응급환자에 대한 설명의무는 어디까지인가?

Abstract

PURPOSE: The number of medical malpractice suits on violation of informed consent is on the rise. While the medical community can encourage its members on informing their patients, the legal community has a considerable amount of studies on the subject. However, there has not been any systematic debate on the subject for emergency medical situations. The exemption of informed consent in emergency medical situations seems to be the common notion. Nevertheless, the recently enacted Emergency Medical Services Law mandates the provision of informed consent in emergency medical situations by the emergency medical personnel. Therefore, a systematic research focusing on the informed consent in emergency medical service was necessary. METHOD: This was a qualitative study by survey. The results of the opinions of emergency physicians surveyed was compared to previous studies by the legal community on informed consent. RESULTS: The legal community view informed consent as a legal duty. But the emergency physicians view it as a part of much professionalized medical act, so the professional ethics should guide the acquisition of informed consent. The legal community and the judicial precedents exempted informed consent in an emergency. But the emergency physicians see informed consent in emergency medical service equal to that of any other medical situation, only that it can be delayed. The emergency physicians have to provide an explanation for each step of the process, but the method varies and the unified form of informed consent provided by the law is not suitable. Informed consent should be acquired even in an emergency like cardiopulmonary resuscitation (CPR), but it can be delayed until the end. Professional ethics should guide the initiation of CPR, but the termination of CPR should be under the informed consent. Non-urgent patients should be informed even in an overcrowded emergency room. The duty is not released or relieved solely on the reason that it is the emergency room. CONCLUSION: There is a difference in opinion between the legal and the medical community, but for the benefit of the emergency patients a compromise should reached.