의사들의 호스피스 관리에 대한 임상적인 접근 = A Clinical Approach to Hospice Care of Doctors'

다국어 초록 (Multilingual Abstract)

Background: Cancer has become the major cause of death in Korea. Doctors who treat terminal cancer come across problems which are too difficult to solve. These problems are related with religious, moral and legal problems. These problems are easy death, patients' or family' s refuse of treatment, practice of cardiopulmonary resuscitation(CPR) in terminal cancer, definition of death and so forth. In Korea, studies related with terminal cancer patients and the doctors who treat them are very rare and the hospice system for terminal cancer patients is not organized yet.
Objectives: The aim of this study was to identify the opinions of doctors who treat terminal cancer about these problems. Materials ðod: This study was performed on 90 doctors working at Chosun university hospital, who are divided in to three parts as staff, residents and interns. We used questionares related with the above problems, composed of 19 items and six general characteristics. We could confirm 75 questionaires.
Results &onclusion: For the question "ve terminal cancer patients was announced their diagnosis and prognosis?"hat was most important to doctors was patients' opinions and the second was their family' s. For the question "eatment which could prolong the life of terminal cancer patients who are unnconscious is performed?"doctors showed a negative opinion. About the easy death of terminal cancer patients, more than half the doctors showed agreement. The prohibition of CPR in terminal cancer patients was agreed by 40%. For the question about the definition of death in terminal cancer patients 76.1% doctors agreed it was brain death. 85.7% subjects answered that they felt moral enmity in treatment of terminal cancer patients. In Korea, the programs for these problems are very poor, and the results of this study can affect the formation of systems and laws about the terminal cancer patients and the doctor's treatment. National support for terminal cancer patients and the hospice care system is required.

목차 (Table of Contents)

• 서론
• 연구 방법
• 1. 조사대상
• 2. 말기 암 환자에 대한 의견 설문내용
• 3. 분석 방법
• 연구 결과
• 1. 조사대상자의 일반적 특성
• 2. 말기 암 환자에 대한 진단명과 예후를 알려주어야 하는가?
• 1) 말기 환자에게 진단명을 인지시켜주어야 하는가?
• 2) 말기 환자에게 예후를 알려주어야 한다고 생각하는가?
• 3) 말기 환자에게 인공 호흡기 등과 같은 적극적인 치료를 할 것인가?
• 3. 말기 암 환자와 이들과 관련된 안락사에 대한 문제
• 1)말기 암 환자가 자살을 원할 때
• 2) 말기 환자에게 안락사에 대한 견해
• 3) 말기환자의 가족이 말기 환자에게 다음의 사항들을 요구한다면?
• 4. 말기암 환자의 심폐소생술 금지에 관한 문제
• 1) 심폐소생술 금지는 필요한가?
• 2) 심폐소생술 금지는 상황에 따라 필요하다고 생각한 경우 그 이유는?
• 3) 심폐소생술 금지는 누가 결정해야 한다고 생각하는가?
• 4) 심폐소생술 금지가 결정된 후 치료는 어떻게 하는 것이 좋은가?
• 5. 말기암환자의 죽음의 기준에 대해서
• 1) 죽음의 기준으로 무엇이 바람직한가?
• 2) 뇌사상태에서 뇌사자의 장기가 이식을 위해 적출 된다면 누구의 동의가 필요한가?
• 3) 말기 환자를 치료하거나 돌볼 때 도덕적 갈등을 느낀 적이 있는가?
• 고찰
• 결론