생전유언, 의료지시서, 자연사법(natural death act) 입법의 사회적 함의


Social Implication of Living Wills, Advance Directives and Natural Death Act in Korea


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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.


I. 들어가는 말
 II. 죽을 권리와 치료중단 관련 판례와 그 사회적 파장
  1. 1970년대의 카렌 퀸란 판결고 생명연장장치의 제거
  2. 1990년대 크루젠 판결과 환자의 생명연장장치 거부권의 헌법상의 권리성
 III. 자연사법규범의 전제 요건들
  1. 미국의 생전유언, 의료지시서, 자연사법 관련 입법현황
  2. 워싱턴 주 자연사법률에서의 치료중단 전제요건
  3. 대만의 호스피스 의료조항(자연사법 : 중화민국 89년 6월 7일 제정공포 8900135080호)
  4. 의사조력자살 관련법과의 비교
  5. 자연사법과 의사조력자살 관련법과의 차이
 IV. 자연사법 입법논의가 주는 사회적 함의
  1. 생전유언 및 사전의료지시서 작성의 제도적 정착
  2. 존엄한 죽음에 대한 환자의 자기결정권 존중문화
  3. 말기의료에서의 의료의 한계에 대한 사회적 성찰
  4. 말기상태에서의 의사의 면책에 대한 규범해석과 지침들
 V. 결론


  • 이인영 Lee, In Young. 홍익대학교 법과대학 부교수, 법학박사


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