Earticle

초록

영어

The Medical law stipulates regulations about the physician’s duty to inform to contribute to patient’s self-determination. This law was most recently revised on December 20, 2016, and came into effect on June 21, 2017. There has been much controversy about this, and it has been questioned whether or not it will be effective for physicians to comply with the duty to inform. Therefore, this study investigated perceptions of physicians of whether they observed the duty to inform and their legal judgment about that duty, and analyzed how the revision of the medical law may have affected the legal cognition of physician's duty to inform. This study was conducted through an online questionnaire survey involving 109 physicians over 2 weeks from March 29 to April 12, 2018, and 108 of the collected data were used for analysis. The questionnaire was developed by revising and supplementing the previous research (Lee, 2004). It consisted of 41 items, including 26 items related to the experience of and legal judgment about the duty to inform, 6 items related to awareness of revised medical law, and 9 items on general characteristics. The data were analyzed using SAS 9.4 program and descriptive statistics, Chi-square test, Fisher’s exact test and Binary logistic regression were performed. The results are as follows. ∙Out of eight situations, the median number of situations that did not fulfill the duty to inform was 5 (IQR, 4-6). In addition, 12 respondents (11%) answered that they did not fulfill the duty to inform in all eight cases, while only one (1%) responded that he/she performed explanation obligations in all cases. ∙The median number of the legal judgment score on the duty to inform was 8 out of 13 (IQR, 7-9), and the scores ranged from a minimum of 4 (4 respondents) to a maximum of 11 (3 respondents). ∙More than half of the respondents (n=26, 52%) were unaware of the revision of the medical law, 27 (25%) were aware of the fact that the medical law had been revised, 20(18%) had a rough knowledge of the contents of the law, and only 5(5%) said they knew the contents of the law in detail. The level of awareness of the revised medical law was statistically significant difference according to respondents' sex (p<.49), age (p<.0001), career (p< .0001), working type (p<.024), and department (p<.049). ∙There was no statistically significant relationship between the level of awareness of the revised medical law and the level of legal judgment on the duty to inform. These results suggest that efforts to improve the implementation and cognition of physician’s duty to inform are needed, and it is difficult to expect a direct positive effect from the legal regulations per se. Considering the distinct characteristics of medical institutions and hierarchical organizational culture of physicians, it is necessary to develop a credible guideline on the duty to inform within the medical system, and to strengthen the education of physicians about their duty to inform and its purpose.

한국어

2016년 12월 20일 신설된 「의료법」 상 설명의무 조항과 관련하여, 시행일(2017. 6. 21)이 일 년여가 지난 지금까지도 그 실효성을 둘러싼 논란이 끊이지 않고 있다. 본 연구에서는 의사 109명을 대상으로 온라인 설문조사를 실시하여 의료현장에서 의사의 설명의무 이행/미이행 경험과 그에 대한 법적 판단을 확인하고, 「의료법」 개정이 의사의 설명의무에 관한 법적 인식에 어떠한 영향을 주었는지 분석하고자 하였다. 연구도구는 기존의 한 연구(이윤영, 2004)에서 사용한 도구를 수정·보완하여 총 41 개 문항으로 구성되었으며 설명의무에 관한 경험 및 법적 판단 관련 26개 문항, 의료법 개정에 관한 인식 관련 6개 문항, 일반적 특성 9개 문항을 포함하였다. SAS 9.4 통계프로그램을 이용하여 자료를 분석한 결과 「의료법」에 설명의무에 관한 내용이 신설되었다는 사실을 모르고 있는 응답자가 전체의 절반 이상이었으며 대부분의 응답자가 설명의무를 이행하지 못한 경험이 있는 것으로 나타났다. 설명의무의 이행 혹은 생략에 관한 13개 사례에 대해 법적 판단을 물은 결과 응답자별 평균 8개 사례에 대해 옳은 판단을 내렸으며, 옳은 판단을 내린 개수는 응답자의 「의료법」 개정 사실에 대한 인식정도와 통계적으로 유의한 관련성을 찾아볼 수 없었다. 이러한 결과에 비추어 볼 때 공법적 제재만으로는 설명의무에 대한 의사의 인식 및 이행 강화에 충분한 효과를 기대하기 어려우며, 의료체계 내부에서 의료기관의 특성과 의사의 조직문화를 고려한 공신력 있는 설명의무 가이드라인 마련과 설명의무와 그 취지에 대한 의사교육 강화를 제언하는 바이다

목차

Ⅰ. 서론
1. 연구 배경 및 목적
2. 의사의 기여성 설명의무
Ⅱ. 조사 방법
1. 자료 수집 및 분석
2. 조사 도구
Ⅲ. 조사 결과
1. 대상자의 일반적 특성 
2. 설명의무에 관한 경험
3. 설명의무에 관한 법적 판단
4. 의료법 개정 사실 및 설명의무 조항에 대한 인식
5. 설명의무에 관한 법적 판단에 영향을 미치는 요인 
Ⅳ. 고찰
Ⅴ. 결론 및 제언
1. 결론
2. 연구의 제한점 및 제언
참고문헌
국문초록
ABSTRACT

키워드

저자

• 김로사 [ Rosa Kim | 연세대학교 보건대학원 ]

참고문헌

발행기관

간행물

표지보기 관심저널 등록

• 간행물명

  의료법학 [THE KOREAN SOCIETY OF LAW AND MEDICINE]

• 간기

  계간

• pISSN

  1229-8069

• 수록기간

  2000~2025

• 등재여부

  KCI 등재

• 십진분류

  KDC 517 DDC 613