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An integrated Method of New Casuistry and Specified Principlism as Nursing Ethics Methodology (새로운 간호윤리학 방법론;통합된 사례방법론)

  • Um, Young-Rhan
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.51-64
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    • 1997
  • The purpose of the study was to introduce an integrated approach of new Casuistry and specified principlism in resolving ethical problems and studying nursing ethics. In studying clinical ethics and nursing ethics, there is no systematic research method. While nurses often experience ethical dilemmas in practice, much of previous research on nursing ethics has focused merely on describing the existing problems. In addition, ethists presented theoretical analysis and critics rather than providing the specific problems solving strategies. There is a need in clinical situations for an integrated method which can provide the objective description for existing problem situations as well as specific problem solving methods. We inherit two distinct ways of discussing ethical issues. One of these frames these issues in terms of principles, rules, and other general ideas; the other focuses on the specific features of particular kinds of moral cases. In the first way general ethical rules relate to specific moral cases in a theoretical manner, with universal rules serving as "axioms" from which particular moral judgments are deduced as theorems. In the seconds, this relation is frankly practical. with general moral rules serving as "maxims", which can be fully understood only in terms of the paradigmatic cases that define their meaning and force. Theoretical arguments are structured in ways that free them from any dependence on the circumstances of their presentation and ensure them a validity of a kind that is not affected by the practical context of use. In formal arguments particular conclusions are deduced from("entailed by") the initial axioms or universal principles that are the apex of the argument. So the truth or certainty that attaches to those axioms flows downward to the specific instances to be "proved". In the language of formal logic, the axioms are major premises, the facts that specify the present instance are minor premises, and the conclusion to be "proved" is deduced (follows necessarily) from the initial presises. Practical arguments, by contrast, involve a wider range of factors than formal deductions and are read with an eye to their occasion of use. Instead of aiming at strict entailments, they draw on the outcomes of previous experience, carrying over the procedures used to resolve earlier problems and reapply them in new problmatic situations. Practical arguments depend for their power on how closely the present circumstances resemble those of the earlier precedent cases for which this particular type of argument was originally devised. So. in practical arguments, the truths and certitudes established in the precedent cases pass sideways, so as to provide "resolutions" of later problems. In the language of rational analysis, the facts of the present case define the gounds on which any resolution must be based; the general considerations that carried wight in similar situations provide warrants that help settle future cases. So the resolution of any problem holds good presumptively; its strengh depends on the similarities between the present case and the prededents; and its soundness can be challenged (or rebutted) in situations that are recognized ans exceptional. Jonsen & Toulmin (1988), and Jonsen (1991) introduce New Casuistry as a practical method. The oxford English Dictionary defines casuistry quite accurately as "that part of ethics which resolves cases of conscience, applying the general rules of religion and morality to particular instances in which circumstances alter cases or in which there appears to be a conflict of duties." They modified the casuistry of the medieval ages to use in clinical situations which is characterized by "the typology of cases and the analogy as an inference method". A case is the unit of analysis. The structure of case was made with interaction of situation and moral rules. The situation is what surrounds or stands around. The moral rule is the essence of case. The analogy can be objective because "the grounds, the warrants, the theoretical backing, the modal qualifiers" are identified in the cases. The specified principlism was the method that Degrazia (1992) integrated the principlism and the specification introduced by Richardson (1990). In this method, the principle is specified by adding information about limitations of the scope and restricting the range of the principle. This should be substantive qualifications. The integrated method is an combination of the New Casuistry and the specified principlism. For example, the study was "Ethical problems experienced by nurses in the care of terminally ill patients"(Um, 1994). A semi-structured in-depth interview was conducted for fifteen nurses who mainly took care of terminally ill patients. The first stage, twenty one cases were identified as relevant to the topic, and then were classified to four types of problems. For instance, one of these types was the patient's refusal of care. The second stage, the ethical problems in the case were defined, and then the case was analyzed. This was to analyze the reasons, the ethical values, and the related ethical principles in the cases. Then the interpretation was synthetically done by integration of the result of analysis and the situation. The third stage was the ordering phase of the cases, which was done according to the result of the interpretation and the common principles in the cases. The first two stages describe the methodology of new casuistry, and the final stage was for the methodology of the specified principlism. The common principles were the principle of autonomy and the principle of caring. The principle of autonomy was specified; when competent patients refused care, nurse should discontinue the care to respect for the patients' decision. The principle of caring was also specified; when the competent patients refused care, nurses should continue to provide the care in spite of the patients' refusal to preserve their life. These specification may lead the opposite behavior, which emphasizes the importance of nurse's will and intentions to make their decision in the clinical situations.

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The Present Status and the Preservation Method of the Rice Terrace as Scenic Sites Resources in Northeast Asia (동북아시아 계단식 논의 명승지정 현황 및 보전방안)

  • Youn, Kyung-Sook;Lee, Chang-Hun;Kim, Hyung-Dae;Seo, Woo-Hyun;Lee, Jae-Keun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.29 no.4
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    • pp.111-123
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    • 2011
  • This study aims to present the basic materials, which lead us to preserve the Korea Rice Terrace as scenic sites resources and study it continuously, through researching about the present status and the preservation method of the Rice Terrace in Korea, China and Japan. The results of this study are as follows. First, The Rice Terrace has a traditional agricultural technique which minimizing the damage of the scenic view while cultivating the slope. And also, it has the value of one of the Korea unique traditional scenic views. However, The no cultivation land or disappearing desert land of rice terrace were increasing by the disadvantage of operation in land cultivation. Therefore, The Government must need preparing the base of scene resources excavation by executed the established of Korea Rice Terrace Database for preserving of Korea traditional scene. however it is getting to disappearance. And also, The High valued of Rice Terrace by cultural and scenic view which is must managed by designation of scenic sites or monument. Second, The internal and external reference book researched and analyzed results are as followings for understanding about Korea Rice Terrace feature. First of all, The Rice Terrace's dictionary meaning is just difference by each nations. However, Generally speaking that It means the terraced land by cultivated of sloped land. The Rice Terrace has cross relation with mountain valley and piedmont slope cultivation in location of condition. It occurred era is before approximately estimated from 3000 of years until 6000 of years. It can divide two type by topography shape those are slope and valley type. However, The natural element of forest has very big position in this part. But, The Rice Terrace is just managed and designated by the scenic sites with the Cultural Properties Protection Law. It must needs more binding force and effectiveness for the Rice Terrace scenic view plan establishment by scenic laws and farming and fishing village laws etc. I think that it must need the Rice Terrace related law establishment as soon as possible for efficient preservation and management of the Rice Terrace. Third, The Rice Terrace were researched and analyzed results are as followings those were executed at the Korea, China and Japan. The Korea and Japan have good Rice Terrace Characteristic. And also, The high valued scenic sites area were good managed by the Cultural Properties Protection Law as well as the superior scenic valued Rice Terrace in China. Those are also managed by designated scenic sites for protection and preservation positively. Those were managed by each autonomous district management Department. The each nation's related laws of Rice Terrace protection were just little bit different. However, The basic purpose is same. for example, it based on superior scenic view preservation and protection. Especially, The Japan's Cultural Properties Law and Scenic law linkage, and China Autonomous district legislation and effectiveness. The Korea Government must need above elements for Korea Rice Terrace culture and scenic view preservation. Fourth, We need inducing the owner system and the policy of Rice Terrace preservation promotion association for efficient preservation of Rice Terrace in japan. The owner system in japan gives the owner of the land a permission to rent the land to Rice Terrace preservation promotion association and the local government. In this system the village would be revitalized by commons in the way of the management of the terraces, beautifying the area around the terraces and etc. And also, Making the each village management operating system for Rice Terrace management through educating civilization. The civilization could receive quick help from a consultative body comprised of experts such as representatives of Cultural Heritage Administration and professors. And it is in a hurry to solve the problem of revitalization of the region by exchange between cities and the village.