평가적 개념으로서의 존엄사 시론(試論)

In recent years, public interest in death with dignity has been growing in South Korea, as evidenced by the introduction of the so-called “Assisted Death with Dignity Bill” in the National Assembly. However, current discourse on the issue remains conceptually fragmented and lacks a coherent theoretical framework. The term “death with dignity” is often conflated with passive euthanasia, the withdrawal of life-sustaining treatment, or physician-assisted suicide, leading to significant conceptual ambiguity. This confusion hinders ethical justification and legal assessment of assisted dying, posing a fundamental obstacle to its normative evaluation. This study begins with the recognition of such conceptual and normative disarray and seeks to redefine “death with dignity” as an evaluative concept. It proposes a value-oriented approach that integrates constitutional principles with medical ethics. Death with dignity is inherently complex, involving inseparable interactions between medical facts and value judgments. Accordingly, it demands more than technical solutions or procedural regulation; it requires deep reflection on the fundamental values and meanings of human life. From a constitutional perspective, death with dignity must be understood within the framework of fundamental rights centered on the principle of human dignity. Rather than viewing the right to life and the right to self-determination as dichotomous, the study explores ways to harmonize them under the overarching value of human dignity. As illustrated by the 2020 judgment of the German Federal Constitutional Court, self-determination encompasses the right to decide when and how to end one's life. However, this is not an absolute right but one whose scope must be defined in harmony with the entire constitutional value system. In the field of medical ethics, this study introduces the notion of relational autonomy as an alternative to traditional individualistic conceptions of autonomy. Relational autonomy is based on the recognition that a patient’s autonomous choices are shaped and realized within relationships—with family, healthcare providers, and the community. This approach does not view vulnerability and dependency as impediments to autonomy but as essential conditions for achieving a deeper form of self-determination. Ultimately, constructive social dialogue rooted in empathy and care is essential for advancing the discourse on death with dignity. The demand for a dignified death emerges from the deeply human desire to maintain humanity even in the face of extreme suffering and anxiety. Therefore, this discussion must begin with sincere empathy for the specific pain experienced by patients and families, and move beyond ideological polarization toward broad-based social consensus.