사전지시와 Physician Orders for Life-Sustaining Treatment의 윤리적ㆍ법적 쟁점*

Abstract

This article examines advance directives (ADs) and physician orders for life-sustaining treatment (POLST), analyzes the differences between them as well as the differences between their English and Korean versions, considers some of the legal and ethical issues surrounding ADs and POLST, and proposes directions for their improvement in South Korea. In the United States, ADs consist of living wills and durable powers of attorney (DPA), both of which have merits and defects and give rise to unique ethical issues. However while POLST overcome some of the limitations of ADs, they cannot fully replace them. This article argues that ADs and POLST have a complimentary relationship. While Korean ADs are similar to those in the United States, the introduction of DPA into Korea may be difficult due to some special features of Korean culture. It is argued that public debate and academic analysis concerning the identity of proxy decision-makers is needed in order to prepare the legal and ethical ground for surrogate decision-makers in Korea. Additionally, this article emphasizes the need for establishing an institution that can assist patients in crafting ADs.