• 제목/요약/키워드: Medical ethics

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호스피스의료와 간호윤리 (Hospice Medicine and Nursing Ethics)

  • 문성제
    • 의료법학
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    • 제9권1호
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    • pp.385-411
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    • 2008
  • The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

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치위생(학)과와 보건계열 대학생들의 생명 의료윤리 의식에 관한 융합연구 (A Convergence Study on the Consciousness of Bio-medical Ethics of Dental Hygiene and Health Science related Majoring Students)

  • 박영남
    • 융합정보논문지
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    • 제9권10호
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    • pp.227-233
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    • 2019
  • 본 연구는 치위생(학)과와 보건계열 학생들을 대상으로 2018년 6월에서 7월까지 생명윤리의식을 파악하여 생명윤리 교육과정 개발에 필요한 기초자료를 제공하고자 설문조사하였다. 생명권과 인공수정 인식도의 관한 상관관계는 성별(r=0.241), 종교(r=-0.176), 학과(r=-0.160)에서 유의하였고, 장기기증 및 장기이식에 관한 인식도에 관한 상관관계는 학년(r=0.129), 종교(r=-0.098), 생명윤리 교육여부(r=0.235)에서 유의하였다. 안락사의 인식도에 관한 상관관계는 종교(r=0.139), 생명윤리교육 여부(r=-0.157)에서 유의하였다. 결과적으로 보건계열 대학생들에게 바람직한 윤리관을 확립하기 위해서는 교육과정을 개발하고 생명의료 윤리의식에 영향을 미치는 요인을 다각적으로 분석하여 체계적으로 교육 프로그램을 운영해야 할 것이다.

인공지능 의료윤리: 영상의학 영상데이터 활용 관점의 고찰 (Ethics for Artificial Intelligence: Focus on the Use of Radiology Images)

  • 박성호
    • 대한영상의학회지
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    • 제83권4호
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    • pp.759-770
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    • 2022
  • 인공지능의 연구 개발 및 활용에서 윤리의 중요성이 의료분야뿐 아니라 전 사회적으로 점차 널리 인식되고 있다. 이 종설은 영상의학 영상데이터를 인공지능 연구에 활용할 때 개인정보의 보호 및 데이터에 대한 권리 측면에서 윤리적으로 고려할 사항들에 대해서 국내 독자들에게 실용적인 정보를 제공하고자 한다. 따라서 이 글에 담긴 내용은 많은 부분이 관련된 국내 법과 정부 제도에 바탕을 두고 있다. 인공지능의 연구 개발 및 활용에서 개인정보 보호는 매우 중요한 윤리적 원칙이며 연구 데이터의 적절한 가명처리는 개인정보 보호를 위한 핵심 방법이다. 아울러 인공지능 연구 개발에 의료 데이터를 상업적 이해관계를 최소화하며 윤리적으로 공유할 필요성도 부각되고 있다. 연구 데이터 공유는 개인정보 유출의 위험을 증가시키므로 개인정보 보호에 더욱 주의가 필요하다.

국내외 뇌사, 존엄사와 안락사에 대한 인식의 변화와 윤리 - 소아를 중심으로 (The change of perspective on brain death, euthanasia and withdrawal of the life supporting medical treatments in Korea for pediatric patients)

  • 권복규
    • Clinical and Experimental Pediatrics
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    • 제52권8호
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    • pp.843-850
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    • 2009
  • A recent High Court's decision regarding the withdrawal of life supporting medical treatment (artificial ventilator) from an elderly female patient in the terminal stage has opened up a new era of the "euthanasia dispute" in Korea. With this decision, the legitimate withdrawal of life supporting treatment became possible under certain conditions and the Korean Medical Association is working toward the establishment of practical guidelines for the terminal-stage patients. However, there are still very few debates on the cases of pediatric patients in the terminal stage or suffering from fatal diseases. For pediatric patients, the core principle of autonomy and following procedure of "advance directives" are hardly kept due to the immaturity of the patients themselves. Decisions for their lives usually are in the hands of the parents, which may often bring out tragic disputes around "child abuse", especially in Korea where parents have exclusive control of the destiny of their children. Some developed countries such as the U.S.A., the U.K. and Canada have already established guidelines or a legal framework for ensuring the rights of the healthcare system regarding children suffering from severe illness, permitting the withdrawal of Life supporting medical treatment (LSMT) in very specific conditions when the quality of life of the children is severely threatened. For the protection of the welfare and interest of the children, we should discuss this issue and develop guidelines for the daily practice of pediatricians.

응급구조과 학생의 소극적 안락사에 대한 태도 (Passive Euthanasia Attitude of EMT Students)

  • 정명애;김재욱;최대범
    • 한국응급구조학회지
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    • 제15권1호
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    • pp.89-99
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    • 2011
  • Purpose : This study was performed to examine the euthanasia attitude of EMT students. Method : The results were based on the revised questionnaires on euthanasia. Total 155 students filled out the questionnaires in September 17-18, 2009. Data were analyzed using SPSS 14.0 in terms of means, $x^2-test$, mean, standard deviation, and one way ANOVA. Results : The euthanasia attitude was no statistically significant difference between three groups. In the area of quality of life, there were no statistically significant difference between three groups. In the area of life respect, there were no statistically significant difference between three groups. In the area of medical ethics, there were statistically significant difference between three groups. In the area of client right, there were no statistically significant difference between three groups. Conclusion : This results showed that education of euthanasia attitude must be instructed to EMT students. It is necessary to make a further development euthanasia program of EMT.

Epidemiology and Preventive Medicine in Times of New Technologies

  • Jenicek Milos
    • 대한예방의학회:학술대회논문집
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    • 대한예방의학회 1996년도 제48차 추계 학술대회 연제집
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    • pp.3-26
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    • 1996
  • Epidemiology and preventive medicine are changing together with Population and health and with ever expanding medical and non medical technologies. New technologies make epidemiology methodologically more sophisticated, but such advances risk overshadowing epidemiology's most important role: raising questions, providing answers, and helping the medical decision-making at ail levels of prevention. Epidemiology also plays a major role in the evaluation of new and other technologies whose effectiveness is poorly known. Epidemiological approaches, methods, techniques, and interpretations are widely used in new and rapidly expanding fields of medicine: research evaluation and synthesis (meta-analysis), establishment of guidelines for clinical preventive practices, new medical technology assessment, guidelines for national and international health policies, evidence-based medicine, outcomes research and disease management ('population-based' medicine and quality of care improvement). In the nearest future, infectious and noninfectious diseases may cease to be almost the sole subjects of epidemiology and they may share their place with other mass phenomena of the next millennium, such as medical practices and care, or political, social and economic actions and their consequences. Not only will primary, secondary, and tertiary Prevention will remain in the epidemiological mainstream, but health protection and health promotion will require perhaps a redefinition of epidemiology in these domains. Epidemiology and preventive medicine are both subjects of medical ethics and dilemma for right choices.

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

  • 김미선
    • 한국응급구조학회지
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    • 제5권1호
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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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인문사회의학의 의사국가시험 도입에 대한 인식도 조사 (A Survey on the Introduction of Medical Humanities and Sociology into the National Medical Licensing Examination)

  • 이승희;정명현;신좌섭;정은경
    • 의학교육논단
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    • 제12권1호
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    • pp.33-41
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    • 2010
  • Purpose: This study aimed at investigating the current situation of Medical Humanities and Sociology-related-curriculum in Korean medical schools, and suggesting the courses of study for the contents and methods of the Medical Humanities and Sociology examination, which can be included in the National Examination for Medical Practitioners. Methods: We analyzed Medical Humanities and Sociology-related courses which are offered in Korean medical schools, and a survey was conducted by medical school professors and students and medical journalists. In the survey, the Medical Humanities and Sociology-related courses were divided into 8 parts, and the participants were asked to evaluate the importance of duty, necessity of education, necessity of evaluation and the evaluation method of each part using a seven-point scale. Results: A total of 207 medical school professors and students and 9 medical journalists participated in the survey. The results were similar for the importance of duty and necessity of education of each part, but those for the necessity of evaluation were different. - As a result, there seems to be a gap between the importance of duty and the importance of education of each course. Medical journalists and students group answered differently on the necessity of evaluation of each course was also reserved. Conclusion: It is necessarily recommended to include Medical Humanities and Sociology-related courses such as medical ethics, self-improvement and doctors' social responsibilities in the National Examination for Medical Practitioners.

인문사회의학 교육과정 개선을 위한 제안 (Suggestions for the Improvement of Medical Humanities Education)

  • 전우택
    • 의학교육논단
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    • 제12권1호
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    • pp.23-31
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    • 2010
  • Medical humanities has become a third area of medical education following basic and clinical medicine. Also, in the national evaluation of medical schools, medical humanities education is an important factor. However, there are many difficulties in teaching medical humanities in medical schools. First, it is still an unfamiliar education area to medical schools and professors. Second, still, there is no consensus on the definition and contents of this education. Third, it is usually very difficult to find professors who have interest and the ability to teach medical humanities. Fourth, even medical students do not understand why they should study medical humanities and sometimes do not eagerly participate in class. This paper suggests some solutions for these problems. First, medical humanities need to be divided into sections according to how easily the contents can be accepted by existing medical education system and apply these sections in the introduction of this education gradually and in stage. One example of the division can be as follows: Group 1) medical ethics and medical law which can be most easily accepted. Group 2) medical communication skills which can be relatively easily accepted. Group 3) medical history and medical professionalism which is relatively difficult to accept, and Group 4) medical philosophy, medicine and music, medicine and literature, medicine and art, medicine and religion, etc. which is the most difficult to accept. In this paper, four things are suggested. Second, divide the contents into mendatory courses and elective courses. Third, allocate the contents throughout the four years from the first year though the fourth year according to the spiral curriculum model. This paper reports some new ideas and methods for medical humanities education. First, to stimulate students' participation, several methods were applied in a large size lecture and student projects. Second, the emphasis of writing in class and evaluation were discussed. Third, the provision of hands on experience is more emphasized than lectures. Fourth, inviting some doctors who work in non-medical areas such as journalism, pharmaceutical industry, etc is suggested. Trial and error is inevitable in this education, but it is essential in molding a good doctor, so medical professors who are interested or in charge of this medical humanities education need to share their ideas and experiences.

사상의학(四象醫學) 장부이론(臟腑理論)의 특징(特徵)에 대(對)한 고찰(考察) (A Study on the Theory of JangBu(臟腑) in Sasang Constitutional Medicine)

  • 김정호;송정모
    • 사상체질의학회지
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    • 제16권1호
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    • pp.20-36
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    • 2004
  • After studying the theory of JangBu(臟腑), that is a physiology of Sasang Constitutional Medicine, in Sasang Constitutional Medicine, the author could draw a conclusion as these. 1. The basic thought of Sasang Constitutional Medicine is emphatic on the human beings itself unlike the idea of traditional Oriental Medicine, that accentuate the universe.(The traditional Oriental Medicine has a concept that the human beings follows the order of universe, but Sasang Constitutional Medicine has a different idea that human beings has the free will to the universe and newly comprehend the relationships between human beings and universe.) 2. Like the preceding, the theory of JangBu(臟腑), the physiology of Sasang Constitutional Medicine, is based on the autonomic mechanisms of human body itself. 3. The medical philosophy of Sasang Constitutional Medicine is Sasang(四象), that is Sa(事), Sim(心), Sin(身) and Mul(物). This Sasang is a classification of universe include human beings.(Sa(事) is event, Sim(心) is mind, Sin(身) is body, and Mul(物) is things. these four elements express the universe and human.) 4. The JangBu(臟腑) theory of Sasang Constitutional Medicine regard mind condition as important. The mind condition is divided into two factors. The one is Seong(性) the other is Jeong(情). The Seong(性) is an attitude toward the world, and the Jeong(情) is response to the stimulation from the world. 5. By the actions of Seong(性) and Jeong(情), the human body has different JangBu(臟腑) function, so the human body can be grouped in four constitutions. 6. Because of emphasis on mind condition, the Sasang JangBu(臟腑) theory has activism of human beings itself. 7. This activismor practical philosophy of Sasang JangBu(臟腑) theory, that is a physiology of Sasang Constitutional Medicine, gave birth to ethics or morality in Medical philosophy, that the human practice of ethics or morality bring a health and well being of human body.

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