의료에서의 사전의사결정(advanced directives)에 대한 도덕적 검토

It was the case of Boramae hospital in 1999 to initiate the deep concern about advanced directives in korean medical community. This medico-legal case is now in process at higher court.

Advanced directives are the statement that express what one want to happen to him when he lose the capacity for making decision. There are three basic forms of advanced directives, namely instruction directive, designation of a proxy decision maker, manifestation of values history, and combination forms of them.

our medical circumstance, the introduction of advanced directives would increase the autonomy and, hence, goods of patients. And it would not do much harm to their families, physicians, and other people at least. Therefore it can be justified on the bases of the principle of patient autonomy and the principle of beneficence.

We believe that the best process introducing advanced directives to korean society is as follows;

1. Pilot trial at one institution with careful concern

2. Advanced directives will revise forms and make improvement based in initial experience from pilot trial by Korean Medical Association level.

3. Law making process will be proceeded according to the result of pilot trial and KMA revision.