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      • 사이버보안 특집 : 연명치료의 중단에 대한 형사법적 검토 -대법원 2009.5.21. 선고 2009다17417 전원합의체 판결을 중심으로-

        전지연 ( Ji Yun Jun ),최아랑 ( Ah Rang Choi ) 연세대학교 법학연구원 의료·과학기술과 법센터 2011 연세 의료·과학기술과 법 Vol.2 No.2

        This decision which reflects the existing theories and discussion has a significant value as the first ruling to pronounce the legal grounds, objective and subjective requirements, and the procedure of terminating meaningless life-sustaining treatment. A majority opinion refer that the legal ground for stopping treatment is founded on the right of self-determination based on the Article 10 of the Constitution which is the human dignity and the right to pursue of happiness, on the other, a minority opinion insist that the right of self-determination is not the only criteria, ceasing meaningless care could be justified by the sense based on the general terms of law and order. The right of self-determination should be understood as the right to choose death with dignity within a limited range rather than the right of unrestricted aggressive disposal. In that sense, this holding is reasonable that the right of self-determination has a certain boundary by the objective and subjective requirements of interrupting meaningless life-sustaining treatment. In terms of this understanding, the illegitimacy of discontinuing meaningless life-supporting care is carved by the Article 24 of criminal acts which is victim`s permission. Regarding the allowance of terminating life-sustaining treatment, this ruling upheld that the status of a patient must objectively come to irreversible stages of death, and patient`s intention to withdrawal of life-sustaining treatment must be confirmed as a subjective requirement. As method to make sure of patient`s intention, his will should be regarded if it was clearly expressed, otherwise the judgement concerned with objective assumption of the intention should be made under the considerable hypothetical circumstances. The problem is that, how can be able to presume patient`s thought objectively, when he comes to unrecoverable stages of death without any expression of his own intent. It is medically senseless compulsion of the law if a meaningless treatment must be continued only owing to an unidentifiable intention of a patient, and as a result, if a sufferer treated by meaningless life-supporting increase, it is hard to avoid heavy criticism that it is not serious consideration of limited health care resources in the real world. Thus, theoretical experiment of a majority opinion, which the removal of life-support device can be flexibly accepted as the right of self-determination even if patient`s intention cannot be recognized, is resonable ruling not only in terms of logical consistency, but also in the aspects of the actual necessity. Even though the major and the opposite opinion have no significant differences in terms of the conditions of withdrawing meaningless care, the fact that each party has a different conclusion in this case with the same factors means that still there is a part of ambiguity or uncertainty. It is worried that the Supreme Court did not establish a procedural device by due process of law regarding problems of fabrication about patient`s will that may be incurred by third parties in the process of ascertaining sufferer`s presumptive intention. Therefore, it is needed to prepare the standards to presume patient`s intention as exact as possible or to consider the system of living will which a patient indicates his will in advance of the case that he is actually unable to express his own thoughts. Henceforth, it is appropriate that through the sufficient social consensus, the National Assembly should legislate for discontinuing a meaningless life-sustaining treatment to embody patient`s right of self-determination as the positive law, at the same time to relax the criminal liability for the medical profession.

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