임종기 진료결정과 관련된 윤리적 문제에 대한 내러티브 분석: 말기 암환자들을 대상으로*

In order to understand fully the issues involved in end-of-life care decisions, it is important to know the genuine wishes and thoughts of terminal patients themselves. This article reports on a narrative analysis of the data drawn from structured interviews with a number of terminal patients suffering from critical diseases such as cancer. Most patients approve of the withdrawal of life support treatment in irreversible and extremely painful conditions. They also admit the necessity of “advance directives” and even active euthanasia. However, their attitudes toward disease and death are emotionally complex. In facing their own death, patients need more emotional/medical support and pain control. Their relationships with family members or friends are also critical in this regard. Terminal patients are not entirely satisfied with current methods of communication with care givers, although they appreciate their concerns and goodwill. This analysis concludes that it is necessary to approach end-of-life care decisions in a more subtle and humane way that should be customized to the demand of each individual patient these decisions should be treated as part of the overall medical care given to terminal patients.