• Journal of Korean Clinical Nursing Research
• /
• v.14 no.2
• /
• pp.59-70
• /
• 2008

Purpose: Purposes of this study were to promote understanding on mutually informed consent by comparing and analyzing the perception and experience of informed consent among physicians, nurses, and patients. Method: Participants in the study were 145 physicians, 300 nurses, and 178 patients from eight hospitals in Busan. To examine their understanding and experience with informed consent, all participants responded to a questionnaire. The collected data were analyzed using SPSS/PC 12.0 program. Results: On the necessity of informed consent, the affirmative percentages were 95.9% for physicians, 99.0% for nurses and 84.8% for patients. As to the most important reason for informed consent 47.6% of the physicians and 64.3% of the nurses answered 'because it is an occupational and ethical duty', while 46.6% of the patients answered 'because it is protection for physicians'. Regarding the legal decision maker for informed consent, 33.1% of the physicians, 27% of the nurses, and 42.1% of the patients answered that the legal decision-making right belonged to the 'patient'. The agreement rate on the necessity of providing a comprehensive explanation about informed consent was 89.0% for physicians, 98.3% for nurses, and 96.1% for patients. Conclusion: Most physicians, nurses, and even patients have inaccurate perceptions and inappropriate experience with informed consent.

• Korean Journal of Biological Psychiatry
• /
• v.19 no.4
• /
• pp.153-158
• /
• 2012

Understanding of a clinical trial is essential in developing clinical guideline and adopting evidence based practice. In designing and executing clinical trials, following ethical requirements should be considered : social value, scientific validity, fair subject selection, informed consent, favorable risk-benefit ratio, institutional review board, and respect for human subjects. According to the stage of drug development, purpose of trials, accumulated scientific data, clinical trials for drug development are classified as phase 1, 2, 3, and 4. Phases of clinical trials can be overlapped and the judgment of entering into the next phase should be considered highly strategically. In reading, evaluating and interpreting clinical trial reports, various skills and challenges exist. Patient sample composition, trial duration, selection of endpoints, responders and non-responders, placebo effect, patient recruitment, and extrapolation to the real world are the examples of those challenges. Treatment success will come from the well balanced approach of evidence based decision making and consideration of specific single case.

• Journal of Korean Neurosurgical Society
• /
• v.42 no.2
• /
• pp.135-140
• /
• 2007

It is not the best way to treat a hopeless patient with life-sustaining medical devices until the heart beats stop. Advanced medical technology may prolong the life for a significant period without recovery from the disease. However, it would give an unbearable economic burden to the family and the society. In 2006, we decided not to operate 9 patients with traumatic intracranial hematomas. We examined those patients with special references to possible legal and ethical problems. It is reasonable to withhold a treatment after documentation that the family never wants any life sustaining treatment when the treatment does not guarantee the meaningful life.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.26 no.2
• /
• pp.176-184
• /
• 2020

Purpose: We explored emergency nurses' experiences of coping with moral distress. Methods: A qualitative research design was used. We conducted in-depth interviews with 11 nurses working at a regional emergency medical center in South Korea. Data were analyzed using conventional content analysis. Results: The main theme of nurses' coping with moral distress was "a passive emotion-based response." We also extracted three categories of coping strategies: "uncritical adaptation to anguished situation," "self-justification for not acting," and "flight from ethical decision making." Conclusion: Nurses coped with moral distress in a passive and emotional way, possibly because of perceived incompetence and compliance to an organizational hierarchy. The findings imply that effective approaches to addressing moral distress in emergency nurses are needed at the individual and organizational levels.

• Journal of Information Technology Services
• /
• v.6 no.2
• /
• pp.1-18
• /
• 2007

Many researches have been done in insurance fraud as the amount and frequency of insurance fraud have been increasing continuously. In particular, the development of insurance fraud detection system using large database management techniques including data mining or link analysis based on visual method have been the main research topic in insurance fraud. However, this kinds of detection system were very ineffective to find unintentional insurance fraud happened by accident even though it was so good to find intentional and organized crime insurance fraud. Therefore, this research suggests insurance fraud as an ethical decision making and applies TPB(Theory of Planned Behavior) for the finding of reasons and prevention strategies of unintentional insurance fraud happened by accident. The results of research show that TPB is very appropriate model to explain the behavior of insurance fraud and that insurance agents force to do insurance fraud as affecting perceived behavior control. Therefore, education and pubic relations for insurance fraud are very effective for preventing insurance fraud and developing insurance service industry.

• The Journal of the Convergence on Culture Technology
• /
• v.4 no.4
• /
• pp.249-259
• /
• 2018

The purpose of this study was to investigate nurses' consciousness of biomedical ethics and professionalism in general hospitals. Participants in this study were 163 nurses working in 3 general hospitals. Data analysis was done using SPSS / WIN 24.0 program. As a result of this study, the consciousness of biomedical ethics of the nurse was moderate. The highest sub-area was 'right to life of fetus' and 'artificial abortion' was the lowest sub-area. The professionalism of the subjects was moderate. The highest sub-area was 'reference professional group' and 'sense of mission' was the lowest sub-area. The nurses' consciousness of biomedical ethics was related to professionalism. Therefore, nurses should be educated to help ethical decision making so that they can have bioethical value and bioethical decision making ability according to the changes and demands of the times. In addition, institutional arrangements to improve professionalism should be provided.

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

• Journal of Distribution Science
• /
• v.13 no.7
• /
• pp.63-71
• /
• 2015

Purpose - The characteristics of the modern management environment in Korea clearly involve the limitations of knowledge management, globalization, changes in industrial structures, polarization of the economy, consumption, and education, and the demand for creative management. To achieve a continuous competitive advantage for individuals as well as organizations, Wisdom Management can be said to be a paradigm for the current environment. The Research is an alternative to environmental management in the early study of the need to conceptualize the theoretical approach to wisdom management. In other words, it presents a new management paradigm for a business environment of uncertainty and unpredictability. Furthermore, it aims to propose Wisdom Management as an alternative in the modern management environment as well as a topic of discourse. Its purpose is to provide basic knowledge to people who study and practice in this field to strengthen the competitiveness of individuals and companies. Research design, data, and methodology - This paper first provides six characteristics of the current management environment at home and abroad. It then attempts to emphasize the necessity of wisdom based on such characteristics by classifying wisdom according to recent management study research. This allows the derivation of definitions of wisdom management, suggesting its components and properties. Results - The six characteristics of the modern business environment are: 1) limits of knowledge, 2) intensifying globalized competition, 3) changes in industry structure - IoT (Internet of all Things) trend, 4) serious polarization and social unrest diffusion, 5) personal and organizational competitiveness creativity requirements, and 6) domestic special national and social situations. Therefore, accordingly, wisdom can be defined and classified as: wisdom that offers potential integration beyond knowledge, practicing and maintaining knowledge wisdom as an efficient strategy for an organization wisdom as a decision-making process that addresses ambivalence wisdom as the pursuit of common goods based on ethics; and, wisdom as creativity that involves intuition and insight. This paper attempts to define Wisdom Management in accordance with these definitions of wisdom. Wisdom Management is a management system that is awareof the current environment given in the multidimensional perspective, achieves the efficiency of the organization and the goals of common good through an uncertain decision-making process, based on the organization of individual and organizational knowledge, and the internal experiences and resources. Wisdom Management components include human beings, virtue, knowledge, creativity, and ambivalent thinking. Its properties include intentionality, self-destructiveness, creative and ethical reflexivity, complexity, insight, unpredictability, ambivalence, and wholeness. Conclusions - Since all organizations face the limitations of their environment, crises, and opportunities, applying wisdom in management to develop as Wisdom Management can be an inevitable alternative to the uncertainties of the management environment faced by modern society. The conceptualization of Wisdom Management forms a valuable context to further advance knowledge management theory into practice. It is also a cornerstone of strategic management and can provide insight into its potential for success and implementation.

• Journal of Korean Academy of Nursing
• /
• v.24 no.2
• /
• pp.190-205
• /
• 1994

Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

• Journal of Radiation Protection and Research
• /
• v.46 no.3
• /
• pp.134-142
• /
• 2021

Background: From 2018 to 2020, the Expert Study on Public Understanding after the Fukushima Daiichi Nuclear Power Plant Accident (the Expert Study Group) identified and analyzed activities designed to promote public understanding of science and radiation since the Fukushima accident, and held discussions on how to achieve public understanding in the situation where public confidence has been lost, and how experts should prepare for dealing with the public. This panel session was held at the 53^rd meeting of the Japan Health Physics Society on June 30, 2020. Materials and Methods: First, three subgroup (SG) leaders reported their research methods and results. Then, two designated speakers, who participated as observers of the Expert Study Group, commented on the activities. Next, the five speakers held a panel discussion. Finally, the rapporteur summarized. Results and Discussion: SG leaders presented reports from researchers and practitioners in health physics and environmental risks who provided information after the Fukushima accident. During the discussion, experts in sociology and ethics discussed the issues, focusing on the overall goals of the three groups, local (personal) and mass communication, and ethical values. Many of the activities instituted by the experts after the accident were aimed at public understanding of science (that is, to provide knowledge to residents), but by taking into account interactions with residents and their ethical norms, the experts shifted to supporting the residents' decision-making through public engagement. The need to consider both content and channels is well known in the field of health communication, and overlaps with the above discussion. Conclusion: How to implement and promote the public engagement in society was discussed in both the floor and designated discussions. Cooperation between local communities and organizations that have already gained trust is also necessary in order to develop relationships with local residents in normal times, to establish an information transmission system, and to make it work effectively.