• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.53-75
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• 2008

The end of life problem in the United States has been evolved from the development of concept of brain death over last 50 yr. The invention of ventilator and the development of emergency medicine also played a key role to elongate the end stage of life and which caused the American people to ask a question about the patients self determination and refusing the unwarranted medical treatment in the view of the death with dignity. With regard to the patient unable to self determination, surrogate decision was also considered. To guarantee the self determination, The patient self determination act also enacted on the level of Federal regulation in 1990s. But no law has effectively dealt with the situation when medical treatment became futile. Along with the significant debates on literature and court cases. The American Medical Association's Council on Medical and Judical Affairs presented formal opinion and the Texas was the first states to regulate the medical futile situation in 1999. Even though that definition was in controversy, the concept of medical futility mainly focused on the doctors' right to refuse the treatment.

• Journal of Korean Neurosurgical Society
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• v.42 no.2
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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.

• Journal of Hospice and Palliative Care
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• v.18 no.3
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• pp.179-187
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• 2015

For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.

• Journal of Korean Philosophical Society
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• v.137
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• pp.193-223
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• 2016

This research examines the recognition of nature as identified by Zhuangzi through the man of truth. Zhuangzi defines inactivity as an act of nature and personifies it as the man of truth, a holy man who achieves salvation. It is the stage that is united with nature by breaking out of secular restriction and achieving the absolute liberal spirit. The man of truth is the origin enabling all the acts of nature. And since the existence of all living things is connected, the change of life and death complies with the operation of nature. It is an irresistible destiny for all human beings. Therefore, the duty of nature recognizes the life and death of all creation into a single perspective. In this sense, the feelings of joy and sorrow that human beings feel are unnecessary. When following the duty of nature and destiny, which is to break out of secular desire and empty the mind, it is possible to go to the stage of futility and enjoy a silent and comfortable life. Zhuangzi explains it as living free from worldly cares, which is the stage of 'Soyoyoo(逍遙遊)'. In this thesis, the principles of courtesy and the virtue of Confucianism are stated and are contrary to the concept of futility asserted by Zhuangzi. But, a different approach could be attempted which recognizes a superman who is even more evolved from the man of truth. The philosophical ideology of Zhuangzi could be a necessary factor for modern people and his oriental natural spirit should be highly appreciated.

• Korean Journal of Adult Nursing
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• v.22 no.3
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• pp.329-341
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• 2010

Purpose: The purpose of this study was to understand the meaning of death experienced by medical and nursing students through end-of-life care practice. Methods: Data were collected by in-depth interviews with twelve (six nursing and six medical) students. Conventional qualitative content analysis was used to analyze the data. Results: This findings were analyzed in three areas: 'feeling from the word of death', 'color association of death', and 'relation between life and death'. Results were three major themes and sixteen categories from the analysis. Three major themes include 'reality of uncertain death', 'have to leave, and 'new perception about death'. Sixteen categories include 'being well', 'fear', 'unknown', 'boundless', 'being with', 'out of sight', 'new start', 'go back to', 'place going by itself', 'place to meet with', 'being transformed', 'a sense of futility', 'the same point', 'a different point', 'continuous line', and 'a crossroad'. Conclusion: The findings suggest a number of themes that nursing and medical students reported about the end of life experiences that could be explored as a way of improving end of life care.

• Korean Journal of Adult Nursing
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• v.14 no.4
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• pp.521-531
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• 2002

Purpose: This study was to identify the meaning of the lived experiences, to describe of the meaning structures and to develop the strategies of nursing intervention centering to these meanings of the smoking cessation. Method: This study was derived from a phenomenological analytic method suggested by Giorgi. The participants in this study were five adults who had the previous experience of smoking cessation. The data were collected from September of 2001 to April of 2002 through systemic interviews and participatory observations. Average of five interviews were performed, and each interview lasted an hour and half. Result: The meaning of smoking cessation was categorized with nine components. That is (1) obstinacy of the habit of smoking ; difficulty of endurance, succumb to temptation of smoking, repetition of smoking and smoking cessation, habit-forming. (2) Bring about a symptom of improving ; took place headache, expectoration of sputum, sense of instability. (3) Waver in worthy ; doubts about smoking cessation, ridiculed smoking cessation. (4) Be narrowed social life ; become estranged from friends. (5) Futility ; unnecessary, harm. (6) Self-repression ; occurred indomitable mind, strong will, endurance. (7) Gratification ; self-admiration, receive praise from family. (8) Delightfulness ; clean in body and clothes, be disgusted with the foul order of smoking. (9) Improvement in welfare ; a clear mind and good memory, improve in health, have a good appetite. Conclusion: The nursing intervention must be focused on these concerns to accomplish successful smoking cessation program.

• Journal of the Korea Concrete Institute
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• v.14 no.1
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• pp.49-57
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• 2002

As composite materials, the addition of steel fiber with concrete significant)y improves the engineering properties of structural members, notably shear strength and ductility. Flexural strength, fatigue strength, and the capacity to resist cracking are also enhanced. Especially the strengthening effect of steel fiber in shear is to prevent the brittle shear failure. In this study, shear-strengthening effect of steel fiber in RC short columns were investigated from the literature surveys and 10th specimem's member test results. From the test results, following conclusions can be made; the maximum enhancement of shear-strengthening effect can be achieved at about 1.5 ％ of steel fiber contents, shear strength and ductility capacity were improved remarkably in comparison to stiffness and energy dissipation capacity in steel fiber reinforced concrete.

• Tuberculosis and Respiratory Diseases
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• v.58 no.3
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• pp.213-229
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• 2005

The first and the longest criminal indictment case of Korean medico-legal battle, so called BORAMAE Hospital Incident, was finally on its end by Korean Supreme Court's decision on June 24, 2004, after 7 years long legal dispute via Seoul District Court and Seoul Superior Appeal Court's decision. Boramae Hospital case was the first Korean legal case of Withdrawing Life-sustaining treatment of mechanical respirator on 58 years old Extradural Hematoma victim who was on Respirator under Coma after multi-organ failure postoperatively(APACHE II score: 34-39). Two physicians who have involved patient's care and had helped to make discharge the Near-death patient to home after repeated demand of patient's wife, due to economic reason, were sentenced as homicidal crime. This review article will discuss the following items with the review of US cases, Quinlan(1976), Nancy Cruzan(1990), Barber (1983), Helen Wanglie(1990), Baby K (1994) and Baby L cases, along with Official Statement of ATS and other Academic dignitaries of US and World.: [1] Details of Boramae Hospital incident, medical facts description and legal language of homicidal crime sentence. [2] The medical dispute about the legal misinterpretation of patient's clinical status, regarding the severity of the victim with multi-organs failure on Respirator under coma with least chance of recovery, less than 10% probability. [3] Case study of US, of similar situation. [4] Introduction of ATS official Statement on Withdrawing/ Withholding Life sustaining treatment. [5] Patient Autonomy as basic principle. [6] The procedural formality in Medical practise for keeping the legitimacy. [7] The definition of Medical Futility and its dispute. [8] Dying in Dignity and PAS(Physician Assisted Suicide)/and/or Euthanasia [9] The Korean version of "Dying in Dignity", based on the Supreme Court's decision of Boramae Hospital incident (2004.6.24.) [10] Summary and Author's Note for future prospects.

• The Journal of the Korea Contents Association
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• v.17 no.10
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• pp.667-685
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• 2017

The purpose of this study was to explore the meaning and essence of experience of family members as care-givers of terminally ill cancer patients at hospice wards. This study was based on the Giorgi phenomenological method, which describes the experiences about the family caregivers. We had in-depth interview with spouses and orthogonal families of nine terminally ill cancer patients. Results were drawn into 13 essential themes, 45 sub themes, and 122 main points. The essential themes are as follows: "cling of life", "bed-keeper", "sacrifice of care", "physical and mental exhaustion during care process","feeling of love and hatred", "avenge on a patient", "self-condemnation", "futility after exhaustion", "consolation of other caregivers", "utmost efforts in resignation", "freedom from suffering", "paradoxical blessing of cancer", "introspected revolution", and "preparation of a dignified death". Implications and limitations are discussed based on study results.

• Proceedings of the Korean Society of Crop Science Conference
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• 2017.06a
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• pp.306-306
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• 2017

Screening for drought and salinity tolerance was undertaken for selected Philippine upland rice landraces during germinative and seedling stages to identify varieties which can potentially be grown in marginally dry and saline soils. While increasing PEG and NaCl concentrations caused obvious signs of injury to all rice genotypes, considerable varietal differences were noted in the nature of responses providing evidence that these genotypes possess broad intraspecific genetic variations for drought and salt tolerance. Inconsistent responses of these varieties during both growth stages highlight complexities involved in stress responses and underscore the futility of utilizing a single stage in the rice plant's life cycle for physiological screening. Notwithstanding these perplexing responses, G_Katiil and Ml-Pilit Tapul were observed to thrive relatively well despite increased salt and drought stress during early growth stages and may therefore possess genes needed in crop improvement efforts for drought and salinity tolerance. While these results do not reflect the entire spectrum of adaptive expression to drought and salinity stress during the life cycle of the upland rice plant, they nonetheless provide an easy, reliable and reproducible method for preliminary identification of drought and salt tolerant rice varieties.