의사의 프로페셔널리즘과 진료자율권

Physicians' dual roles -healer and professional - are linked by codes of ethics governing behaviour and are empowered by science. Being part of a profession entails a societal contract. The profession is granted a monopoly over the use of a body of knowledge and the privilege of self-regulation and, in return, guarantees society professional competence, integrity and the provision of altruistic service. Societal attitudes to professionalism have changed from supportive to increasingly critical-with physicians being criticised for pursuing their own financial interests, and failing to self-regulate in a way that guarantees competence. Physician's professional autonomy in Korea has been threatened by several factors. The most important are the unreasonable national healthcare system and negligence of education of the professionalism in medical schools. It asserted that physicians exploited their monopoly to create a demand for services which they then satisfied. It identified serious failures in self-regulation, and abuse of collegiality to protect incompetent or unethical physicians. It criticised physicians for pursuing their own financial interests at the expense of both individual patients and society. For the ideal of professionalism to survive, physicians must understand it and its role in the social contract. They must meet the obligations necessary to sustain professionalism and ensure that healthcare systems support, rather than subvert, behaviour that is compatible with professionalism's values. In this, they acquire responsibility for its integrity, for its proper application, and for its expansion, which, for medicine, means the support of science. Professions have an obligation to transmit their knowledge by teaching it to future practitioners, the general public, and their patients. Even if the medical profession itself carries out ethical value education, it is unlikely that the values cherished by physicians for centuries can be preserved unless their preservation is encouraged and supported by society through the structure of the healthcare system. Healthcare systems can actively promote desirable behaviour or they can encourage physicians to place their own interest first. Without question, the medical profession itself wishes to function within a system dominated by a healthy and flourishing professionalism. Both government and publics should wish for the same type of physician- competent, moral, idealistic, and altruistic. This is best guaranteed by a reasonable health care system.