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| 발행년 : | 2018 |
|---|---|
| 구분 : | 학위논문 |
| 학술지명 : | 학위논문(박사)-- 대구가톨릭대학교 대학원 : 문화영성학과 |
| 관련링크 : | http://www.riss.kr/link?id=T14753341 |
한국사회의 사전연명의료의향서 및 연명의료계획서 적용에 관한 윤리신학적 고찰
= Contemplative Moral Theological Application of Advance Medical Directives and Advance Care Planning for Korean Society
저자[authors] 홍준표
발행사항 경산 : 대구가톨릭대학교 대학원, 2018
형태사항[Description] xi, 236 p. ; 26 cm
일반주기명[Note] 지도교수: 김정우
학위논문사항[Dissertation] 학위논문(박사)-- 대구가톨릭대학교 대학원 : 문화영성학과 2018. 2
발행국(발행지)[Country] 경상북도
출판년[Publication Year] 2018
주제어 윤리,연명의료
소장기관[Holding] 대구가톨릭대학교 중앙도서관 (247023)
초록[abstracts]
As the life expectancy increased due to the improvement of the medicine, our society has entered the aged society beyond the aging society, and individual period of old age has become longer. Also, today's advanced medical technology has been able to pull or slow down death. Despite the medical achievements, this artificial control of human life has been causing various ethical problems. Unlike in the past, life is now assessed by practicality and relativism, or judged by utilitarianism. Thus, it is expected that conflicts surrounding the death would increase due to advancing medicine and longer life expectancy. Therefore, people began to ignore the life ethics with justifications such as passive euthanasia and death with dignity, and even continue on meaningless medical care which only extends biological lifespan. Such life-sustaining treatment may lead to medical futility. The rights for death with dignity of end-stage patients who need to face death naturally, are violated by those who are left behind. Extending the time of death does not mean that death will never come. Meaningless life-sustaining treatment gives patients more period of suffering rather than extending their lifespan. Some may insist on euthanasia, claiming the right to die with a reason that it will relieve one from extreme suffering, but this is merely a murder, not a merciful act. The right to life only belongs to God. Nevertheless, people misunderstand the concept of death and they are asserting wrong opinions. To prevent this, our study began with a necessity that people need to face the death with dignity in a Christian way by writing Advance Medical Directives or Advance Care Planning to proceed a planned medical care without intentionally terminating or denying life.
The purpose of this study is to help people to face death with dignity through right understanding of life and death.
In the first chapter, this paper focused on life. In the beginning, the theory of the origin of life and natural science point of view were discussed to understand life. Yet understanding the nature of life could not be resolved by ignoring the spiritual aspect of life. The religious interpretation of life was inevitable. Accordingly, perspectives of life from various religions were investigated. Based on the Christian perspective of life from the revelation, the origin of life comes from God. Also, other religions beside the Christianity discuss the value of life and primitive noble value of human life with their own view of life. Thus, each religion is commonly positive about the present value of life and its role. In particular, each emphasizes that the value of human life does not came from any ability or appearance, but rather comes from the existence itself.
The second chapter unfolded problems about death, centered on various ethical debates arising from misunderstanding the concept of life. Although human life must begin and end unharmed at any circumstance, the rapid development of biotechnology and medicine has provoked human intervention of life. Depending on the situation of patients, a patient may extend its own lifespan or refuse meaningless prolongation of life. However, these demands deprive patient’s opportunity to face death with dignity as a human being, which is coupled with the life-sustaining treatment, or provoke serious ethical conflicts, claiming the right to die by asking for euthanasia. Therefore, this study indicated problems of life-sustaining treatment and medical futility, and passive euthanasia and its cessation, then presented guidelines of the Catholic Church. Fundamentally, the Catholic Church never allows any act of killing or accepts passive euthanasia.
In the third chapter, solutions regarding the life-sustaining medical issues were attempted to avoid any denial of universal value at imminent death and conflict between a patient’s life and medical ethics. Even though the value of life and graceful way of death are constantly being mentioned, in real medical environment, the value of life is often relativized for just one’s own freedom or social cost. To solve such problems, before a patient becomes critical, he or she must sign the Advance Medical Directives or Advance care Planning, plan a future treatment after consulting with a doctor, and then finally determine whether to continue on the life-sustaining treatment. The life-sustaining treatment must not simply be a meaningless extension of biological life. Also, decision to stop the treatment must not lead to undesirable death, which is against the teachings of the Catholic Church that highly values the sacredness of life and the good of patients.
In the forth chapter, to apply the Advance Medical Directives and Advance care Planning according to the teachings of the Catholic Church in the Korean society, potential obstacles and the role of the church to overcome them were suggested. The reason that the death is not accepted well among Koreans, especially by the Korean Catholic, was discussed. As a result, it was found that the right perception of death comes from the formation of the right life values. Here, this study corrected any inappropriate view that limits right application of the Advance Medical Directives and Advance care Planning, and suggested a necessity of death education by the church as its role to settle the proper culture of death. Accordingly, this study first reviewed the general understanding of death a part of death education, and then discussed views of philosophy and religion that have demonstrated and solved problems of death. Then, as advanced course of the death education, the Bible, the Catechism of the Catholic Church, and theological interpretation were illuminated and lastly practical solution was suggested.
The conclusions from this study are as follows.
First, no one should harm any innocent life with misunderstanding of life, and everyone is given an ethical mission to protect the dignity of human life.
Second, the right to die must not be chosen by the will and action of others, and a human being has the right to face a peaceful death with dignity.
Third, medicine and society have obligations to ensure that human beings die with the highest dignity, and the Advance Medical Directives and Advance Care Planning must be completed.
Fourth, to properly understand death and face death with dignity, death training and death preparing education are necessary. These may help to apply the Advance Medical Directives and Advance Care Planning effectively.
Death is a part of human existence. As M. Heidegger's existentialism and K. Rahner's existential theology suggest, the perception of death is a perception of life, and rejection or avoidance of death is also refusal or a avoidance of life. Oftentimes, people have difficulties accepting death even at imminent death due to lack of proper insight and preparation for death. In order to resolve such conflicts and face death with dignity as a human being, the Advance Medical Directive and Advance Care Planning are necessary. However, the decision not to prolong one’s life with the life-sustaining treatment should be an expression of love and care, not utility. The reason is that the practice of worthy freedom for human beings excludes impersonal judgment of utility. Death with dignity is the matter of right to life as well as the matter of life. The right to life means that it does not end a living patient, nor insists on unnecessary, meaningless, and unprofitable medical practices, and indicates the rights for an end stage patient to receive a proper care and face death peacefully. For this reason, the Catholic Church positively accepts suspending the life-sustaining treatment and implementing hospice palliative care to accept death as a part of life.
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