Article

연명치료중단과 유보 결정에 대한 한국 중환자 전담의사 인식과 실행

김소윤1, 강현희2, 고윤석3, 고신옥4,
So Yoon Kim1, Hyun Hee Kang2, Younsuck Koh3, Shin Ok Koh4,
Author Information & Copyright
1연세대학교 의과대학 의료법윤리학과
2연세대학교 의료법윤리학연구소
3울산대학교 의과대학 내과학교실
4연세대학교 의과대학 마취통증의학교실
1Department of Medical Law & Ethics, Yonsei University College of Medicine
2Yonsei University, The Asian Institute for Bioethics and Health Law
3Department of Internal Medicine, University of Ulsan College of Medicine
4Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute Yonsei University College of Medicine
교신저자: 고신옥. 연세대학교 의과대학 마취통증의학교실. 마취통증의학 연구소. 02-2228-2420. sokoh@yuhs.ac

ⓒ Copyright 2009 The Korean Society for Medical Ethics. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: Mar 31, 2009

ABSTRACT

Purpose: This study was performed to evaluate both the attitudes and practices of critical care physicians in Korean ICUs regarding end-of-life care decisions as well as the factors that influence those attitudes and practices.

Methods: A questionnaire was developed and delivered to 100 members of the Korean Society of Critical Care Medicine in September 2007. The questionnaire was divided into six parts including personal information, decision-making processes, the withdrawing and withholding of life-sustaining treatment, informed consent, consultation with ethics committees, and guidelines.

Results: Eighty eight responses from 53 different institutions were received. The results of the questionnaire include the following. There was a significant difference between the attitude and practices of respondents concerning family consent and patient’s consent. Attitudes toward patient and family consent differed significantly according to the clinical experiences of the respondents (p<.05). There was a significant difference between the attitudes and practices of respondents concerning how often caregivers effectively communicated with patients and family members. Attitudes toward family participation in decision-making processes differed significantly according to the respondents’ gender. There was also a significance difference between the attitudes and practices of respondents regarding the withdrawal of life-sustaining treatment. Attitudes and practices on this issue varied according to the type of ICU where the respondents worked and their medical specialty. Practices concerning informed consent for “do not resuscitate” orders varied significantly according to respondent’s age and type of ICU. Finally, attitudes on the participation of ethics committees in decision-making processes varied significantly according to respondent’s clinical experiences (p<.05).

Conclusions: This study found significant differences in the attitudes and practices of critical care physicians in Korean ICUs concerning end-of-life care decisions and the withdrawing and withholding of life-sustaining treatment. The study also found that the factors influencing these attitudes and practices include age, specialty, clinical experiences, and the types of ICU in which physicians work. However, there are some limitations in generalizing these findings.

Keywords: 연명치료중단 결정; 윤리위원회; 주치의; 연명치료 및 연명치료중단
Keywords: End-of-life care decision; Korean ICU; Critical care physician; Withholding and withdrawing life sustaining treatment


한국의료윤리학회지 28권 2호 모집


한국의료윤리학회지는 1997년에 창립된 한국의료윤리학회의 공식 학술지이자 한국연구재단 등재학술지로서, 임상현장에서의 윤리, 의료윤리교육, 그리고 의학 및 생명공학 기술 발전으로 제기된 삶과 생명 문제에 대한 윤리적 ∙ 철학적 ∙ 법적 ∙ 사회적 성찰에 대한 여러 분야 연구자들의 학술연구 결과를 게재하고 있습니다.

 

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