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KMID : 1011120140080020227
Bioethics Policy Studies
2014 Volume.8 No. 2 p.227 ~ p.252
Analysis and Criticism of Korean Supreme Court¡¯s Decision on Grandma Kim¡¯s Case - Conflicts between Respect for Self-determination and Best Interests for a Patient -
Choi Kyung-Suk

Abstract
Korea Supreme Court¡¯s case of Grandma Kim is an important cornerstone for the withdrawal of life-sustaining treatment in a relatively short history of Bioethics in Korea. The Court¡¯s decision has its significance in that it declares, in principle, a patient¡¯s right of self-determination on his/her treatments. However such a right should be very carefully exercised under a very restricted circumstance. The Court shows that when a patient has been in the irreversible procedure of dying, his/her withdrawal of lifesustaining treatment is allowed with the satisfaction of some qualification. But the Court takes a mistake in mentioning the irreversible consciousness as an element of the irreversible procedure of dying. The Court accepts not prolonging the end point of death on the basis of the conception of natural death. However, the Court does not fully develop the logic of the conception and also appeals to the principle of respect for selfdetermination. This reveals that the Court does not fully understand the logical implications of the principle of respect for self-determination. This problem results in restricting the scope of self-determination. Thus, the Court¡¯s argument is totally different from those of Quinlan¡¯s case and Cruzan¡¯s case in America, which focus on the principle of respecting for autonomy. Although the Court finally follows substituted judgment standard, it appeals to both best interests for a patient and respect for self-determination with the misuses of these principles. In addition, the Court¡¯s decision shows its limitation in that it deals with one of issues related to lifesustaining treatment, that is, the issue of artificial respiratory device alone.
KEYWORD
Grandma Kim¡¯s case, withdrawing or withholding life-sustaining treatment, respect for autonomy, best interests for a patient, advance directives
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