• Title/Summary/Keyword: Death Decision

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A Survey on Willingness to Accept Community Pharmacist's Consultation Service Regarding Well-dying (웰다잉 인식과 사전연명의료의향서 작성 관련 지역약국 상담서비스 이용 의향)

  • Shin, Ki Ung;Sohn, Hyun Soon
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.2
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    • pp.145-152
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    • 2021
  • Background: The Life-Sustaining Treatment Decision-Making Act has allowed anyone aged 19 or older to sign an Advance Directive not to receive life-sustaining treatment when they are in the 'death process'. Recently, the Korean Pharmaceutical Association announced to raise awareness of the Advance Directive to the general public through community pharmacies across the country. This study aimed to investigate the public's willingness to accept pharmacist's consultation regarding the Advance Directive and to present future directions to pharmacists Methods: This cross-sectional questionnaire study using 16-items was conducted in adults, Study subjects were recruited by convenience sampling method during August 5-15, 2020. Results: Of 460 respondents, 51.7% were younger than 30-year-old and 58.7% were not in the healthcare field in terms of job or major. 60.2% knew about the Advance Directive and 81.7% agreed the necessity to sign when healthy. 50.0% had the willingness to consult with pharmacists on the Advance Directive for well-dying and 80.4% preferred verbal explanation together with written information. Simple linear regression analysis results showed a significant relationship between trust in pharmacists or satisfaction with pharmacist's communication and willingness to use pharmacist' consultation on the Advance Directive (1-point increases in values measured on a five-point scale are associated with 0.464 and 0.486 increases, respectively.) Conclusion: This study suggests that pharmacists need to improve the public's trust and communication capability to satisfy with public's demands on well-dying service.

The Effect of confirmation bias on Intentionality Judgment: The Role of Crime Typicality and Seriousness (고의성 판단에 확증편향이 미치는 영향: 범죄의 전형성 및 심각성의 역할)

  • Choi, Seung-Hyuk
    • Korean Journal of Culture and Social Issue
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    • v.26 no.3
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    • pp.329-349
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    • 2020
  • Confirmation bias is well known to be the cause of widespread misjudgment in the field of forensic decision-making. In this study, we examined the psychological mechanisms by which confirmation bias affects intentionality judgment in serious injury and death cases that combine the moral characteristics of the perpetrator and victim differently. As a result, participants perceived the case as a more typical criminal case when both the perpetrator and victim were bad people, and gave higher intention to perpetrators' actions in these typical crimes. In particular, it was found that people with a high degree of confirmation bias highly judge the intention of the offenders in a consistent way with the stereotype of criminal cases. However, in serious criminal cases, the moderate effect of confirmation bias has disappeared and only the effect of crime typicality has existed. Finally, we discussed implications of this study and ways to reduce bias in intentionality judgment.

Problems Related to the Act on Decisions on Life-Sustaining Treatment and Directions for Improvement

  • Heo, Dae Seog;Yoo, Shin Hye;Keam, Bhumsuk;Yoo, Sang Ho;Koh, Younsuck
    • Journal of Hospice and Palliative Care
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    • v.25 no.1
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    • pp.1-11
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    • 2022
  • The Act on Decisions on Life-Sustaining Treatment has been in effect since 2018 for end-of-life patients. However, only 20~25% of deaths of terminally ill patients comply with the law, while the remaining 75~80% do not. There is significant confusion in how the law distinguishes between those in the terminal stage and those in the dying process. These 2 stages can be hard to distinguish, and they should be understood as a single unified "terminal stage." The number of medical institutions eligible for life-sustaining treatment decisions should be legally expanded to properly reflect patients' wishes. To prevent unnecessary suffering resulting from futile life-sustaining treatment, life-sustaining treatment decisions for terminal patients without the needed familial relationships should be permitted and made by hospital ethics committees. Adult patients should be permitted to assign a legal representative appointed in advance to represent them. Medical records can be substituted for a patient's judgment letter (No. 9) and an implementation letter (No. 13) for the decision to suspend life-sustaining treatment. Forms 1, 10, 11, and 12 should be combined into a single form. The purpose of the Life-sustaining Medical Decisions Act is to respect patients' right to self-determination and protect their best interests. Issues related to the act that have emerged in the 3 years since its implementation must be analyzed, and a plan should be devised to improve upon its shortcomings.

School Zone Automobile Accidents in Republic of Korea: Comparative Law Analysis on Criminal Responsibility of the Driver

  • Byung-Woon Lyou
    • Journal of Auto-vehicle Safety Association
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    • v.15 no.3
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    • pp.7-16
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    • 2023
  • In 2019, a child died by a school zone traffic accident in Asan, Chungcheongnam-do, the Republic of Korea. Just after the accident, under the name of the "Minsik Law", the Road Traffic Act and the Specific Crime Aggravated Punishment Act were partially revised and went into effect in Korea on March 25, 2020. The new Korean law providing for harsh penalties is designed to reduce automobile accidents in school zones. However, the penalties under the new law seems to be unconstitutionally and unduly harsh. Under the new law, a negligent driver who kills a child at a school zone could be sentenced to indefinite imprisonment, or imprisonment for 3 years or more. The criminal responsibility of a negligent driver at a school zone is the same as serious intentional felonies such as rape, robbery, abandonment resulting in death. Also, even in the case of a school zone accident, if an accident driver complies with the speed limit and other traffic laws and it is impossible to avoid the accident, the driver should not be punished. So, in order to meet the principle of proportionality, the new Korean law should be revised again. In order to find out the appropriate level and punishment method for drivers who cause accidents in school zones, this thesis will compare and analyze the laws of Korea with those of the United States, Germany, and Japan. This paper also reviews the decision of the Constitutional Court of the Republic of Korea in February 2023 that the "Minsik Law" was constitutional. Based on these analyses, this thesis seeks the direction and amendments to properly revise Korean law. In addition, this thesis is intended to present exemplary measures to improve the school zone safety.

Development of a Value Inquiry Model in Biology Education (생물교육에서의 가치 탐구 모형 개발)

  • Jeong, Eun-Young;Kim, Young-Soo
    • Journal of The Korean Association For Science Education
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    • v.20 no.4
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    • pp.582-598
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    • 2000
  • There are many bioethical issues in line with the rapid advance of biology. In this situation, it is important for students to make a rational decision on value problem. In this study 'value inquiry in biology education' is defined as 'the process of rational value judgement and wise decision-making in the biology-related value problem' and the model was developed. To develop the model, value inquiry models were reviewed. Value clarification model is helpful for the formation of the personal value as the process of individual value inquiry, but it isn't helpful for clarifying the value conflicts. Value analysis model focuses on the rational solution of value problem through the logical procedure. But it has the limitations that overemphasizing the logical and systematic aspects results in devaluating students' affective aspects. So it is necessary to coordinate psychological and logical aspects of value inquiry. In this regard, the model was developed, including identifying and clarifying value problem, understanding biological knowledge related to conflict situation, considering on the related persons, searching for alternatives, predicting the consequences of each alternative, selecting the alternative, evaluating the alternative, and final value judgement and affirming it. The educational objectives of value inquiry were selected in consideration of the ability to carry out the steps of the developed model. And the selected contents were animal duplication, test-tube baby, genetic engineering, growth hormone injection problem, brain death, organ transplant, animal to be experimented and were organized on the basis of the 6th and the 7th science curriculum. And the suitable instructional models for the value inquiry education were selected: bioethical value clarification decision-making model, group presentation according to the value analysis model, role play and debate, and discussion through web forum. And the interview was considered to be suitable to evaluate the students' value inquiry ability and the rubric was made to evaluate the attainment of the educational objectives for value inquiry.

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Recognition and Attitudes on DNR of College Students (Focused on Comparison between Nursing and Non-Health Department College Students) (DNR에 대한 대학생들의 인식 및 태도(간호대학생과 비 보건계열대학생 비교를 중심으로))

  • Kim, Sung-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.12
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    • pp.4907-4921
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    • 2010
  • The object of this descriptive survey research was to provide basic information source for building objective standards of DNR (Do Not Resuscitate) that can be clinically applied, by analyzing college students' awareness and attitude toward DNR. The participants of the study were 1,267 students from one college of Daegu, South Korea. The structured survey questionnaire was used for data collection, and the survey was conducted from 1-31 July, 2010. The error and percentage was estimated by SPSS 17.0 program, and analyzed with $x^2$-test. As a result of comparing the nursing students' and non-health care major students' awareness and attitude toward DNR, the significant differences were found in the necessity of DNR, reason for supporting DNR, reason for opposing DNR, and DNR decision-maker, among the awareness dimension; among the attitude dimension, significant differences were found in implication of family DNR and self-DNR. Comparing the nursing students' and non-health care major students' awareness toward DNR related information provision, researchers have found significant differences in the necessity of giving information on DNR, timing of the DNR information provision, result of the DNR-related information provision, and guidelines for the DNR information provision. In terms of the difference in DNR's necessity recognition by the demographic information, the significant differences existed based on the religion and the history of blood donation; in terms of the differences in attitude toward DNR decision-maker, the differences were found on the religion and the number of siblings. For the attitude toward family member's DNR, the significant differences existed for the sex, age, economic status, religion, the number of siblings, the history of familial illness and death, and experience of blood donation; the attitude toward the DNR for the self was significantly differed by the sex, economic status, the number of siblings, and the history of familial illness and death. To establish the standards for DNR based on the study, we suggest more well-designed future studies.

A survey of infant sleep positions associated with sudden infant death syndrome (영아 돌연사 증후군과 연관하여 아기를 재우는 방법에 대한 인식 연구)

  • Lee, Dong Jun;Jang, So Ick;Shim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.602-609
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    • 2006
  • Purpose : As the prone position is thought to be an important factor in sudden infant death syndrome(SIDS), this study was conducted to contribute to reducing SIDS by analyzing sleeping positions of infants. Methods : A face-to-face questionnaire was carried out with a total of 170 parents with a baby aged less than 6 months. Results : A total of 170 infants included 95 males(55.9 percent) and 75 females(44.1 percent); their average age was 2.8 months. 45.3 percent slept in a supine position; 34.7 percent in a side or supine position; 7.1 percent in a side position; 4.7 percent in a prone position; 4.1 percent in a non-specific position. Among those in a side position, 59.7 percent were in a supine position in the morning; 19.5 percent were in the side position; 13.4 percent were in a non-specific position; and 4.1 percent were in a prone position. To the question why they slept in a specific position, 34.9 percent answered their baby slept comfortably, and particularly, 42.9 percent in the prone position group answered so. In the supine position group, 21.6 percent answered they had no reason. Both in the prone position and side position groups, 21 percent each answered they were worried about the shape of their baby's head. In the side position group, 22 percent answered that they had a fear of choking due to vomiting. In all sleeping position groups, 8.2 percent and 7.4 percent answered it was because they had a fear of suffocation and they wanted to avoid SIDS, respectively. Conclusion : Many of the parents preferred unstable positions, e.g. the side position and the prone position, which could cause SIDS. Their decision on their baby's sleeping position was not based on exact medical knowledge, but on convenience in taking care of their baby. As it was found that only 6 percent of the subjects were advised from their pediatrist about their baby's sleeping position, moreover, it is necessary to carry out more studies and activities for preventing SIDS caused by improper sleeping positions and educating patents about recommended sleeping positions for their baby.

Validity of Referral of High Risk Pregnancy in MCH Center (모자 보건 센터에서의 고위험 산모 의뢰 기준의 타당성)

  • Kim, Gui-Yeon;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.1 s.25
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    • pp.146-152
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    • 1989
  • To test the validity of referral of high risk pregnancy in the MCH Center, 6,017 pregnant women who visited MCH Center of South District Health Center for delivery between 1 April 1985 and 31 March 1987 were interviewed on arrival to obtain the data for demographic characteristics and obsteric history and traced to check the delivery outcome. Out of 5,820 women whose delivery outcomes were confrmed, 704 women(12.1%) were referred to other hospital or clinic for high risk factors. The proportion of poor delivery outcome(stillbirth, low birth weight and neonatal death) among referred cases was 4.4% while that of the women delivered at the MCH Center was 2.2% (p<0.01). Decision of the midwives for the referral of high risk pregnancy based on their clinical assessment was consistent with the delivery outcome (good or poor) in 86.5%. Major reasons for referral were premature rupture of membrane(46.5%) and cephalopelvic disproportion(20.0%) and the C-section rates for these cases were 10.1%, 17.6%, respectively. Discriminant analysis of the demographic characteristics and obstertric history for the discrimination of delivery outcome showed that gestational age had the highest discriminant function coefficient(0.88) and it was followed by parity(0.37) and maternal education(0.30). Referral of high risk pregnancy by the midwives based on their clinical assessment was considered to be reasonably valid. However, a risk scoring system for an MCH Center which can improve the validity may be developed if one applies the discriminant analysis for more comprehensive independent variable(including clinical assessment of midwife, demographic characteristics and obstetric history) and dependent variable (including medically indicated C-section, complication of pregnancy and delivery, stillbirth, low birth weight, neonatal death and maternal death).

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Economic Value of the Sirolimus Eluting Stent($CYPHER^{TM}$) in Treating Acute Coronary Heart Disease (관상동맥질환 치료를 위한 시롤리무스 방출 스텐트 ($CYPHER^{TM}$)의 경제성 분석)

  • Lee, Hoo-Yeon;Park, Eun-Cheol;Park, Ki-Dong;Park, Ji-Eun;Kim, Young;Lee, Sang-Soo;Kang, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.339-348
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    • 2003
  • Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.

Legal Issue in Case of Death or Injury of an International Crew While on Board (국제항공운송 승무원이 항공기내에서 사상(死傷)을 당한 경우 법률관계 - 국내외 판례의 분석을 중심으로 -)

  • Kim, Sun-Ah
    • The Korean Journal of Air & Space Law and Policy
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    • v.35 no.2
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    • pp.137-168
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    • 2020
  • Air passengers may be compensated for damages based on the above agreement when the passenger suffers an accident to the extent that they are recognized as an accident under Article 17 of the Montreal Convention in 1999. If a flight or cabin crew and passengers both undergo an accident, passengers are subjected to compensation under the Montreal Convention however flight cabin crews will be compensated by the Labor Law, which is the governing law in the labor contract with the airline. The flight or cabin crew boarding the aircraft work is on a work contract, not a passenger transport contract. Therefore, if the flight or cabin crew on the aircraft is injured due to an accident, and the air carrier is liable for default due to a labor contract, the Labor Law, workers or survivors claim damages due to illegal acts against the employer. In which case, civil law will apply. In this regard, if a Chinese cabin crew working for a Chinese airline dies due to an accident in the Republic of Korea, whether the family of the deceased claims damages against the Chinese airline or not has international court jurisdiction in the Republic of Korea, which is the place of tort. We examined whether it is the law of the Republic of Korea or whether it's the Chinese law, the law applicable to the work contract, is applied. Also, Seoul District Court 1995.5.18. The sentence 94A 14144 was found that if the injured crew during the flight work was not satisfied with the insurance compensation under the Labor Standards Act and the Industrial Accident Compensation Insurance Act, he could claime to damage under the civil law against an air carrier or third parties responsible for the accident. This law case shows that you can claim a civil damage as a cause. In case of death due to an existing illness while on the way to work, the Korea Workers'Compensation and Welfare Service did not recognize the death of the deceased as an occupational accident, and the trial was canceled by the parents of the deceased for the survivor's benefit and funeral expenses. (Seoul Administrative Court 2017.8. 31. Although the sentence was judged as an occupational disaster in 2016, the 2016 8816 Decision), it was defeated in the appeals court (Seoul High Court 2018.7.19.Sentence 2017 No. 74186) and I criticized the judgment of the appeal by analyzing the deceased's disease and related the cause of it to workload. Sometimes, a flight or cabin crew is on board not for the flight duty such as transferring to another flight or returning to the home base or lay-over place after their scheduled flight, this is called "Deadheading". If the crew who is not considered the same as a passenger, but is not on duty, is injured in an accident, does the crew claim compensation for damages under the labor contract or whether the Montreal Convention is applied to the passenger. In conjunction with the discussion, there was a similar case, In re Mexico City Aircrash of October 31, 1979, 708 F.2d 400 (9th Cir. 1983), Demanes v. United Airlines, 348 F.Supp. 13 (C.D.Cal. 1972), Sulewski v. Federal Express Corp., 749 F.Supp. 506 (S.D.N.Y. 1990) and reviewed by the European Court of Justice (CJEU) at Wucher Helicopter GmbH and Euro-Aviation Versicherungs AG v. After examining several acts in several countries it's undeniably crucial to clearly understand the definition of "passenger" as stated in the Fridolin Santer case.