 따라 연명 의료를 중단할 수 있다는 대법원 판결이다. 연명의료결정법은 헌법상 생명권과 자기운명결정권이라는 기본권 충돌이 발생한다. 두 기본권이 서로 상충 할 때에는 어떠한 기본권을 우선해야 하는지가 실질적으로 문제되는데, 이익형량을 통한 규범의 조화로운 해석을 통해 해결해야 한다. 또한 이 법의 흠결과 문제점을 고찰하여 개정작업이 진행되어야 한다.

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치료중단행위에 대한 의료형법적 고찰 -의학적 충고에 반한 퇴원 사례를 중심으로- (A Study on Medical-criminal Problem of Withdrawing Life-Sustaining Treatment)

  • 조인호
    • 의료법학
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    • 제9권1호
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    • pp.319-382
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    • 2008
  • As a withdrawing care's study, the purpose of this study is searching about withdrawing care's acceptance and circumstances through Bora-mae hospital case(chapter 1). Withdrawing life-sustaining treatment has various forms. Though the meaning of euthanasia, death with dignity, natural death, physician assisted suicide are duplicated, the meaning of those are different slightly. Firstly, this study looks about the difference of the those meaning and acceptance range(condition) by withdrawing care's forms(chapter 2). Bora-mae hospital case sentenced guilty about physician who discharged incompetent patient who was after surgery by patient's wife determination. This Bora-mae case that sentenced guilty about discharge against medical advise(DAMA) that is regarded to custom has brought intensive confliction of legal, social, medical aspect, Bora-mae hospital case has many legal problems. First, as to criminal law rule 250(murder), the problem is whether discharge and withdrawing life-sustaining treatment is commission or omission. this study concluded omission(district court: omission, appeal, supreme court: commission). Because legal denounce point of discharge and medical treatment withdrawing is omission that physician who is obligatory on patient to cure. If physician's act is regarded omission, it is necessary to determine whether he has guardian status and obligation. Without guardian status and obligation, omission crime can't exist. This study decided that physician had guardian status and obligation and foundation of guardian status was pre-action or acceptance of emergency patient. Physician's medical treatment duty finished when patient(or patient's guardian) demands discharge. But when patient death is foreseen and other possible treatment does not exist, his duty of life prolonging treatment does not finish. This originate from physician's social responsibility and public status that limits patient's private liberty. This study regarded physician's action as accomplice about whether physician's discharging action is accomplice or the principal offender(district court: the principal offender, appeal, supreme court: accomplice). Though the principal offender needs criminal determination and action, there is no this common determination and functional action control of physician in Bora-mae case(chapter 3). Bora-mae hospital case partly originated from deficiency of legal, institutive system including medical security system shortage, the instruction is 1. medical security system strengthening, 2. hospital ethical committee's activity strengthening, 3. institutionalization of withdrawing life-sustaining treatment, 4. acceptance of pre-decision making system, 5. sufficient persuasion of physician for patient and faithful writing of medical paper, 6. respect for patients' self-determination and rights, 7. consciousness's changing for withdrawing life-sustaining treatment and persistent education about medical ethics(chapter 4). Considering Bora-mae case, medical sector is not the dead ground of a criminal punishment. Intervention of criminal law in medical sector give rise to ill effect, that is, excess medical examination and treatment, safeguard treatment, delay of discharge from a hospital. Because sufficient guarantee of life becomes mere empty slogan under situation that impose a burden of heavy cost to family or hospital, public and systematic solution should be given(chapter 5).

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