• 보건행정학회지
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• 제23권4호
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• pp.314-325
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• 2013

Background: Stem cell research competition is accelerating globally since President Obama signed an executive order, repealing Bush-era policy that limited use of federal tax dollars for embryonic stem cell research. Methods: In this paper, we conducted a comparative analysis of stem cell research policy changes in three countries, including the Human Fertilisation Embryology Act (HFEA) of UK, executive order 13,505 (removing barriers to responsible scientific research involving human stem cells) of USA, and Bioethics and Safety Act of South Korea. Debates on stem cell research are based on conflicts of fundamental beliefs that exist in the supporting and opposing coalitions. We compared regional characteristics of the advocacy coalitions in three countries and presented various factors that might be related to the policy changes. Results: The UK government, parliament, and the HFEA have sought expert consultations and public opinions to establish guidelines. UK has made social consensus through continued discussion for a long time. US President's veto power was one strongest factors influencing policy. South Korean policy was influenced by public opinion and policy brokers. Also, South Korea has not made social consensus. UK had a strong leadership and strong adjustment of coalitions but US and South Korea had not. Dr. Hwang's scandal has had one of the greatest impacts on policy decision in South Korea. Conclusion: The power of public opinion was critical in all three countries. In particular, the influence of public opinion was noticeable in South Korea. Also it turned out that in US and South Korea, the presence of a policy broker who could pursue his or her goals was the most powerful factor among the advocacy coalition factors.

• 한국치위생학회지
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• 제14권2호
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• pp.241-250
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• 2014

Objectives : The purpose of the study was to examine the ethical requirements for the protection of human subjects in the publication guidelines of dental health journals. Methods : The guidelines of 27 dental health journals were reviewed to determine ethical standards alone, with Helsinki Declaration, by an institutional review board (IRB), informed consent, protection of subject privacy and confidentiality, and no conflicts of interest. Results : 1. Dentistry journals listed on National Research Foundation of Korea had a conflict of interest disclosure provisions of the contribution(76.9%) and the IRB approval(61.5%). 2. Half of the dental health journals were not listed on National Research Foundation of Korea Society but they agreed the advance posting provisions. 3. Dental hygiene journals provide 100% of ethics alone and receive 75% of IRB in the papers. 4. Dental health and dental hygiene journals have conflicts of interest disclosure regulations(59.2%) and IRB approval(51.8%). 5. There existed statistically significant differences between the dental health journals whether they were listed on the human subjects and ethical standards for protection in National Research Foundation of Korea or not. Conclusions : While the publication guidelines of dental health journals have followed to a greater extent in recent years, there is still a need for further instructions to ensure that the authors satisfy all ethical requirements in conducting research on human subjects. IRB approval for dental journals must be standardized and reinforced reflecting the characteristics of each journals. The researchers should obey the code of ethics suitable for education and the editors must review the paper continuously.

• 보건행정학회지
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• 제28권3호
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• pp.315-319
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• 2018

This paper aims to make a step-by-step strategy to formulate an unified health system by clarifying and overcoming challenges facing South and North Korea and to estimate costs needed for South Korea to assist North Korea to recover to normal health delivery system. We explored implications through literature review and estimated costs under the assumption that supportive activities be provided for 5 years in three ways: support for the development of health and medical care manpower; support for health and medical facilities; and support for the provision of both preventive and primary health care. Step-by-step strategy is formulated for a unified health system with the cost estimation resulting as follows: in case of basic scenario, a total of 3 trillion and 341 billion won (at present value of the year 2017) is in need for the 5-year period at the initial 'recovery support stage' with 135.9 billion won for the development of health and medical care manpower, approximately 2 trillion won for health and medical facilities, and 1.2 trillion won for the provision of both preventive and primary health care. Step-by-step approach is more realistic and applicable in formulating unified health system. Suggested stages are 'recovery support stage,' 'system homogenization stage,' and 'unified system stage.' Strategies at 'recovery support stage' suggested in this paper need to be pursued and followed by those at 'system homogenization stage' and 'unified system stage.'

• 과학기술학연구
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• 제8권1호
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• pp.55-95
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• 2008

본 연구는 2000년부터 2002까지 진행된 세포응용연구사업단 설립과정을 토대로 배아줄기세포 연구를 둘러싼 기대역학구조를 분석하고자 시도되었다. 기대역학은 기대구성-재원확보-연구의무이행-기대구성의 과정이 반복적으로 나타나면서 구조화된다. 일반적으로 연구자들은 해당 연구결과에 대해 매우 신중하고 중립적인 태도를 보인다. 하지만 일부 관련 연구자들의 경우 과도한 전망을 제시하며 기대구성에 적극적인 모습을 보이는데 이는 재원확보와 윤리적 논쟁방어를 위한 역학창출이라는 전략적 관점에서 이해될 수 있다. 거대규모의 재원과 인력이 소요되는 생명공학연구개발의 경우 기대역학창출은 연구개발의 성패에 결정적인 요인으로 작용하기 때문에 이러한 전략구사는 더욱 중요한 의미를 갖게 된다. (배아)줄기세포를 둘러싼 연결망을 '기대역학'이라는 개념틀을 이용해 분석하게 되면 국내 (배아)줄기세포 연구자의 정체성이 좀 더 분명하게 드러나게 되고 정책담당자나 대중의 의사결정과정에 도움이 될 만한 의미 있는 결론에 도달할 수 있다.

• 대한간호학회지
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• 제49권6호
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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.

• 지역사회간호학회지
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• 제29권2호
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• pp.244-256
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• 2018

Purpose: This study tried to understand discourses of life-sustaining treatments in general daily and healthcare newspapers. Methods: A text-network analysis was conducted using the NetMiner program. Firstly, 572 articles from 11 daily newspapers and 258 articles from 8 healthcare newspapers were collected, which were published from August 2013 to October 2016. Secondly, keywords (semantic morphemes) were extracted from the articles and rearranged by removing stop-words, refining similar words, excluding non-relevant words, and defining meaningful phrases. Finally, co-occurrence matrices of the keywords with a frequency of 30 times or higher were developed and statistical measures-indices of degree and betweenness centrality, ego-networks, and clustering-were obtained. Results: In the general daily and healthcare newspapers, the top eight core keywords were common: "patients," "death," "LST (life-sustaining treatments)," "hospice palliative care," "hospitals," "family," "opinion," and "withdrawal." There were also common subtopics shared by the general daily and healthcare newspapers: withdrawal of LST, hospice palliative care, National Bioethics Review Committee, and self-determination and proxy decision of patients and family. Additionally, the general daily newspapers included diverse social interest or events like well-dying, euthanasia, and the death of farmer Baek Nam-ki, whereas the healthcare newspapers discussed problems of the relevant laws, and insufficient infrastructure and low reimbursement for hospice-palliative care. Conclusion: The discourse that withdrawal of futile LST should be allowed according to the patient's will was consistent in the newspapers. Given that newspaper articles influence knowledge and attitudes of the public, RNs are recommended to participate actively in public communication on LST.

• 한국의료질향상학회지
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• 제23권2호
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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.

• 한국산학기술학회논문지
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• 제16권6호
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• pp.4048-4055
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• 2015

본 연구는 요양병원 간호사의 생명의료윤리 의식정도를 파악하는 것이다. 본 연구는 광주와 전남 지역 요양병원에 근무하고 요양병원에서 근무한지 5개월 이상 된 간호사 183명을 대상으로 설문지를 사용하였으며, 수집된 자료는 SPSS 21.0 프로그램을 이용하여, 기술통계, Independent t-test와 one-way ANOVA, 사후검증은 $scheff{\acute{e}}$ test, 상관관계분석(Pearson's Correlation Analysis)으로 분석하였다. 본 연구에서 대상자의 생명의료윤리 의식에 대한 대상자들의 의식은 중간보다 높은 수준이었다. 생명의료윤리 하위영역별 의식 중 태아생명권의 의식과 임신중절의 의식이 가장 유의한 양적 상관관계가 있었다. 요양병원 간호사의 생명의료윤리의식 정도는 높았으나, 가치관이 정립되지 않아 임상상황에서 의사결정이 혼돈된다. 따라서 기관의 신규간호사나 간호대학생에게 생명의료윤리 교육을 통해 윤리적 가치관을 확립하여 환자의 안녕에 기여해야 할 것이다.

• 한국산학기술학회논문지
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• 제15권2호
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• pp.1074-1082
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• 2014

본 연구는 응급구조학과 학생들의 DNR에 대한 인식과 윤리적 태도를 알아봄으로써, DNR에 대한 객관적인 기틀을 마련하기 위해 시도된 서술적 조사연구이다. 연구대상은 전라남, 북도에 소재한 응급구조학과 학생 257명을 대상으로 하였다. 자료수집 기간은 2012년 9월 1일부터 9월 30일까지였으며, 자료수집 방법은 구조화된 질문지를 이용하였다. 자료 분석 방법은 SPSS 18.O program을 이용하여 빈도, 백분율, $x^2$-test, 교차분석이다. 연구 결과 대상자의 일반적 특성에 따른 DNR과 관련된 윤리문제에 대한 태도 차이는 성별, 연령, 학년, 종교, 교육유무에 따라 윤리적 태도간의 유의한 차이가 있었다. 따라서 본 연구 결과를 바탕으로 객관적인 기준이 될 수 있는 지침서와 생명윤리에 따른 전문적인 DNR 교육이 계속적으로 이루어져 충분한 정보제공이 이루어져야 할 것이라 사료된다.

• 의료법학
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• 제10권1호
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• pp.39-75
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• 2009

The development of the biomedical science and technology has extended an argument about a status in constitutional law of unborn human life and a protection of the potential human life to that of an embryo and a gamete beyond a fetus. This argument has been focused on whether we should provide unborn or potential human life with human dignity and the right to life that are guaranteed by the constitutional law altogether or separately. If the right to life is given to unborn or potential human life, on what grounds can we restrict this right. Those who argue for the unity of the right to life with human dignity and the inseparability of those two claims that the right to life in itself should be guaranteed absolutely. According to the constitutional law, however, any constitutional right of the human person within the protection of essential part of the right can be compared with each other and restricted with some valid reasons from the legal perspective. This measure is unavoidable in reality because one right can come into conflict with another right frequently. Since fetus and embryo are in a process of developing into the human person, it is difficult to think that they are the same with the human person. For that reason, it is hard to consider that the right to life of fetus or embryo is the same with that of the human person. However, since a fetus has a special status as a potential human person, and an embryo also has a special value as a potential fetus upon an implantation, the right to life of fetus or embryo should be judged differently according to the stage of their development. A study on a constitutional status and protection of a fetus and an embryo is essential because unborn or potential human life is the origin of human person. Therefore, we have to make much account of their right to life and seek the legal respect for their inherent value.