Journal of The Korean Society of Integrative Medicine
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v.11
no.2
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pp.87-99
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2023
Purpose : This study intended to provide essential data for developing measures for the stable settlement and expansion of the life-sustaining treatment decision system by identifying the effects on preparing advanced directives. Methods : The effects on preparing advance directives of older people were identified based on Andersen's behavioral model, using the 2020 Korean national survey on elderly. Data were statistically analyzed with SPSS Statistics ver 25.0 and the significance level (α) was set to .05. Results : For factors that influence the preparation of advance directives, the predisposing factor was .769 times less for women than men (p=.026). By age, it was 1.410 times higher (p=.006) for people in their 70s compared to people in their 60s and 1.675 times higher (p=.003) for those in their 80s. By the level of education, it was 1.617 times higher (p=.026) for those who have elementary school education compared to those who have no education, 1.596 times higher (p=.048) for those who have a middle school education, 2.313 times higher (p<.001) for those who have a high school education, and 3.827 times higher (p<.001) for those who have a college education. By religion, it was 1.328 times higher (p=.008) for those who have faith compared to those who do not. For possible factors, it was 2.325 times higher (p=.003) for those who spend 100,000 won or more on healthcare (monthly average) compared to those who do not spend. For necessary factors, it was 1.439 times higher (p=.041) for those with the chronic disease compared to those without. Conclusion : It is deemed a measure that can increase the preparation of advance directives, considering the characteristics of each cause, for the stable settlement of the life-sustaining treatment decision system.
In every society, citizens must decide how to punish criminals, uphold the virtue of justice, and preserve the security of the community. In doing so, the members of society must ask themselves how they will punish those who carry out the most abhorrent of crimes. Many common responses to such a question is that death is an acceptable punishment for the most severe crimes. But to draw some theoretical distinction between a crime that deserves incarceration and a crime that is so heinous that it deserves capital punishment is subject to three errors. First, what possible line could be drawn? To decide on a particular number of deaths or to employ any standard would be arbitrary. Second, the use of a line would trivialize and undermine the deaths of those whose murderers fell below the standard. Third, any and all executions still are unjust, as the State should not degrade the institution of justice and dehumanize an individual who, although he or she has no respect for other human life, is still a living person. Simply put, all murders are heinous, all are completely unacceptable, and deserve the greatest punishment of the land; however, death as punishment is inappropriate. Also, while this article arrives at the conclusion that the death penalty is an inappropriate form of punishment, I have not offered an acceptable alternative that would appease those who believe capital offenders deserve a punishment that differs in its quality and severity. This is a burden that, admittedly, I am unable to meet. I finally conclude that the death penalty is unjustified retribution. This is the only claim that can effectively shift the intellectual paradigms of the participants in the debate. The continued use of the death penalty in society can only be determined and influenced by the collective conscience of the members of that society. As stated at the outset of this article, it is this essentially moral conflict regarding what is just and degrading that forms the backdrop for the past changes in and the present operation of our system of imposing death as a punishment for crime.
Based on the analysis of criminal investigators' recognition of judicial autopsy, this study presented policy alternatives as follows. First, a procedure is needed that optometrists and investigators jointly make previous explanations to bereaved families the status of investigation and the results of examination to their satisfaction and collect their opinions, for the purpose of obtaining an agreement to autopsy from them. Second, the dignity of the dead should be kept. To this end, particular consideration should be given to women bodies. Also, we need to minimize the number of autopsy witnesses and obtain agreement from bereaved families when there is an on-the-spot study. Third, we need to establish a guideline that investigators could request a warrant later in certain cases of dead bodies. Also, if a bereaved family positively asks for autopsy, it should be allowed through tentatively named ‘Request for Autopsy.’ Finally, To make a careful decision on whether an autopsy should be made or not, we can form a joint investigation team of public prosecutors and criminal investigators; however, an autopsy should be done only if it is deemed inevitable, considering the bereaved family's opinion.
The Supreme Court of Korea first admitted compensation for damages caused by breach of informed consent in 1979. From then on, specific details of informed consent are shaping up and developing through court precedents. The duty of informed consent of doctor is based on article 10 of the Constitution and medical contract, and is expressly prescribed Article 12 of Framework Act on Health and Medical Services and other acts and regulations. By the way, the regulations about duty of informed consent of doctor have been established in Medical Law revised on December 20, 2016, and the revised Medical Law will be implemented on June 21, 2017. According to the revised Medical Law, medical practices subject to description and consent are operation, blood transfusion and general anesthesia that threaten to cause serious harm to human life or to the body. When performing these medical activities, the written consent must be explained and agreed upon in advance. If a doctor violates the law, he will incur fines of less than 3 million won. Comparing and viewing the revised Medical Law and existing legal principles about the duty of informed consent, we can confirm that there is a substantial difference between the two parties. Accordingly, despite the implementation of the revised medical law, the existing legal principles are unlikely to be affected. However, from the perspective of legal uniformity and stability, it is undesirable that legal judgments on the same issues differ from each other. The revised Medical Law about informed consent needs to be reformed according to existing legal principles. And, as in the case of Germany, it is desirable to include the matters concerning informed consent in the civil code.
Journal of the Korea Academia-Industrial cooperation Society
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v.21
no.9
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pp.113-119
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2020
This study examined the effects of stepwise education for operation patient care according to nursing satisfaction on the critical thinking disposition and clinical performance. The participants were 192 junior students who signed a consent form with an explanation of the study. Data were obtained from the students on the first day of junior's first semester and the last day of junior's first and second semester. Data analysis was performed using the number, percentage, mean, standard deviation, Chi-square test, t-test, and repeated measure ANOVA through the SPSS/WIN 23.0 program. Results showed that nursing students with high nursing satisfaction had higher critical thinking disposition than those with lower nursing satisfaction (F=4.57, p=.012). There were no significant differences according to time (F=0.20, p=.821). The clinical performance was not significantly different according to nursing satisfaction (F=1.08, p=.343) and time (F=1.58, p=.210). This means that increasing nursing satisfaction would be a strategy for increasing the critical thinking disposition that was the core competency of nursing students.
Purpose: This study is to understand how community members perceive past life recollection and preparation for death. Methods: Using a questionnaire, we surveyed 160 adult residents of one of the districts (gu) in Seoul, Korea. Descriptive statistics were used. Results: Participants chose their 30s and 40s as the most difficult time in their lives. The most painful experience was "an illness of a family member", followed by "trouble with a spouse", and "trouble with children". As for the most difficult social experience, "sense of loss in life" was ranked the highest. Personally, the happiest time was "accomplishment of a goal", while it was "happiness through children" in family relationship and "contribution to society through my career" in social life. As for the most regrettable experience, personally "having lived without purpose" was the highest, "not meeting my parents' expectation more" in family relationship; "not providing sufficient education" in relationship with children; "not having an occupation that I wanted" in work life, and "lack of social skills" in social life. More than 87% of the surveyed showed a positive attitude about the system of the do not resuscitate (DNS) order. For a situation where participants were supposed to have an incurable disease, "I want to be notified of the true condition" and "I want to write a will and advanced directives" ranked high, receiving more than 3.1 points out of 4. Conclusion: These results demonstrate the need for death education to provide people with an opportunity to accept their regrettable experiences in the past as part of their life. Also, this study suggests the importance of writing advanced directives for people to prepare for "death with dignity" how it can help their decision to be better respected.
Purpose: To compare the effectiveness of the in-phase (IP) sequence and the opposed-phase (Op) sequence in the detection of focal hepatic lesions in the single breath-hold hepatic MR imaging with fast gradient T1-weighted pulse sequences. Materials and Methods: IP and OP T1-weighted breath-hold imaging was performed using fast gradient echo sequences in 45 patients referred for known focal hepatic lesions, in which 78 lesions were detected. Three blind readers independently reviewed the images for lesion detectability. The signal-to-noise ratio (SNR) of the liver, the lesion-to-liver contrast-to-noise ratio (CNR) and the liver-to-spleen CNR were also compared. A consensus was reached by three readers to determine which sequence is better in image quality. Results: On OP images, 61(78%), 61(78%), and 63(89%) lesions were correctly identified for reader 1, 2 and 3, respectively. On IP images, 66(85%), 65(83%), and 65(93%) lesions were detected for each reader, respectively. When two image sets were combined, 71(91 %), 69(88 %), and 76(97%) lesions respectively were detected for each reader. In cases of hepatocellular carcinoma, liver-to-Iesion CNR was greater on the OP images(p (0.05), but in other lesions significant difference was not demonstrated. Liver-to-spleen CNR was higher on OP images(p ( 0.1), but the SNR of the liver was higher on the IP images. Conclusion: Use of both IP and OP imaging can be helpful to avoid erroneous missing of some focal hepatic lesions.
Kim, Hyun-Kyung;Nam, Eun-Mi;Lee, Kyoung-Eun;Lee, Soon-Nam
Journal of Hospice and Palliative Care
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v.15
no.1
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pp.30-35
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2012
Purposes: Most medical schools in Korea do not provide adequate education in end-of-life care. This study was designed to illustrate the need to improve end-of-life care education and to assess the effect of the education on fourth-year medical students' awareness and attitude towards hospice and palliative care for terminally ill patients. Methods: One hundred sixty six fourth-year medical students were surveyed with questionnaires on end-of-life care before and after they received the education. Results: Before receiving the education, students most frequently answered "at the end of life" (33.6%) was appropriate time to write an advance medical directive. After the education, the most frequent answer was "in healthy status" (58.7%). More students agreed to withholding or withdrawing futile life-sustaining treatment increased after the education (48.1% vs. 92.5% (P<0.001) for cardiopulmonary resuscitation, 38.3% vs. 92.5% (P<0.001) for intubation and mechanical ventilation, 39.1% vs. 85.8% (P<0.001) for inotropics, 60.9% vs. 94.8% (P<0.001) for dialysis and 27.8% vs. 56.0% (P<0.001) for total parenteral nutrition). Significantly more students opposed euthanasia after the education (46.6% vs. 82.1%, P<0.001). All students agreed to the need for education in end-of-life care. Conclusion: After reflecting on the meaning of death through the end-of-life care education, most students recognized the need for the education. The education brought remarkable changes in students' awareness and attitude towards patients at the end of life. We suggest end-of-life care education should be included in the regular curriculum of all medical schools in Korea.
Hong, Jae-bum;Bae, Do Yong;Shim, Ki Jun;Hwang, Yujin;Kim, Sung-tae
Journal of the Korean Data Analysis Society
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v.20
no.6
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pp.2993-3002
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2018
This case study introduces the process of developing the technology rating evaluation model for investment. The technology evaluation rating model for investment is a project that the Financial Services Commission and the Ministry of Commerce, Industry and Energy collaborated to expand the scope of technology finance from loan to investment. The technology evaluation model for investment was developed with the aim of predicting high growth companies. The model consists of a statistical model and an expert model. Here, statistical models were modeled by using logistic regression analysis. Expert models gathered opinions of experts and identified the weight of each evaluation item and set the model. The rating system of the model is composed of 10 grades. The distribution of the model was consistent with KTRS grade distribution. Interestingly, the emphasis is on technology and marketability. In the technology valuation grade model for the goddess, there is a considerable difference from the emphasis on managerial competence or business performance.
Journal of Korean Academy of Fundamentals of Nursing
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v.26
no.2
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pp.96-106
/
2019
Purpose: The purpose of this study is to investigate the safety of nursing students during fundamentals of nursing practicum in Korea. Methods: This study used a descriptive design. A total of 106 nursing instructors teaching fundamentals of nursing longer than one year participated in this study. Data were collected using self-report questionnaires from July 24 to August 28, 2018. The questionnaires consisted of general characteristics, characteristics of fundamentals of nursing course, physical and emotional safety issues during fundamentals of nursing practicum, and obtaining an informed consent prior to practicum. Results: The average number of physical safety accidents during practicum of fundamentals of nursing in the past 5 years was $1.12{\pm}2.44$. The most common safety accident was punctured wound. The mean score of the participants' stress on physical safety accidents was $3.53{\pm}1.12$ out of 5. The average number of emotional safety accidents of fundamentals of nursing practicum in the past 5 years was $1.05{\pm}2.72$. The mean score of stress on emotional safety accident was $3.00{\pm}1.09$ out of 5. We found that 47.2% of the participants obtained an oral consent or a written consent for safety of fundamentals of nursing practicum. Conclusions: The results of this study indicate that it is necessary to establish safety strategies for fundamentals of nursing practicum for nursing students.
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