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죽음을 대하는 현대의학의 태도 비판- 어네스트 베커의 실존주의 심리학의 관점에서
박중철 한국의철학회 2017 의철학연구 Vol.24 No.-
Since the solidarity of the traditional community has collapsed, deaths in modern society are proceeding with privatization, banalization, and medicalization. In particular, 75 percent of Koreans are dying in medical institutions today, so the death in hospitals has become a common occurrence. There is also a proliferation of medical futility in life-sustaining treatment, which is closely related to attitude of medicine toward death. Such attitude have several characteristics. First, the medical profession recognize death as a medical defeat, and they resist it through advanced technology. Second, such resistance is rationalizing through ‘Dogma’, such as ‘principles of ethics’ and ‘treatment guidelines’. This article analyze the medical futility relying on ‘technological possibility’ and ‘medical dogmas’ in perspective of ‘existentialist psychology’ which persist that Human beings overcome the fear of death through an attempt to be a hero. One of them, Ernest Becker, explained how human beings become heroes through the psychological mechanisms of ‘narcissism’ and ‘transference’. According to Becker, It is narcissism to regard one’s ability as basis of self-esteem, and transference is the identification by subjugate ones’ own self under superior groups or cultures. Modern medicine has depended on the technological narcissism, and subjugating under the dogmas(laws, principle of ethics, treatment guidelines) to preserve itself from the fear of death. Ultimately, these technicism and dogmatism have become the identity of modern medicine against inevitable death. This identity of medical practice ultimately justifies life-sustaining treatment by allowing it’s intervention to deprive patients’ sovereignty in their dying process. If the patient wants to refuse life-sustaining treatment, they should rely on the legal and ethical principles of the law. In this case, the death of a patient is because of its own abandonment, not because of medical failures. And medicine can preserve the identity which it have to struggle against death. Medicine now needs a new identity to protect its self-esteem without violating patients’ sovereignty over their dying process. In order to achieve this, it is necessary to move the goal of medical practice to helping the completion of life not artificial prolongation of life. Ultimately, this will serve as an opportunity for our society to renew the culture of death.
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