치매와 의사결정지원- 미국의 의사결정지원법(Supported Decision- making Law)의 검토를 중심으로 -

Dementia is a disease in which cognitive function has gradually deteriorated, and dementia patients experience various difficulties in the areas of daily life function, and serious symptoms such as depression, hallucination, and violence may be accompanied in the end. Dementia patients have difficulty protecting their rights or defending against danger because they are accompanied by mental constraints along with weakening physical function. Elderly people with weak family support systems to provide appropriate care may be infringed on their rights, so the existence of assistants who actively support the will of the elderly and guarantee their rights is required. In Korea, it is questionable whether the adult guardianship system and the system to support the decision-making of those with insufficient decision-making skills are implemented, but the utilization rate is not only low, but also actually helps patients lead their lives through decision-making support, and respects their autonomy. Respect for patient autonomy can be said to be the basis of medical law. Even if adults have the right to make medical decisions on their own and are judged to lack decision-making ability, the law must prepare procedures to reflect the patient's values, beliefs, and preferences. In particular, it is most important to ensure patient autonomy in connection with the physical integrity of dementia patients, and the domestic adult guardianship system is mainly used in relation to property management and is evaluated as systematically insufficient in terms of personal protection. In this paper, the domestic system for medical decision-making of dementia patients and the decision-making support system in the United States are reviewed and considered comparatively.