earticle

영어

This is the case for Jehovah’s Witness patient’s refusal of blood transfusion. During the surgery, the doctor could not do the blood transfusion timely due to patient’s strong will and therefore the patient died. The doctor was prosecuted by a charge of professional negligence resulting in death. He was sentenced not guilty both in trial and appellate court due to lack of illegality since the doctor treated the patient by the way of patient’s choice. However, the Supreme Court criticized the reasoning of trial and appellate court. The Supreme Court finds that patient’s self-determination right is not necessarily superior to the protecting life duty of the doctor in which the patient self-determination act brings conflict with the protecting life duty of the doctor based on the nation’s duty of protection of life. The Supreme Court finds that the self- determination act is legal only when that act can be evaluated equal to life. If a self-determination act cannot be evaluated as equal to life, or can be evaluated below the life, the act should not have binding effect to the doctor. In this case, the Supreme Court might think that the main issue should be which value is more superior between “the self-determination right by a patient” and “protecting life duty by a doctor” when a Jehovah’s Witness patient reveals his intention of refusal of blood transfusion. When these two conflicting values are compared, the former is not always superior to the latter. The former is equal to the latter only when special conditions are met. Only in this special exceptional case, the doctor can be exempted from the duty of protecting life and he can choose any proper treatment by using his professional discretion. However, I think, the main issue here in this case is not comparing two conflicting values but judging whether a patient’s specific self-determination act steps over the limit of a fundamental right exercise. The Supreme Court should give clear and definite guidelines to avoid confusion but it didn’t. The court demands 3 safety measures to protect life. First, the doctor should warn the patient the risk of specific treatment and treat the patient with due care. The patient’s will of specific treatment is allowed only if the life threatening risk becomes not real. If the life threatening risk becomes real, the things are changed. The patient’s will is no more effective. Second, if the risk becomes real and the life threatening situations happens, then the doctor should reconfirm the patient’s will. If the patient become unconscious, the doctor ask the family’s intention and decide what the best choice is given the patient’s supposed intention, the family’s intention and other circumstances. In this stage, the doctor should evaluate which value is more superior between self- determination right and duty of protecting life. The doctor should respect the patient’s will only if the former is equal to the latter. Third, the court judge the final answer when the dispute appears between the patient and the doctor. Even though the doctor evaluate the self-determination right is equal to the duty of protecting life and treat the patient according to his judge, he can be prosecuted later if the court judged the situation differently. I think the Supreme Court’s 3 stage safety measures are making only chaos in reality. It’s not necessary to demand the doctor again to consider his duty of protection of life in 2nd stage. Since the protection of life is already considered in the first stage, the doctor need not reconsider his duty of protection of life in 2nd stage. If the patient’s specific will is regarded passing the limit of the fundamental right exercise, then the doctor doesn’t have to respect the patient’s illegal will and can do proper treatment what he think. The court should judge whether a patient’s specific refusal of treatment due to religious reasons pass the limit of fundamental right exercise. If the act is within the limit, then the doctor should respect the patient’s will and do exactly what he wants to do in his treatment. If the act is regarded passing the limit, then the doctor doesn’t have to respect the patient’s will.

한국어

여호와의 증인의 수혈거부의사표시에 따라 수술도중 위험에 처한 환자에 대해 수혈을 하지 못하게 되었고 결국 상황이 악화되어 환자가 사망하게 되자 의사가 업무상과실치사혐의로 소송을 제기당한 사례이다. 1심과 2심 모두 담당의사가 환자의 치료방법 선택에 따라 수술과정에서 타가수혈을 하지 않은 행위는 위법성이 없다고 판단하였고, 업무상과실치사 공소사실이 범죄의 증명이 없거나 범죄로 되지 않는 경우에 해당한다고 보았다. 이에 대해 대판은 원심의 판단 이유 중에서, 환자의 자기결정권 행사가 의사의 일반적인 의무, 즉 국가의 생명권 보호의무에 기초를 두고 있는 환자의 생명을 구할 의무 등과 직접 충돌하는 상황이 발생할 경우에는 원칙적으로 자기결정권의 행사를 의사의 의무보다 우위에 두어야 한다는 취지로 설시한 부분은 적절하다고 할 수 없다고 비판하였다. 그 이유는 자기결정권의 행사가 유효하다고 하더라도 특별한 사정이 있는 예외적인 경우에 한하여 생명과 대등한 가치를 가지는 것으로 평가된다고 보았다. 다만 원심판단의 논거가 수혈 거부에 대한 환자의 자기결정권 행사에 따른 의사의 진료의무에 관한 법리에 상응하는 것으로 수긍할 수 있고, 여러 가지 사정들을 종합적으로 고려하여 보면, 이 사건에서 환자의 생명과 자기결정권을 비교형량하기 어려운 특별한 사정이 있으므로, 타가수혈하지 아니한 사정만을 가지고 담당의사가 의사로서 진료상의 주의의무를 다하지 아니하였다고 할 수 없다고 보아 업무상과실치사죄를 부정한 1심과 원심판단을 지지하였다.