연명치료중단 결정에서 의학적 무의미함(medical futility)

Abstract

Most discussions about medical futility focus on the determination of when continued medical treatment is futile. However, there are no simple answers to this question, despite best efforts to define medical futility. Decisions concerning medical futility should involve not only physicians,but also patients and their family members, since value judgments are also relevant to the determination of medical futility. This raises the question of who actually holds the authority to make final decisions concerning medical futility. In this article we argue that shared decisionmaking should occur between patients, physicians, and family members. Even if disagreements arise in the decision-making process, each party’s opinions should be voiced and taken into consideration in reaching a resolution. Furthermore, we argue that, for the purposes of establishing a futility standard, what is needed is not a fixed and invariable law, but a process, which assists patients, physicians, and family members to debate, consult, and reach a resolution. In other words, communication skills as well as policy guidelines are required in order to optimize decision-making concerning medical futility.