고령자 웰다잉(Well-Dying)을 위한 법제 개선 방안 (1) — 호스피스･완화의료와 연명의료결정을 중심으로 —

The purpose of this paper is to analyze the current status of well-dying from a legal perspective and to seek improvement points for well-dying, which is relatively abstract and approached from various perspectives as part of the study of the elderly. As one of the research areas of well-dying to be discussed from a legal perspective, this paper focused on hospice (physical, social, and mental care for terminally ill cancer patients or terminally ill patients who are nearing the end of life so that they can die a natural death with human dignity), palliative care (medical care aimed at alleviating the pain and symptoms caused by the disease rather than improving the disease) and life-sustaining medical decisions First, the current status of legislation and operation related to hospice and palliative care were reviewed. In addition, the following three points were proposed as measures to improve the current legal system. The first is to expand the scope of hospice and palliative care from the current five diseases, and this requires an amendment to Article 2, paragraph 6 of the Act On Hospice And Palliative Care And Decisions On Life-Sustaining Treatment For Patients At The End of Life (hereinafter referred to as the Life-Sustaining Treatment Act). Second, it is necessary to designate a hopice specialized institution and expand the training and support of hospice personnel, and for this, it is required to establish governance through the role of local governments to actively support local governments' policies. Third, there is a need for publicity and awareness that can encourage the active participation of hospice and palliative care professionals. Next, as a discussion about decisions on life-sustaining treatment, this paper reviewed the relevant provisions of the Life-Sustaining Treatment Act, which legally regulates life-sustaining medical treatment. And as an improvement plan, the following three points were proposed. First, the timing and decision maker were reviewed with regard to the provisions that a person must make a decision on life-sustaining treatment in advance with a written statement called “advance statement on life-sustaining treatment” and such decision is made by the agreement of all family members in the case of a medical condition that does not allow such an expression of intent without prior decision-making. Second, it is proposed to include terminally ill patients as a decision-makers of discontinuation of life-sustaining treatment. Third, it is reviewed about various supports for follow-up measures in the process of implementing decisions such as the termination of life-sustaining treatment.