• Journal of Hospice and Palliative Care
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• v.14 no.2
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• pp.81-90
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• 2011

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.

• Development and Reproduction
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• v.14 no.2
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• pp.143-154
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• 2010

This article analyzes two leading Korean cases which led to opposite conclusions: the Boramae Hospital Case (Korean Supreme Court 2002 Do 995) and the Shinchon Severance Hospital Case (Korean Supreme Court 2009 Da 17471). In doing so, it pays particular attention to the acceptance, modification, and rejection of paternalism, specifically 'physician paternalism' and 'familial paternalism', both of which have long and strongly influenced the Korean medical environment. In Boramae Hospital, the Court emphasized the obligation of the physician in terms of the life of the patient (eg: protecting and preserving the life and welfare of the patient). Its position seemed to be based on the traditional physician paternalism which presupposes the ability of physicians to identify right and wrong choices according to natural laws. However, the Court saw itself as the final arbiter of who identifies and determines the real world content and consequences of that natural law. In short, the Court elevated itself to the supreme guardian of the patient, and held that its decision cannot be overruled by that of the patient's family. So without specifically referring to the importance of the family and the role of familial decisions, both long-observed traditions in medical decision-making in Korea, the Court shifted away from familial paternalism. In Shinchon Severance Hospital, the Court explained the meaning of the patient's powers of self-rulemore concretely, explaining its scope and substance in greater detail. The Court held that one can exercise the right of self-rule, even over issues such as death, in the form of 'previous medical directions'. However, this case does not represent a wholesale acceptance of medical autonomy (ie: it does not accept self-rule unconditionally). Rather, the Court accepted the importance of the opinions and decision of physicians and of the Hospital Ethics Commission, and the Court still retained to itself the authority to review and make alterations to 'material' decision. The Court did not overlook the importance of the decision of the patient's family, but it also did not relinquish its status as supreme guardian, emphasizing the 'objective' nature of a decision from the court.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2691-2703
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• 2015

This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.3-36
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• 2023

The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.

• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.143-162
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• 1998

This is a study for the construction of nursing care based upon the Korean attitude toward medicine. Factors which were investigated include the source of nursing care, the reason for choosing care, the type of heath care chosen, the accessability of caregivers, and the desired location of death. The population examined in this study consisted of 517 adults distributed in six large cities and 191 adults from five rural communities. Data was analyzed using frequency, percent, Cronbach alpha, $X^2$ - test, t - test, F - test and scheffe post hoc contrast with an SAS program. The results of this study are summarized as follows: 1. Among sources of nursing care used, first rank rated-pharmacy(54.4), private hospital(18.2), general hospital(8.4), folk remedies in house (5.0), chinese hospital(2.8), prayer(2.8) and others(8.4), and the reasons for choosing nursing care rated 'the easiest method' (63.6), 'the best method'(15.7), 'reliable'(10.8) and 'lower cost burden'(4.6) in order of preference. 2. The type of nursing care chosen rated western medicine(6.80), chinese medicine(6.15), folk remedies(5.46), faith remedies(3.51) and divination remedies (1.41). There were significant differences in the effect recognition degree to various kinds of medicine. 3. The difference of the type of nursing care chosen according to general characteristics showed that urban residents were higher than rural community residents(t=2.15, p=0.0320) in western medicine, and urban residents, women, and singles were higher than rural community residents(t=2.04, p=0.0414), men (t= -2.89, p=0.0039), and married(t=2.50, p= 0.0126) on folk remedies. With repect to age and education those 21-30, under 20 and 31-40, graduated from college and graduate school were higher than above 51, above 61 (F = 7.76, p = 0.0001), graduated from elementary school(F=4.39, p=0.0006) on folk remedies. In other categories, rural community residents, women, younger people. Christians were higher than urban residents ( t = -2.73, p=0.0305), men(t= -4.15, p=0.0001), older people (F=2.48, p=0.0307), Catholic, Buddhist, or atheist (F= 70.18, p=0.0001) on faith remedies. Those graduated from high school and Buddhist were higher than unschooled, graduated from middle school(F=3.18, p= 0.0075), atheist, Catholic or Christian(F=18.32, p=0.0001) on divination redemies. There were significant differences concerning age and education level. 4. The accessibility of caregivers rated 'caregivers should be nearby if the patients need them' (50.0), 'caregivers must be there all day (24 hours)' (39.6), 'caregivers must be there at night only'(5.0), 'caregivers must be there during the day only'(2.6), 'caregivers always should visit during visiting hours' 0.4), 'caregivers don't need to be there at all' (1.2). The frist rank of suitable caregivers were rated as spouse(66.6), mother(24.2), daughter (3.6), daughter-in-law(1.9), and the reasons of thinking thus were rated as 'the most comfortable' (81.5), 'people should correctly with regards to family they'(7.1), 'the easiest' (5.4), 'take good care of the patient' (5.1) and 'lower cost burden' (0.4). 5. The desired location of death rated as the following: his/her house (91. 6) to the hospital(8. 4). A person going to encounter death in the hospital wanted his house(78.5) over the hospital(21.5), and a person dieing in the hospital prefered his house(52.9) over the hospital(47.1) as a funeral ceremony place. The following suggestions are made based on the above results. 1. A sampling method that enhances the re presentativeness should be used in regional and/or national related research and replicated to confirm the result of this study. 2. This study should be used to understand the Korean view of medical centers and to meet the expectations of patients in Korean nursing. 3. Research on the Korean traditional view of humans and expectations of the sick, health and illness, and health behavior, the perception of dying, the decision to heal, and the view of general medicine should continue to be conducted continuosly so that Korean nursing theory can be advanced on these concepts.

• Journal of Hospice and Palliative Care
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• v.9 no.1
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• pp.11-16
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• 2006

Purpose: This study is aimed to confirm nurse's attitudes and to investigate the factor analysis on organ donation in brain dead donors. Methods: This survey were collected from 198 nurses in three university hospitals and four general hospitals in B city with questionnaires developed by the author. The consent for this research was obtained from nursing managers, head nurses, and staff nurses after explaining the purpose of this research. Results: In questionnaires, 45 items about attitudes were included and positive and negative attitude were analyzed. The contents of factors are 'legal permission of brain death', 'one's will of organ donation at the brain death', 'need for educational program about brain dead during college curriculum', 'organ donation is good presents for others', 'connection with professional institutes', 'necessity of brain death', 'convenient to control of brain death' and 'the goods for organ transplantation in brain dead donors' as positive attitudes. Meanwhile, 'contrast to certain religion and dignity to life', 'negative dangers on brain dead permission', 'unbelief to the medical teams', 'burdens to ask organ donation to brain deads/families' and 'economical compensation' are factors as negative attitudes about organ donation in brain dead. The total mean point score of positive attitudes about organ donation in brain dead donors was $3.753{\pm}3.398$. The total mean point score of negative attitudes about organ donation in brain dead donors was $2.915{\pm}0.472$. Conclusion: The results of this study may be of help for the nurses who concern organ sharing and make effective interventions and educations to facilitate the decision making process for organ donation in brain dead donors or families.

• Journal of Korean Academy of Nursing
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• v.31 no.1
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• pp.94-106
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• 2001

The purpose of this study was to verify the use of Seo's Elderly Stress Scale (SESS), which was developed in 1996. Through the modified tool, it is possible to examine the stress of Korean elders and to contribute to the welfare of them. The subjects were 350 elders over 65 years old who live in Seoul, Kwang-Ju, Yang-Ju Gun Kyung-ki Do, Ui-Jong Bu, and Young-Am Kun, Jeun-Ra Nam Do. the data of 331 elders (94%) were analyzed. Data were collected between January and March in 1996 and analyzed using the SPSS Win 8.0. The result are as follows: 1. Items with low correlation with the total items were removed. So 27 items were removed and 37 items remained. This 37 items were death in the family and/or close friends, family member's behavior not meeting expectations, marriage of daughter, marriage of son, friction with daughter- in-law, argument among children, children refuse to live with parent, children leaving home, sex injury or accident, in frequest visits from children and grandchildren, providing care for your daughter or daughter-in-law post-partum, decrease in decision making and authority in home, Lunar new year and the harvest featival, house sitting, working in the house, performing a sacrificial rite, missed birthday, not living with the eldest son, decreased eyesight, decreased strength, decreased memory, sleep pattern changes, thoughts about death, loneliness, decreased hearing, change of dental condition, change in your diet or eating style, difficulty in self care, moving because of disease or aging, argument with friend or neighbour, travel, dealing with the procedure of heritage, loss of money or property, not enough pocket money, hearing on elderly neglect in television or radio, hope of going home and ignorant from others. 2. Overlapped items were discussed by colleagues and were modified. 'marriage of daughter' and 'marriage of son' were modified in 'marriage of children'. 'self injury or accidents' and 'family accidents' were modified in to self or family accidents. 3. Factor analysis was done in order to identify validity and three factors were obtained from the result. The first factor familial relation area, included 17 items. The second factor, physical area, included 9 items. The third factor, psycho-socio-economic area, included 9 items. Cronbach coefficient alpha for the 35 items was .923. 4. Pearson's correlation was .704 between SESS and SOS (Symptoms of Stress) in order to confirm construct validity. Based on the result, the following is suggested; 1. The modified SESS needs to be reverified with elder. 2. Korean elder's health promotion can be made by development of stress intervention which was accurately measured with SESS.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.21 no.2
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• pp.33-43
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• 2022

The number of car crashes increases along with the increasing number of vehicles. Hence, diverse initiatives on traffic accidents have been implemented, targeting zero crash fatalities. According to the 3rd Traffic Safety Master Plan of 2016, the current standard selecting road accident black spots prioritizes locations with the high cumulative death toll. While this standard is suitable for roads that a city government manages to some extent, it is not suitable for roads less than 20 meters that a borough (Gu) handles. The roads under the supervision of a borough do not have enough death toll, and thus improvements on its road accident black spots are highly limited. In addition, discovering the causes of traffic accidents is not easy when the number of car accidents is obtained by considering only fatal accidents, which are relatively low in number. Therefore, including all traffic accidents might identify causes of accidents and result in better advancements. Therefore, this research follows rational decision-making and suggests new National Traffic Safety Master Plan standards. These new standards are obtained by comparing accident costs between the location of fatal crashes and road accident black spots. The analysis result shows that considering all types of accidents yields better results. For example, a Three-way Intersection in front of Zion Day Care Center, one of the selected spots under the current standard, has lower road crash costs than Sinchon Intersection, a selected spot under a new standard. Therefore, the study concludes that the standards to select road accident black spots need to include traffic accident severity and road crash costs.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.11 no.2
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• pp.63-73
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• 2016

In these days startup became one of the most hot issue in business world. The problem is many startup couldn't overcome the valley of death. For this reason many startup want to funded by venture capital. However startup's business is trade secret itself, so they have to make strategic approach to venture capital. The purpose of study is to find the way to make strategic decision for startup. By analyzing the relation between startup's characteristic and venture capital's investment portfolio. Four famous venture capital(Sequoia capital, Lightspeed venture, Firstround and Khosla venture) and their seed invested startup Dropbox, Airbnb, Snapchat, Uber and Instacart was selected for this study. As a result, each venture capital has their own invest category characteristic and their seed funding belong to their category. Moreover, between seed funded startup and 36,4% of 244 past invented company shown vertical relationship, beside 0.5% of past 244 invested company shown horizontal relationship. This result shown the importance of the relation between startup's characteristic and venture capital's portfolio. Startup have to check the venture capital's portfolio for the strategic approach for funding and venture capital have to make mutual positive portfolio for decreasing the risk.

• Journal of the Korea Society for Simulation
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• v.29 no.1
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• pp.47-55
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• 2020

This paper presents a real-time autonomous computation of shot numbers and aiming points against multiple soft targets on grounds by applying an unsupervised learning, k-mean clustering and Monte carlo simulation. For this computation, a 100 × 200 square meters size of virtual battlefield is created where an augmented enemy infantry platoon unit attacks, defences, and is scatted, and a virtual weapon with a lethal range of 15m is modeled. In order to determine damage types of the enemy unit: no damage, light wound, heavy wound and death, Monte carlo simulation is performed to apply the Carlton damage function for the damage effect of the soft targets. In addition, in order to achieve the damage effectiveness of the enemy units in line with the commander's intention, the optimal shot numbers and aiming point locations are calculated in less than 0.4 seconds by applying the k-mean clustering and repetitive Monte carlo simulation. It is hoped that this study will help to develop a system that reduces the decision time for 'detection-decision-shoot' process in battalion-scaled combat units operating Dronebot combat system.