• 임상간호연구
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• 제14권2호
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• pp.59-70
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• 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.

• 생물정신의학
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• 제19권4호
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• pp.153-158
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• 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
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• 제42권2호
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• pp.135-140
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• 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.

• 한국간호교육학회지
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• 제26권2호
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• pp.176-184
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• 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.

• 한국IT서비스학회지
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• 제6권2호
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• pp.1-18
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• 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.

• 문화기술의 융합
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• 제4권4호
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• pp.249-259
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• 2018

본 연구는 종합병원에 근무하는 간호사들을 대상으로 생명의료윤리의식과 전문직업성 정도를 파악하여 간호사들의 바람직한 생명윤리관 확립을 위한 교육의 필요성과 방향을 탐색하는 기초자료를 마련하고자 시도하였다. 연구대상자는 G광역시 3개 종합병원에 재직 중인 간호사 163명을 대상으로 하였고, 자료 분석은 SPSS/WIN 24.0 프로그램을 이용하여 통계처리하였다. 본 연구결과 간호사의 생명의료윤리의식은 보통 이상으로 나타났고, 하위 영역 중 태아의 생명권 영역이 가장 높았으며, 인공임신중절 영역이 낮게 나타났다. 대상자의 전문직업성은 보통 이상으로 나타났고, 전문조직에의 준거성 영역이 가장 높았으며, 소명의식 영역의 점수가 가장 낮은 것으로 나타났다. 간호사의 생명의료윤리의식의 함양은 전문직업성과 관계가 있는 것으로 나타났다. 따라서 간호사들에게 시대적 변화와 요구에 따른 확고한 생명윤리 가치관과 생명윤리 의사결정 능력을 갖출 수 있도록 윤리적 판단을 도와줄 수 있는 교육방안과 전문직업성을 향상시킬 수 있는 제도적 장치를 마련해야 할 것이다.

• 한국산학기술학회논문지
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• 제16권4호
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• pp.2691-2703
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• 2015

본 연구는 중환자실 간호사들의 DNR에 대한 윤리적 문제의 인식과 태도를 파악하여 DNR 환자간호에 도움이 되는 기초자료로 활용하고자 시도하였다. G광역시 상급종합병원 1개소, 전라 남 북도 700병상이상 종합병원 각각 1개소 중환자실에 근무하는 간호사를 대상으로 2014년 8월 1일 부터 9월 5일까지 설문조사하여 154부를 최종분석 하였다. 첫째, DNR 결정 태도는 치료를 거부하는 환자의견에 반대, 예후가 좋지 않은 환자라도 생명의 연장에 찬성, 환자가 원했을 경우 어떠한 상태라도 DNR 미실시, 보호자의 요구에 의한 치료와 가망 없는 환자의 CPR실시에 반대하였다. 둘째, 환자가족에 의한 인공호흡기 및 다른 치료의 적극적 실시에 반대, 보호자의 중환자실 입실에 대립적인 입장을 보였다. DNR 환자에 대해 의사의 인공호흡기의 소극적 사용에 찬성, 환자의 신체적 심리적 안정을 위해 기본적인 간호도 줄여야 하고, 무균술을 지키지 않은 처치에 묵인하는 입장이며, 가족에 의한 환자의 상태변화를 주치의에게 여러 차례 보고하는 것에 반대하였다. 셋째, 의사의 관심감소를 인정하고, 이에 보호자의 항의가 있을 때 의료팀을 옹호하며, DNR 결정을 주치의가 내린 것에 대립적인 입장이며, DNR 지침에 따른 결정에 반대하였다. 예후가 좋지 않은 환자에게 그대로 설명하는 것에 반대 또는 중립적이며, 환자나 보호자에게 환자상태를 있는 그대로 설명하는 것과 사망에 가까운 경우 환자나 보호자에게 상태를 그대로 설명하는 것에 반대하였다. 결론적으로 DNR 주체는 환자이며, 환자의견이 충분히 반영 되어야 하며, 의료행위의 범위와 결정과정에서의 갈등을 최소화하고 환자중심의 윤리적 의사결정이 되도록 DNR 결정에 대한 표준과 지침이 필요하며, 충분한 설명을 근거로 한 동의가 이루어 져야하겠다.

• 유통과학연구
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• 제13권7호
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• pp.63-71
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• 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.

• 대한간호학회지
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• 제24권2호
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• pp.190-205
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• 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
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• 제46권3호
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• pp.134-142
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• 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.