인폼드 컨센트(Informed Consent)의 법리구조 (The Structure of Legal Principles in Informed Consent)

서지정보

· 발행기관 : 한국법학회
· 수록지 정보 : 법학연구 / 33호 / 111 ~ 134페이지
· 저자명 : 최상회, 윤종민

초록

환자 자신의 몸에 어떤 일이 발생하였는가를 관리하는 환자의 법적, 윤리적 권리와 치료에서 환자를 돌보는 의사의 윤리적 의무로부터 시작하는 인폼드 컨센트(Informed consent)법리는 환자에게 충분한 정보를 제공하여 그 자신의 치료에 관한 선택을 할 수 있도록 하는 과정이라고 할 수 있다.
환자 쪽의 이해는 제공되는 정보만큼 똑같이 중요하기 때문에, 대화는 문외한인 환자들이 쉽게 알 수 있는 용어로 진행되어야 하고, 환자는 설명을 듣는 과정에서 이것을 이해할 수 있을 것이다.
인폼드 컨센트 법리는 수술 전 환자와의 대화나 병원에서의 의학적 동의서 형식들은 좋은 치료에 필요한 권한을 주는 것이기 때문에 이 동의서가 강압적인 상황에서 이루어지면 안될 것이고, 환자가 자유롭게 의사결정을 할 수 있도록 해야 할 것이다.
이 논문에서는 인폼드 컨센트 법리구조의 전반적인 내용들과 우리나라의 판례를 유형별로 알아보고 특히 그 한 축인 설명의무의 범위와 관련하여 많은 논쟁이 있지만 설명의무를 검토하는 단계적인 방법들을 통하여 의료법에서의 설명의무조항 신설의 필요성을 언급하고자 하였다.

영어초록

Informed consent is the process by which a fully informed patient can participate in choices about her health care. It originates from the legal and ethical right the patient has to direct what happens to her body and from the ethical duty of the physician to involve the patient in her health care.
The informed consent doctrine is generally implemented through good healthcare practice: pre-operation discussions with patients and the use of medical consent forms in hospitals. However, reliance on a signed form should not undermine the basis of the doctrine in giving the patient an opportunity to weigh and respond to the risk.
The most important goal of informed consent is that the patient have an opportunity to be an informed participant in his health care decisions. It is generally accepted that complete informed consent includes a discussion of the following elements: (ⅰ) the nature of the decision/procedure, (ⅱ) reasonable alternatives to the proposed intervention, (ⅲ) the relevant risks, benefits, and uncertainties related to each alternative, (ⅳ) assessment of patient understanding, (ⅴ) the acceptance of the intervention by the patient
In order for the patient's consent to be valid, he must be considered competent to make the decision at hand and his consent must be voluntary. It is easy for coercive situations to arise in medicine. Patients often feel powerless and vulnerable. To encourage voluntariness, the physician can make clear to the patient that he is participating in a decision, not merely signing a form. With this understanding, the informed consent process should be seen as an invitation to him to participate in his health care decisions. The physician is also generally obligated to provide a recommendation and share her reasoning process with the patient. Comprehension on the part of the patient is equally as important as the information provided. Consequently, the discussion should be carried on in layperson's terms and the patient's understanding should be assessed along the way.
I would like to suggest a step by step method in reviewing the physician breach of his obligation to explain.
Although there is still some controversy over the exact scope of facts that the physician must explain.
The physician must explain (ⅰ) the specific method of treatment, (ⅱ) matters required for obtaining informed consent or approval from the patient and (ⅲ) financial impact of the treatment.
Some of the medical problems that physician confront cannot be solved merely through the application of objective medical knowledge and technology. Some medical problems involve a moral dimension related to the life of the patient. Therefore, physician shoud be interested, not only in medical technologies and techniques, but also in the lives of their patients.

참고자료

· 없음