시신기증 영향요인 및 활성화 방안에 관한 연구

국문 초록 (Abstract)

국문초록

최근 의학교육의 추세는 실기위주의 교육으로 변화되고 있고 더불어 다양한 치료법의 개발과 치료 기술의 습득에 해부실습의 중요성 역시 증가하고 있다. 우리나라 의과대학의 해부실습은 주로 시신기증을 통해 이루어지고 있으나, 공급의 부족으로 시신의 수입과 원정 해외 해부실습이 이루어지고 있어, 비윤리적이고 불법적인 사회문제의 야기 가능성이 있다. 이러한 사회적 문제의 해결 방안으로 본 연구에서는 시신기증 활성화에 주안점을 두고 시신기증 활성화 영향요인을 비교하여 활성화 방안을 제시하였다.

연구방법은 선행연구의 검토에서 도출된 시신기증 영향요인과 시신기증 현황에서 도출된 문제점을 종합하여 시신기증 활성화 영향요인 들을 1차수준의 영향요인(인구학적 특성, 법적·제도적 특성, 전통적 유교관의 개선)과, 2차수준의 하위요인(연령, 교육수준, 소득수준, 시체해부 및 보존에 관한법률의 개정, 기증자에 대한 예우의 확대, 시신의 훼손을 꺼리는 문화의 개선, 화장을 꺼리는 장제문화의 개선)으로 분류하여 관련업무를 담당하고 있는 의과대학의 책임자나 담당자를 대상으로 전문가 설문을 실시하였고, 계층분석법(AHP)을 적용하여 영향요인 간 쌍대비교를 통하여 중요도를 파악하였으며, 이중 통제 불가능한 요소를 배제하고, 통제 가능한 요소에 대한 활성화 방안을 제시하였다.

이렇게 도출된 시신기증 활성화 방안은 다음과 같다.

첫째, 시신기증 홍보 활성화로 단순한 홍보활동 뿐만 아니라 시신기증에 대한 이해와 지식을 높일 수 있는 교육프로그램과 병행되며, 기증자들이 사회적 기여도에 대한 자긍심이 전통적 유교관 으로 인한 시신기증 거부감을 상쇄시킬 수 있는 있는 방향으로 전개되어야 한다.
둘째, 기증자와 유가족에 대한 사회적 예우와 보상으로 기증자에게는 사회적 기여도의 자긍심을 느낄 수 있고, 사회의 존중감이 표출되는 방향으로 이루어 져야 하며, 유가족에게는 직접적인 금전적 보상보다는 가족을 잃은 상실감을 감소시킬 수 있는 적절한 사회적 보상이 이루어 져야 한다.
끝으로 시체해부 및 보존에 관한 법률의 개정으로 기증시신에 대한 효율적 관리와 사용을 위하여 장기기증 및 조직기증과 시신기증을 모두 총괄하는 통합법을 제정하여 하나의 감독기관에서 관리할 수 있도록 하여 법령의 입법취지와 현실과에 뒤처지는 점을 보완하고 각 지역별, 의과대학별 차이를 감소시켜 효율적인 해부실습교육이 이루어 질수 있도록 하여야 할 것이다.


주제어: 시신기증, 장기기증, 조직기증, 해부실습, 시신기증 활성화 방안

다국어 초록 (Multilingual Abstract)

A Study on Impact Factors and Their Promotion remedies of Body Donation


Today, the medical education is more based on developing practical experiences including treatments, techniques as well as dissections of human bodies. In Korea, most of medical schools are conducting dissection practice by using donated bodies. However, due to the short supply of donated bodies, they import corpses and conduct practice education abroad, which might bring about immoral and illegal social problems. Under the background, the purpose of study is to discuss the remedies to promote body donations by analyzing their impact factors.
The major findings are as follows. The crucial impact factors of body donation were classified into the first (high level) and second (low level) categories, whose weight and importance were analyzed by the AHP (Analytical Hierarchy Process) method. The first category include Demographic characteristics, Legal·Institutional characteristics and Traditional Confucianism. The second category include Age, Education level, Income level, Amend of The Act of Corpse Dissection and Preservation, Compensate for the expansion of the donor, Promotion of the body donation, Improvement of the hostility to the idea of body donation, and Improvement of the hostility to the idea of cremation

Three policy recommendation are suggested to promote the body donation. Firstly, the promotion activities should be carried out along with the educational programs which may provide knowledge and information about body donation. Also, donators should be educated to take great pride in their contribution to society rather than being hostile to the idea of body donation.
Secondly, donators and their families should be treated with social respect and reward so that they can feel pride for their contributing to social welfare. Instead of receiving direct pecuniary rewards, the donators’ families need to be compensated for psychological damage of losing a family member.
Finally, for the effective use and management of donated bodies, we should amend the laws about the dissection and preservation of dead body and make a unified law and supervision about donations of organs, tissues and body. It will overcome the gap between the spirit of the law and the reality, as well as offering equal opportunities of dissection practices for all the medical schools in the nation.

Keywords: body donation, organ donation, tissue donation, dissection practice, promotion remedies of body donation

목차 (Table of Contents)

• 목 차
• 국문초록 ··················································································· vii
• 제Ⅰ장 서론 ·········································································· 1
• 제1절 연구의 배경 및 목적 ··················································· 1
• 제2절 연구의 범위와 방법 ························································· 4
• 제Ⅱ장 이론적 고찰 및 선행연구 검토 ······················· 6
• 제1절 해부학의 역사 ································································· 6
• 1. 서양의 해부학의 역사 ····························································· 7
• 2. 동양의 해부학의 역사 ····························································· 11
• 3. 우리나라 해부의 역사 ····························································· 13
• 제2절 인체기증 ·········································································· 14
• 1. 장기기증 ··············································································· 14
• 2. 시신기증 ··············································································· 15
• 3. 인체조직기증 ········································································· 16
• 제3절 인체기증 관련 법률 ························································· 16
• 1. 장기 등 이식에 관한 법률 ······················································· 17
• 2. 인체조직안전 및 관리 등에 관한 법률 ······································· 21
• 3. 시체해부 및 보존에 관한 법률 ················································· 23
• 제4절 시신기증 활성화 요인에 대한 선행연구 ·························· 25
• 제5절 선행연구에서 도출된 시신기증 활성화 영향요인·············· 35
• 1. 인구학적 특성 ······································································· 37
• 2. 법적·제도적 특성 ··································································· 39
• 3. 전통적 유교관의 개선 ····························································· 45
• 제Ⅲ장 우리나라 시신기증 실태 및 문제점 ········ 49
• 제1절 우리나라 시신기증 현황 ·················································· 49
• 1. 해부학 교육용 시신의 수요 ······················································ 49
• 2. 시신기증 현황 ········································································ 49
• 3. 시체해부 및 보존에 관한 법률 ················································· 52
• 제2절 문제점 ············································································· 53
• 제IV장 분석틀 설정 및 조사설계 ·························· 54
• 제1절 분석틀의 설정 ································································· 54
• 제2절 조사 설계 ········································································ 56
• 1. 조사표본 설정 ······································································· 56
• 2. 분석방법: 계층분석방법(AHP) ·················································· 57
• 제V장 분석결과 논의 및 활성화 방안 ················ 59
• 제1절 시신기증 영향요인 분석 결과 ········································· 59
• 1. 1차수준의 분석결과 ································································ 59
• 2. 1차수준의 분석결과 ································································ 60
• 제2절 종합분석 ·········································································· 63
• 제3절 시신기증 활성화 방안 ····················································· 65
• 1. 시