‘Death with dignity’ patient dies after 201 days

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‘Death with dignity’ patient dies after 201 days


After breathing on her own for 201 days, a comatose woman, whose artificial respirator had been removed under a court ruling based on her presumed will for “death with dignity,” died yesterday. Kim Ok-gyeong was 77 years old.

“She died of multiple organ failure including pulmonary edema and kidney dysfunction,” Dr. Park Chang-il, head of Yonsei University’s Severance Hospital, said in a press conference yesterday. “Based on the Supreme Court ruling, we removed the artificial respirator from her on June 23 of last year. She, however, has been receiving other treatments such as oxygen and a nutrition supply.”

“The court ruling was about turning off the respirator, so we did provide other treatments,” Park said. “We express our condolence to the family and wish her to rest in peace.”

The woman fell into a coma in February 2008 as a result of bleeding during a lung biopsy at the Severance Hospital. Later, her children asked a local court to grant them legal permission to stop medical treatment that was keeping her alive. Despite the hospital’s resistance, the Supreme Court ruled in May of last year that the artificial respirator be terminated. Based on the way she acted and talked before she fell ill, the court said the patient would have wanted such action.

Dr. Park Mu-seok, the physician who was in charge of Kim, said yesterday the family had rejected an artificial respirator, cardiopulmonary resuscitation and blood transfusions, but asked for internal treatments such as providing antibiotics, oxygen and nutrition when necessary.

“It is inaccurate to say that she died because her life support system was removed,” Park Chang-il said. “Stopping life support treatment is about ending all treatments including nutrition and oxygen,” he said. “In her case, the artificial respirator was removed, but other treatments were given.”

The Severance head also said it was medically inappropriate to discuss “death with dignity” with her case. “The death of Cardinal Stephen Kim Sou-hwan is a case of the death with dignity. When a terminal patient, like the cardinal, is about to die, no measures to lengthen his life were taken and I think that is the death with dignity,” Park said. “In her case, only the artificial respirator was turned off. Medically speaking, death with dignity is not an appropriate expression for this case.” Asked if removal of the artificial respirator was a direct cause of her death, Park said she would have lived longer if it had been used.

By Ser Myo-ja [myoja@joongang.co.kr]

Related Korean Article

연명치료 중단 201일 만에 사망

‘존엄사’ 논쟁에 불을 지폈던 김모(78) 할머니가 10일 숨졌다. 대법원의 판결에 따라 인공호흡기를 뗀 지 201일, 의식불명 상태가 된 지 328일 만이다. 고인이 입원해 있던 연세대 세브란스병원의 박창일 연세의료원장은 10일 “김 할머니가 낮부터 호흡이 불규칙해지며 상태가 나빠지다 오후 2시57분쯤 사망했다”고 발표했다.

김 할머니는 직계 가족들이 지켜보는 가운데 숨을 거뒀다. 김 할머니는 병상에서 ‘자연스러운 죽음이란 무엇인가’라는 질문을 우리 사회에 던졌다. 반면 ‘법원 판결에 의한 죽음의 방식’에 대해서는 논란을 일으키기도 했다. 그는 의학적으로 회생이 불가능하다는 판정을 받았다. 이런 환자에 대한 연명치료 문제를 공론화하는 계기가 됐다. 각 병원 중환자실에서 흔히 제기되는 것인 데도 이른바 ‘보라매병원 사건’의 여파로 의료계에서는 금기된 이슈였다. 보라매병원 사건은 식물 상태의 환자를 보호자 요구에 따라 퇴원시켜 줬던 담당 의사가 2004년 대법원에서 살인방조죄 판결을 받은 것이다.

◆입원에서 사망까지=김 할머니는 2008년 2월 폐암이 의심돼 기관지 내시경 시술을 받던 도중 식물인간이 됐다. 자녀들은 인공호흡기를 떼어 달라며 소송을 제기한다. “평소 깔끔했던 어머니였다. 중환자실에서 벗은 몸에 시트 하나 걸치고 인공호흡기와 소변줄·수액 등을 주렁주렁 달고 누워 생명만 유지하는 모습은 결코 원하지 않을 것”이라는 주장이었다. 국내에서 완전한 뇌사가 아닌 식물 상태 환자의 연명치료 중단을 놓고 소송이 제기된 것은 처음이었다.

사회적 격론 끝에 지난해 5월 대법원 전원합의체가 인공호흡기 제거를 명한 원심판결을 만장일치로 확정했다. 그러나 호흡기를 떼면 곧 사망할 것이라던 의료진의 예상은 빗나갔다. 김 할머니는 스스로 호흡을 이어 갔다. 호흡수·맥박·혈압·산소포화도 등 주요 생명신호(vital sign)도 비교적 안정적이었다. 그동안 영양 공급 등은 임종 시까지 계속됐다. 그러나 10일 고비를 넘기지 못했다.

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