응용현상학과 임상의료윤리

Applied Phenomenology and Clinical Medical Ethics: The Case of Richard M. Zaner

제이너의 임상윤리상담은 자문가로서의 윤리학자가 아니라 임상가로서의 윤리학자를 전제로 하는 것처럼 보인다. 그는 지식을 바탕으로 최선의 선택을 조언하는 사람이 아니라 스스로 드러나는 책임 있는 선택을 선명하게 깨닫도록, 혹은 인정하도록 이끄는 역할을 하고 있다. 이 논문은 제이너의 임상윤리상담의 태도와 그 과정을 살펴보고 이런 접근이 한국의 의료윤리학계에서 그 중요성에 어울리는 관심을 받지 못했던 임상윤리상담에 갖는 함의를 논할 기회를 마련하는 데 그 목적이 있다. 그의 주요한 저작과 학문적 방향성을 간략히 살펴본 후, 현상학자로서 제이너의 의철학인 임상적 만남(clinical encounter)을 소개할 것이다. 이어 그의 초기 상담 기록을 바탕으로 그의 현상학자적인 접근이 드러나는 방식과 이런 접근이 갖는 함의를 모색하려고 한다.

This paper explores the intersection of applied phenomenology and clinical medical ethics, focusing on the work of Richard M. Zaner. The paper discusses how philosophers often find themselves in a precarious position in the clinical environment, where their principles, concepts, and theories are not directly applicable to clinical practice. The core argument revolves around the concept of human dignity, autonomy, and the “situated subject” in the context of illness. Zaner's approach to clinical ethics counseling suggests a shift from traditional ethical decision-making processes to a more engaged and dialogical method. He emphasizes understanding the patient's experience and context, considering the complexities of human interaction and communication in medical settings. The paper elaborates on Zaner's life and major works, his commitment to phenomenology, and his significant contributions to medical ethics. Zaner's methodology in clinical encounters and ethical consultations is examined, showcasing his unique approach to addressing ethical dilemmas in healthcare. Two cases are presented to illustrate Zaner's method in practice. The first case discusses the ethical dilemmas surrounding a critically ill newborn and the parents' role in decision-making. The second case involves the ethical considerations in the treatment of a terminally ill patient, highlighting the complexities of family dynamics and decision-making processes. In conclusion, the paper asserts that Zaner's achievements demonstrate the potential benefits of a phenomenological approach to clinical ethics. It suggests that this approach can bridge the gap between theory and practice in medical ethics, providing a more holistic and empathetic way of addressing ethical issues in healthcare.