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2011, Vol.12, No.1

  • 1.

    The Role of Narrative in Biomedical Ethics

    황임경 | 2011, 12(1) | pp.1~18 | number of Cited : 7
    Abstract PDF
    Narratives are discursive form which is to narrate the life events in time. Man is a storytelling animal. Human experience is understood, reconstructed and transmitted as a narrative form and we seek the meaning of life from the narrative. Recently, so-called ‘narrativist turn’ has occurred in the many fields of humanities and sociology. The scholars influenced by postmodernism are concerned about narrative, because it represents the concrete aspects of the human life. There has also been growing interest about narrative in medicine to make an approach to the suffering of patients. Narrative approaches to biomedical ethics have been also well known in the fields of biomedical ethics. It is grounded in the certain assumptions of principlism, which is the dominant paradigm in the fields of biomedical ethics, can not represent and solve the real problems in clinical practice. Narrative approaches to biomedical ethics can be categorized as supplement, method, form, foundation and substitution in view of function and relationship to the principlism. This paper explores a context of a rise of narrative with a reflection of the success and shortcomings of principlism in biomedical ethics. By careful scrutinization of its method, theoretical framework and potential application to practice, the authors argue that ‘narrative biomedical ethics’ can be useful as an alternative method of biomedical ethics and its education.
  • 2.

    Critical Approach to Rule Centered Bioethics : focused on the integrity of the activity

    KIM Soo-Jung | 2011, 12(1) | pp.19~32 | number of Cited : 1
    Abstract
    Biomedical issues have been dealt with four major principles: Respect for human person, non-maleficence, beneficience, justice. The application of particular principles to each particular biomedical issue depends on its characteristics. Organ distribution focuses on distributive justice whereas studies involving human subject emphasizes the importance of respect for human person, non-maleficence, and justice. However, principle based approach tends to overlook the complex structure of human action and focus on individual events, particular intentions, and results of human behavior. Biomedical technology intervenes human activities and modes of human existence which were regarded as integrated whole and has caused their fragmentation. Biomedical ethics needs to examine various ways any particular biomedical technology intervene human activities and explore their meaning and social implication in human life. The seriousness of biomedical issues lies in the fact that its impacts are not limited to the individual concern but extended to society and human history. Frequent interventions of biomedical technology to human life have raised fresh and diverse ethical issues and threatens our understanding of human activities, human person, and intrinsic values of human life. This paper will criticise principle based approach of biomedical ethics and suggest value-oriented approach. First, it will present Aristotle's understanding of the structure of human action. In particular, the presentation of virtuous agent in Aristotle will be compared with Kant's understanding of moral person, and Aristotle's understanding of human end will be distinguished from Mill's understanding of human intention. Second, interventions of biomedical technology such as human growth hormone and enhancement using steroid in sport will be analysed through the complexity of human action, the role of human emotion, and human end. Third, the authenticity of sports and intrinsic values of medical profession will be argued against threats of fragmentation of human activities due to the biomedical technology.
  • 3.

    The Need of Public Discussion for the Desirable Operation of a Biobank

    YI, Sang wook | Cho, Eun Hee | 2011, 12(1) | pp.33~52 | number of Cited : 8
    Abstract
    We argue that there are a number of important ethical, institutional, and cultural issues we need to examine for the successful operation of a biobank, which is recently pursued by many countries. A biobank requires the commitments of lots of people for a long period of time, and the information gathered there are diverse, and some of them, sensitive. Also, the informed consent for a biobank has to be quite comprehensive due to the intrinsically uncertain nature of the future research related to it, and social, due to the unique characteristics of genetic information. These facts suggest, we claim, that a biobank poses additional ethical challenges to those of conventional biomedical research. In order to tackle the challenges, we argue, it is crucial to establish proper social support for the biobank research and trust in its management. We discuss British and Japanese approaches to a biobank in contrast to Iceland's and Tonga's approaches, illustrating our claims. We also discuss the limitations of conventional anonymization in the case of biobanks, and consider the 'open consent' strategy of the Personal Genome Project as a potential alternative.
  • 4.

    The Criminal Protection of Human Gamete, Embryo and Fetus

    황만성 | 2011, 12(1) | pp.53~70 | number of Cited : 5
    Abstract
    After a year-long discussion, on October 14, 2003, the government bill, “Bioethics and Biosafety Act,” was referred to the Korean National Assembly, the assembly that ultimately passed the Bioethics Act in December 2003. The Act placed a strict ban on the manipulation of human embryos for research purposes. An act of implanting a cloned embryo through SCNT technology into a woman's uterus, an act of maintaining the implantation of a cloned embryo, or an act of leading to the birth of a cloned baby is prohibited. A violator or a would-be violator shall be imprisoned up to ten years. Participating in, inducing one into, or brokering any act conducted for the purpose of human cloning is also prohibited and penalized. Article 12 provides a ban on interspecies implantation. Additionally, the following acts are prohibited: 1) fertilizing human eggs with animal sperms or vice versa; 2) transplanting a nucleus taken from an animal somatic cell into a human anucleated egg; 3) fusing a human embryo with an animal embryo; 4) fusing a human embryo with different genetic information; or 5) implanting an embryo created from the above acts into a human or animal uterus. Human embryos may not be created for any purpose other than pregnancy. Moreover, human embryos shall not be produced by any of the following acts of fertilization: 1) selecting a sperm to select the sex of a baby; 2) using an egg or a sperm from a dead person; and 3) using a sperm or an egg from a minor. Any person would be prohibited from acquiring or transferring human sperm or eggs for valuable consideration, such as monetary or property gains. Under Bioethics and Biosafety Act, Human embryos is not respected as Human being, but as “special things”. Criminal law gives very little recognition to a fetus's rights. Unlike tort law, criminal law is almost exclusively statutory. Under the Criminal Law, a “human being” is interpreted as “a person who has been born and who is alive.” Therefore, the fetus is not recognized as a protected class under some criminal statutes. There have been some exceptions, but these have been narrowly construed. Feticide statutes, which make the destruction of a fetus a crime parallel to homicide, recognize the right of the fetus to be protected from certain conduct. Again, however, in the jurisdictions in which such statutes have been adopted, the courts have narrowly construed these statutes to exclude maternal conduct that leads to the death of the fetus.
  • 5.

    Critical Consideration of Neuroethics and Its Prospect

    CHOI Kyungsuk | 2011, 12(1) | pp.71~85 | number of Cited : 7
    Abstract
    In this paper, I point out that most issues in neuroethics are similar to those raised when a new science was shown up. I emphasize that we have to pay attention to new issues because most of issues may be resolved by broadening current bioethical discourse into neuroethical one. One of important issues beyond current bioethical discourse is how we understand features of the mental. The other is about neural determinism. Dealing with those issues, I argue for minimal physicalism that does not imply reductionism and strong neural determinism. The mental supervenes on its relevant activities of neurons. There are causal laws among activities of neurons. In this perspective, I argue against the view that free will is identified with a pure mental entity as well as brain-centralism that a self is identified with a brain. In addition, I point out that strong neural determinism is not plausible because we have to distinguish causation from determinism. Brain as a part of nature is subject to natural laws. However, what we know about them is mainly about relationships between necessary cause and its effect or correlations among them. Neuroscience, of course, has a task to discover any physical laws among neurons. In addition, it has to identify what mental entities supervene on particular activities of neurons. This research will provide with us a chance to voluntarily intervene causal relationships by improving our knowledge of causation in neural activities, rather than reinforce strong neural determinism.
  • 6.

    Discussion about the morality and legality between Bioetics and the Law

    In-Young Lee | 2011, 12(1) | pp.87~109 | number of Cited : 4
    Abstract PDF
    Questions about the relationship between law and morality have a long history. Current legislation on bioethics is being made and ethical issues have been resolved by legislation. According to Kant, law and morality are separate from each other. In the Groundwork of the Metaphysics of Morals, He observes that the only thing that is unconditionally good is the good will and that the basis for any possible giving of positive laws' lies in the sum of the conditions under the choice of one can be united with the choice of another. Kant's philosophy of law is that law is the conditions for jointly possible freedoms and the sum of conditions under which the choice of one can be united with the choice of another in accordance with a universal law of freedom. However, according to Kant, morality is the foundation of the legitimacy. Legislation regarding the life sciences increased recently. Law can not be neutral, since there are a conflicts of the interested parties with regard to the development of life sciences. When we establish the Bioethics Law, it should be based on basic principles of bioethics such as categorical imperatives. The idea of ​​respect and protection of human dignity should be declared in the legislative process of bioethics law. However the ethical debates have recently been increased on the embryo's legal status whether it may respect its dignity and life in the course of research with embryonic stem cell. But, the degree of protection on human dignity should be considered between the historical and political, social cultural values of our society.