• Title/Summary/Keyword: Ethics of Care

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A Review on the Change of Health Policy Based on Ethical Issues (윤리적 쟁점을 중심으로 한 보건의료정책 변화의 고찰)

  • Lee, Dong Hyun;Kim, So Yoon;Sohn, Myongsei
    • Health Policy and Management
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    • v.28 no.3
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    • pp.222-225
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    • 2018
  • Health policy is a historical product in the process of development, including the political and economic factors of the state as well as the social and cultural elements of the country. Bioethics began to debate the ethical questions that arise in the overall process of life's birth and death, and gradually evolved by presenting ethical directions for various social phenomena. Especially, according to the moral awakening of 'scientific medicine' which caused in some human problems in the rapidized scientific society from the late 19th century to the early 20th century, as a result of distress including the concept of various social relations, it is possible to say that it has reached the bioethics. Although health policy and bioethics are different in terms of starting and concept, they can be found in common with social, cultural, and political diversity in the times. In 2004, 'Bioethics Law' was enacted through the issue of research ethics in the life sciences. Therefore, in order to examine ethical aspects of current health policy direction and major issues, it can be divided into before and after enactment of 'Bioethics Law' in 2004. The authors would like to examine how the evolution of the ethical viewpoint on the health policy has changed in line with the enactment of the 'Bioethics Law' and how it is trying to solve it from an ethical point of view. Through the various events that took place in the 1990s and the 2000s, various discussions on bioethics were conducted in Korea. Prior to the enactment of the 'Bioethics Law,' ethical judgments of professions, distribution of healthcare resources, if the discussion focused on the ethical judgment of abortion, and the various events that appeared in the early 2000s became the beginning to inform that the ethical debate about the life, death, and dignity of human beings began in earnest in Korea with the enactment of the 'Bioethics Law.' Since then, 'Hospice and Palliative care Law' which was enacted in 2017, is based on the fact that the health policy of our country focuses on the treatment of the past diseases, health promotion, and delivery of health care services. It was an opportunity to let them know that even the quality problems were included. Therefore, considering the various circumstances, the ethical issue facing Korea's health care system in the future is the change of the demographic structure due to aging and what is to be considered as the beginning and the process of life in the overall process of life. It is the worry about how to die and when it sees as death. This has far exceeded the paradigm of traditional health care policies such as disease prevention and management and health promotion, and calls for innovative policy response at the national level that reflects the new paradigm, which in many cases creates a predictable ethical environment. And health policy should be shifted in the direction of future ethical review considering sustainability in the development process of future health care rather than coercive management.

A Study on the Patient-centered Medical Delivery System -Focusing on EU examples of strengthening primary care- (환자 중심의 의료전달체계 구축에 관한 연구 -일차 의료 강화와 관련된 유럽연합의 예를 중심으로-)

  • Kim, Yong-Min
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.235-262
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    • 2019
  • While traditionally threatening human infectious diseases are decreasing, chronic diseases such as cancer and diabetes, including cardiovascular diseases, are spreading rapidly. Reflecting the characteristics of chronic diseases that are difficult to treat, the management of risk factors and the preparation of health promotion policies corresponding to them have emerged as important concerns around the world. Providing so-called multi-sector approach such as health promotion and disease prevention policy and solution for community response, The value of primary care is once again highlighted in the changed medical environment. As the existing medical delivery system has become difficult to cope with the people's desire for rapid aging, disease paradigm change, and quality of life improvement, European Union countries have made various efforts to improve the quality of their primary medical system, which provides continuous, com- prehensive and coordinated management. This paper examines the current status and problems of the healthcare delivery system in Korea, draws implications from the European Union examples related to the strengthening of primary care, and discusses the plans for establishing a patient-centered future medical delivery system.

A Study of the Ethical Values of EMT students (응급구조과 학생의 윤리적 가치관에 관한 연구)

  • Kim, Mi-Seon
    • The Korean Journal of Emergency Medical Services
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    • v.5 no.1
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    • pp.37-51
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    • 2001
  • This study is aimed at examining the ethical values of EMT students. The results below are based on the revised questionnaires, which can be applicable to EMT from the original questionnaires developed by Lee(1990), with a sample of 124 students consisting of 63 first and 61 second year students, conducted November 2-8, 2001. Data were analyzed using SPSS in terms of means, standard deviations, t-test, ANOVA, Pearson's correlation coefficient. The results are as follows: 1. In the area of Human life, all subjects showed utilitarian disposition. All respondents perceived the item "When patients recognizing there is no hope for survival ask for euthanasia, it is ethically right to accommodate their opinions." as the most utilitarian item, whereas they perceived the item "When an hopeless patient is on cardiac arrest, it is ethically right to do CPR as the most deontoogical item. 2. In the area of patient relationship, all students of two groups took on deontoogical characteristics, but there were no statistically significant differences between two groups. All students perceived an item "EMT have to keep it secret if patients disclose their suicide intentions and ask for absolute secrecy" the most utilitarian item, whereas they perceived an item "Even though patients act and speak in a very rude manner, EMT people should do their best to provide care for patients." as the most deontoogical item. 3. In the area of task relationship, first year students perceived an item "Given time limitations, it is ethically right to give priority to the patients who can be rehabilitated over the patients who can't be fully recovered." as the most utilitarian item, whereas second year students perceived an item "Under no circumstances should any placebo be administered to patients." as the most utilitarian item. All students perceived an item "When EMT students see an unconscious person lying in the street, they have to give him/her emergency treatment." as the most deontoogical item. 4. In the area of coworker relationship, all students of two groups took on deontoogical disposition, but there were no significant differences between two groups. All students of two groups perceived an item "Suppose you are regarded as the person who would be promoted. However, you think that your coworker is more competent than you. In that case you should tell your supervisor about your coworker." as the most utilitarian item. First year students perceived an item, whereas second year students perceived an item "When you observe coworkers' misconduct at work, it is ethically right to ignore their misdeeds." as the most deontoogical item. 5. This study demonstrated that for the first year students, there is a correlational relationship between areas of human life and task relationship, and between areas of task relationship and coworker relationship, whereas for the second year students, there is a correlational relationship between areas of human life and task relationship. 6. In areas of human life and task relationship, there are significant differences according to attitudes toward EMT and attendance at ethics training sessions. In the area of coworker relationship, there are significant differences according to religion, attendance at ethics training sessions, and a code of ethics. Recommendations for future research, 1. Sample items to measure ethical values and the instrument tailored to the needs of EMT should be developed. 2. A longitudinal study to track ethical value changes according to the amount of work experience is needed. 3. A code of ethics and/or ethics training, which could apply in actual situations, should be implemented.

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Perception and Effectiveness of Education Regarding Disclosure of Patient Safety Incidents: A Preliminary Study on Nurses (환자안전사건 소통하기에 대한 인식 및 교육 효과 분석: 간호사를 대상으로 한 예비 연구)

  • Lee, Won;Choi, Eun-Young;Pyo, Jee-Hee;Jang, Seung-Gyeong;Ock, Min-Su;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.23 no.2
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    • pp.37-54
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    • 2017
  • Objectives: The purpose of this preliminary study was to identify the nurses' perception regarding disclosure of patient safety incidents (DPSI) and to evaluate the effectiveness of education for DPSI. Methods: DPSI education was conducted for nurses majoring in clinical nurse specialist at an university. Before and after the education, the nurses made a questionnaire to evaluate the perception of DPSI. The questionnaires were divided into four categories: first, overall perception of the DPSI; second, recognition evaluation of the DPSI using hypothetical case, third, opinion on legal and nonlegal measures for facilitating the DPSI; and fourth, socio-demographic factors. The Wilcoxon signed rank test was performed on the DPSI questionnaire response to compare the perceptions before and after the education. Results: A total of 10 nurses participated in the education. DPSI education showed the possibility of improving the overall perception, necessity, effect, obstacle, and promotion method of DPSI, although there were also several responses where there was no statistical significance. In particular, DPSI education led to statistically significance change in the perception of obstacles for DPSI. For example, the number of respondents who agreed to the item "DPSI will increase the incidence of medical lawsuits." was 7 before education but decreased to 3 after education (P-value: .025) Furthermore, nurses' perception of DPSI from this study was generally positive regardless of education. Conclusion:In the future, it will be necessary to carry out DPSI education and training and to evaluate its effectiveness for more nurses.

A Study on the Use of Physical Restraints in ICUs (일 종합병원 중환자실의 억제대 적용 실태조사)

  • Cho, Yongae;Kim, Jungsook;Kim, Nari;Choi, Heejung;Cho, Junggu;Lee, Heejung;Kim, Ryungin;Sung, Younghee
    • Korean Journal of Adult Nursing
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    • v.18 no.4
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    • pp.543-552
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    • 2006
  • Purpose: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. Method: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characteristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. Results: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was $36.76{\pm}55.7$ hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. Conclusion: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.

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The Scope of Practice for Registered Nurses in 64 South Korean Laws

  • Choi, Sungkyoung;Jang, Seung Gyeong;Lee, Won
    • Journal of Korean Academy of Nursing
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    • v.49 no.6
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    • pp.760-770
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    • 2019
  • Purpose: The role of registered nurses is expanding in scope as the healthcare paradigm shifts from acute, hospital-based care to community and population-based care. Given this paradigm shift, this study explores the legal aspects of the role of a registered nurse. Methods: We used document analysis for extracting laws and legal orders related to nursing from the entirety of Korean law. Using textualism approach, we examined the contents utilizing a framework that was developed based on the role classification of community nurses by Clark in this study. Results: A total of 119 items related to nursing were derived from 64 laws. Of these, 71.4 % can be performed by people in multiple types of occupations including nurses. As a result of analyzing required qualifications, 45.4% of 119 items required additional qualifications besides registered nurse license. Analysis of workplace and activity type demonstrated that 26.1% of the 119 items were related to medical institutions, with nurses performing mostly "Client-oriented role." More than half (68.9%) were non-medical institutions, with nurses performing mostly "Delivery-oriented role." Some, however, did not stipulate the nurse's roles clearly. Conclusion: Therefore, to match the enhanced scope and responsibilities of registered nurses and to appropriately recognize, guide, and hold these nurses accountable, laws and policy must reflect these changes. In doing so, these updated laws and policies will ultimately serve as a basis for improving the quality and safety of nursing services.

A Study on the Family Planning Practice of Some Urbanites (일부 도시지역 주민의 가족계획 실천에 관한 연구)

  • Kim, Young-Ha;Cha, Hyung-Hun;Yum, Yong-Tae
    • Journal of agricultural medicine and community health
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    • v.9 no.1
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    • pp.27-38
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    • 1984
  • The Family Planning Project as a birthcontrol policy has been enthusiastically carried out by the government since 1962. But gradually it get less enthusiastic. Therefore, it is required to establish a more comprehensive and systematic plan and to carry out it thoroughly. And it is needless to say that people's knowledge about family planning, their attitudes and their practice should be concretly comprehended. Taking these things into consideration, this study surveys the general situation on family planning among 237 married women of less than 34 years in Guro 6-dong, one of target areas for Korea University Health Project from Sep. 17, 1984 to Oct. 13, 1984. The results are as follows; 1) Most of the subjects (62.8%) want 2 children and 13.6% want one child. But son-preference consciousness is remarkably revealed among them, which is thought to cause social inequality between man and woman. Therefore, it needs to change the traditional son-preference convention, for equality of all men regardless of sex. 2) The rate of induced abortion experience by person is 61.6% and the average frequency is 1.4. Almost all the induced abortion are carried out at clinics and hospitals during 2~3 months after conception. To prevent these unnecessary conception and induced abortion in view of maternal health, ethics and economics, proper contraceptive measures should be emphasized. 3) Temporary contraceptives should be sold more widely in the basis of free trade in order to practice the intensive and comprehensive family planning because the degree which Health Center has been utilized for buying temporary contraceptives is low. 4) There are serious problems such as the side effects and the lack of follow up care in permanent contraceptives. Those lower the practice rate of permanent contraception. Therefore it is necessary to improve the quality of permanent contraception practice and strengthen the follow-up care.

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Impact of Nursing Students' Knowledge, Moral Sensitivity, and Behavioral Beliefs on the Nursing Intention of COVID-19 Patients

  • Jae eun LIM;Yunmi KIM;Jaemo AN;Sangwoo YU;Jisu YUN;Dayoung LEE;Yewon LEE;Minjeong LIM;Gyuri JEONG;Heekyung JUNG
    • The Korean Journal of Food & Health Convergence
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    • v.9 no.3
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    • pp.19-25
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    • 2023
  • This study is a descriptive survey research to identify factors affecting the nursing intention of nursing college students who will nurse COVID-19 patients. This study was analyzed through convenience sampling for freshmen, sophomore, junior, senior attending the Department of Nursing at E University in Gyeonggi-do from May 17 to August 11, 2022. As a result, it was found that the intention to care for COVID-19 patients increased by 20% every time the knowledge score on COVID-19 increased by 1 point . If the average score for each item in the moral sensitivity question increased by 1 point, the nursing intention increased significantly by 5.21 times, and it was found that the nursing intention for COVID-19 patients increased significantly by 6.93 times each time the average score for each behavioral belief item increased by 1 point. Based on the results of this study, it was confirmed that the higher the knowledge, moral sensitivity, and behavioral beliefs of nursing students, the higher the intention to care for new infectious disease patients. Based on the results of this study, it was confirmed that It is necessary to develop and apply educational and psychological intervention programs and integrated nursing ethics programs.

Comparison of Job Tasks and Task Elements of Korean Nurse Anesthetists by Type of Medical Institution: Hospital, General Hospital and Higher General Hospital (의료기관 규모에 따른 마취전문간호사의 직무관련 특성, 직무 및 직무요소의 수행빈도 차이 비교)

  • Bai, Chungsim;Yoon, Haesang
    • Journal of Korean Academy of Nursing Administration
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    • v.19 no.2
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    • pp.239-253
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    • 2013
  • Purpose: This study was done to identify job tasks and task elements of Korean nurse anesthetists according to type of medical institution. Methods: A job task scale which consisted of 9 job tasks and 40 task elements was developed. Data were collected from December, 2009 to February, 2010 from 182 nurse anesthetists who were working in medical institutions (response rate: 75.8%). Results: Forty-eight percent of nurse anesthetists were independent from anesthesiologists in anesthetic practice. Preanesthetic nursing assessment was much more frequent in small hospitals than in general hospitals (p<.05), and anesthetic nursing intervention, administering the anesthetics, monitoring the patient's status during anesthesia, and provision of safety and compliance with anesthetic ethics were much more frequent in general hospitals than medical centers (p<.001). There were no differences among the medical institutions for job tasks in post-anesthetic nursing interventions (p=.229), administering anesthetics (p=.354) and monitoring patients' status during anesthesia (p=.099), providing safe anesthetic environment (p=.896), and management of ancillary personnel/equipment (p=.617). Conclusion: Results indicate that nurse anesthetists contribute significantly to anesthetic practice in small hospitals and general hospitals. Therefore, it recommended that nursing leaders make efforts to enact legal nurse anesthetist-related policies for safe and high quality anesthetic nursing care.

Reflections on the Prospects of Korean Advanced Practice Nurses : Based on Flexner's Professional Characteristics (한국 전문간호사의 전망에 관한 고찰: Flexner의 전문직 특성을 기반으로)

  • Kim, Eun Mi;Choi, Su Jung
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.1-10
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    • 2023
  • Purpose : This study explores the professional status of Advanced Practice Nurses (APNs) in Korea, who, despite being legally certified, face instability in their professional standing, including their scope of practice and compensation. Method : The study uses Flexner's professional characteristics as a framework to analyze and project the future trajectory of Korean APNs. Results : First, to ensure social accountability, professional bodies need to establish uniform nursing policies related to job roles, and healthcare institutions must adhere to these policies. Second, nursing leaders should spearhead the creation of nursing knowledge essential for the profession's advancement, aiming to establish it as the foundation for nursing practice through a consensus process within the nursing community. Third, the curriculum for APNs should enhance the quantitative and qualitative aspects of practice in response to societal needs. Fourth, professional bodies should formulate consistent nursing policies based on a thorough analysis of the healthcare environment and legal considerations, and guide their implementation in clinical practice through a consensus process within the nursing community. Lastly, guidelines should be established for professional standards suitable for the Korean context. Conclusion : Based on this review, it is recommended that all APNs adhere to the professional standards set by their respective organizations, actively participate in personal quality improvement initiatives, and fulfill their duties and roles as members of these professional bodies. Furthermore, these organizations should devise practical strategies to solidify the APN system and should spearhead a systematic consensus process that garners the agreement of all members within the nursing community.