안락사에 관한 연구

Abstract

Euthanasia is a word stemming from the Greek Word ″Eu-Thanatos″, whose original meaning is the Attitude toward death and a good & honorable death. Recently, however, with the development of medical skill and instruments which make it possible to extend the average length of biological life, the concept of euthanasia has changed. Euthanasia has been meant to indicate the case where a medically incurable patient is led to death by relieving extreme physical pain with good intentions. Also, Euthanasia means to cause a patient to die comfortably who can′t be cured by the knowledge and technology of modern science or who is in a terminal condition and on the point of death, such cases to remove the severe physical suffering due to sincere request of patient himself or of his relatives. How can Euthanasia, which is used for the purpose of eliminating the pain of body in the case of a disease which can′t be cured by modern medical science, be in harmony with the life-respect principle? Because of this, there has been no little argument about Euthanasia in many aspects. Euthanasia is dealt with in Literary, moral, religious, philosophical and medical ethics. Many questions have been raised so far : What is death and what is Life? How should one live his life? No satisfactory answer, either philosophical or medical, has been given so far. What is death to our human being? There is not yet a good answer or explanation to the problem of how we should be have toward death, because death is a thing of moment and a thing of self-being. We are living with the question of death and doubt concerning meaningful or meaningless existence on the earth in this present epoch, because, amidst the modern social structure and culture, there appear often persons in chronic vegetative state and patients of incurable disease and mental abnormality in considerable numbers. It seems that the urgent need of sex educations of a century ago is now replaced with another urgent need of education and knowledge of death, that is why I put this topic of euthanasia before you with a certain concpet in my way. Attitudes toward death affects one′s attitude of life. So both are co-relative with each other, and this can be understood form a point of philosophy and medical science ; Therefore, this article, subject of ″Study on Euthanasia″, will discuss whether or not euthanasia is necessary and is to be implemented. And of the same time I looked at problems of death and pain. This discussion of euthanasia boils down to a question of whether on can be permitted to shorten his life term in actuality. It is closely related with quality of life and essential value of life. It must be considered from all points, not only from the aspects of medicine and law but also from the aspect of philosophy, religion, social ethics and economics as well. It is a very complicated question. First , This subject is summerised from a point of medical science. A) Mercy killing as an active and intentional act is unaceptable. This can not be allowed. B) A passive case requires the following terms : a) A patient′s physical life is being maintained by a special medical aid or device. b) A biological terminal state is imminent without question. c) Medicare can be withheld or ceased under consent of patient himself and his lineal family. When the above three conditions (a-c) are met, euthanasia can be allowed. But, It can be claimed that there is no moral obligation to maintain a patient′s life in all cases without exception. For example, medicare by medical doctors is faithful to a prime principle of keeping of life, this is an absolute mandate. And also, there are some schools which insist that medical treatment under a premise of expecting death is unaceptable in terms of medical conduct. Second, An ethical position on euthanasia can be considered from a point of situational ethical theory. Argument in support of this position can include the following: a) There must be action to the patient who has limited life and unbearable pain, and hopeless terminal disease. b) Individual choice and liberty, so long as they don′t do any harm to others, should be left to one′s self-control. c) There is no ordinary and moral rules to prohibit euthanasia. The important point is that it should rest with a particular situational state. If sustaining one′s life is worthless in the sense of personality and if its sustaining one′s life results in production of pain only, such a patient should be given a priviledge to take death of his own choice. This is demanded from a humanistic point of view. And so Euthanasia is a required evil, forced to be chosen in certain compelling situations. Third, There are pros and cons on the legality of euthanasia among the people. But we can understood and sympathize with the feeling of an absolutely hopeless patient who, by the use of modern <112tif 입력누락> toward Death when one is still alive. And so, I suggest this issue of a Living will may be one of the main issues of Euthanasia in the future. Life is not merely being alive, but being alive and being well (=Eu-daemonia), & that concept is closely related with the idea of Dying well. (=Eu-thanatos);안락사의 문제는 자신의 삶을 스스로 청산할 수 있는 권한이 없다고 믿는 사람들에게는 논란의 여지가 없는 논제가 되겠지만, 최근에 이르러 안락사의 도덕적·법적 정당성 문제를 둘러싼 논의가 매우 활발하게 진행하고 있다. 안락사는 일차적으로 죽음이 임박한 환자가 견딜 수 없을 만큼 극심한 고통으로 괴로워 할 경우, 또는 의학적으로 회생의 가능성이 전혀 없을 때, 인위적인 방법으로 안락하게 생을 마감하게 하려는 것을 가르킨다. 이러한 '자비로운' 안락사를 둘러싼 도덕적·법적 쟁점들은, 인간에게 과연 "행복하게 살 권리"와 함께 "행복하게 죽을 수 있는 권리"가 있는가?하는 물음에서 비롯된다. 특히 자연적인 죽음의 시기를 조정하려는 하는 안락사의 경우, 그것은 살인이나 청부 살인의 범죄를 구성하는 행위가 되지 않을까 하는 법적인 문제까지 제기되기도 한다. 거기에다가 당사자가 의사를 표시하지 않았거나, 의사 표현이 가능하지 않을 경우 누가 이 환자의 안락사를 결정할 수 있으며 그 시술방법은 어떠해야 하는 문제 또한 그대로 남는다. 따라서 안락사론은 학자들에 따라, 각 분야의 입장에 따라, 또는 사회적 조건에 따라, 그 관점에 의하여 찬·반의 견해차가 생길 수 있어, 현재 안락사를 허용하는 나라와, 이를 허용하지 않는 나라가 있으며, 또 같은 나라에서도 허용 여부는 지역에 따라 차이가 있는 경우도 있다. 본 논문에서는 안락사에 대한 역사적 고찰 및 의학적·법률적·문학적·윤리적 견지에 있어서의 안락사에 대한 찬·반론의 종합적 견해와 아울러, 안락사의 문제와 근본적으로 연관될 수 밖에 없는 고통과 죽음의 문제, 존엄사와 (Death with Dignity) 관련하여 인격개념의 가치 기준과(Criteria on Value of Personality) 무의미한 생존의 기준(Determination of Nonsignificant existance) 그리고 終命遺言(Living Will ; 자기 삶의 종식에 관한 유언)의 문제를 여러 학자들의 견해와 함께, 철학을 공부하는 임상 의사인 견지에서 다루어 보았다. 서양에서는 죽음의 한 방법의 선택적인 면에서, Living Will의 운동이 전개되고 있다고 한다. 필자는 본 논문을 통해 이러한 Living Will의 문제를 동양적인 사상에 입각하여, 죽음의 한 형태가 아닌 삶의 至高한 福의 개념을 도입하여 자기 삶의 종식에 관한 유언적 입장에서「Living Will」을「終命遺言」으로 이해하고자 한다. 동양의 五福중에「考終命」이란 말이 있다 아홉가지를 잘 하였어도 마지막 한가지 실수가 인생의 성패에 결정적 영향을 미치듯이, 평생을 잘 살았다 해도 마지막 잘 죽지 못하면 福된자가 될 수 없다는 뜻이겠다. 따라서 Eu-thanatos는 Eu-daemonia의 결론적 의미를 지니며, 행복한 삶과 아름다운 죽음은 서로 상관성이 있을 것이라는 입장에서 안락사에 대한 새로운 인식의 계기를 마련해 보고자 노력하였다.