KJC Korea
Journal Central

This article reports on a study designed to assess the professional training in, and attitudes toward, medical ethics among the resident physicians in one university hospital in Korea. The study is based on a questionnaire, which was administered to the 470 residents at Asan Medical Center. Of the 346 (73.6%) residents who responded, 66.8% reported having completed a medical ethics course during their residency training. Serious ethical dilemmas were encountered by 69.1% of the residents at least once a year. The majority of these residents claimed to have resolved those dilemmas either alone or through discussions with colleagues. Frequently encountered issues included doctor-patient relationships, decisions to discontinue life-sustaining therapies, and do-not-resuscitate orders. Most respondents were aware of the existence of the hospital ethics committee, but did not know how to consult it. Furthermore, most participants were willing to attend medical ethics courses and believed that these should be mandatory during residency training. The results of this study suggest that hospitals should provide a well-developed medical ethics education program for resident physicians.

This article reports on the results of a study of nurses and nursing students' sensitivity to the ethical dimensions of nursing practice. The sample consisted of 215 nursing students from two nursing colleges and 283 nurses working in two medical centers. The instrument used was the Moral Sensitivity Questionnaire (MSQ), a self-reporting Likert-type questionnaire consisting of 30 assumptions related to moral sensitivity in health-care practice. Each of these assumptions was categorized into a theoretical dimension of moral sensitivity: relational orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing moral conflict, and following rules. In structuring moral meaning, relational orientation, and following rules, significant differences were found between nurses and nursing students. However, a significant difference in the general characteristics of subjects was not found.

This article was written for the purpose of improving communication and understanding between nurses and doctors. It is written from the standpoint of doctors. The “ethics of nurses” is used in this article to refer both to the ethical standards or principles that nurses observe in nursing practice as well as to statements concerning the ethical principles with which nurses or their associations claim to comply. It is pointed out that medical practice requires a division of labor and that most associations of medical and paramedical practitioners explicitly endorse principles specifying the need for, and duties regarding, collaboration among medical and paramedical practitioners. Such principles of collaboration not only promote systematic cooperative relationships, they also encourage each group to hold the other in check, so as to safeguard medical ethics in clinical practice. It is argued that nurses and doctors should strive to reconstruct an advanced, democratic, complementary, coexistent, productive, and consonant relationship in order to promote effective communication in medical practice.

This article attempts to characterize the appropriate role of doctors in relation to their patients. A guiding question is “What is the relation between the doctor’s role and the doctor’s professional ethics? Several authors have described the possible conflicts between role morality and common morality and have stressed the importance of the former. This article defends the idea that the appropriate attitude of doctors toward their patients is detached concern, which combines detachment and compassionate care, and represents the impersonal and personal aspects of a doctor’s role. The question of whether detached concern could ever work as an ethical prescription is also explored. The answer provided is that detached concern should function, not as a direct ethical prescription, but as an overarching attitudinal norm for medical professionals.

This article describes the origins and rationale of the Dutch policy on euthanasia. Euthanasia is in principle illegal in the Netherlands, as it is in other countries. However, under certain conditions euthanasia is “tolerated” in the Netherlands. The Dutch ethicist Bert Gordijn attributes this to the typical Dutch mentality to avoid radical positions and instead compromise in disputes. According to Gordijn, two dominant and somewhat contrary social forces from the 17th century influenced the Dutch mentality and policy: conservative Calvinism and free trade. Disputes emerging from conflicting interests were traditionally resolved according to the policy of tolerance, and certain illegal acts remained unpunished. The Dutch policy concerning euthanasia, a typical example of pragmatic tolerance, attempts to prevent the greater evil of unregulated euthanasia by tolerating the lesser evil of euthanasia under strict preconditions. Ongoing public discussion in the Netherlands about the legitimacy of more liberal euthanasia laws have given rise to the current Dutch policy on euthanasia and medically assisted suicide.

In 2002, an exhibition of human cadavers entitled “Body Worlds” was staged in Korea. Since then a number of similar exhibitions have been held across the country, drawing a total of more than four million visitors. These exhibitions, which display plastinated human cadavers in various poses, have been widely regarded as having scientific and educational value, teaching people about human life and health. However, there has been little public debate or discussion of the ethical issues associated with the exhibition of human cadavers. This article explains that the ethical principles governing cadaver use for medical education are as follows: 1) there should be no viable alternative to human cadavers for this purpose; 2) there should be concrete and explicit benefits from the use of cadavers; 3) informed consent should be obtained; 4) the cadavers should be respected and not be used for commercial purposes; and 5) privacy and confidentiality should be maintained. However, as it is argued in this article, the public exhibitions of human cadavers mentioned above violate several of these ethical principles: there are alternatives to the use of human cadavers for the purposes of health education, no explicit and concrete benefits were gained by using these human cadavers, the commercial dimension of the exhibitions violates the principle of respect for the dead body, and it is doubtful that informed consent was obtained from the people whose bodies were on display in these exhibitions. Thus, this article concludes that the exhibitions of human cadavers in Korea were unethical.

This paper examines the conception of medical professionalism reflected in the Korean Medical Act. Several articles of the Korean Medical Act dictate that physicians should adhere to improved medical techniques or higher ethical standards in their field. The authority of professionals is grounded in their knowledge and expertise; indeed it is the nature of their authority that makes their professionalism necessary. The values of professionalism (expertise, morality, self-regulation, patient welfare) have traditionally been different from the values of commerce. In this article I argue that medical professionalism will be challenged if physicians must prove their innocence in medical malpractice litigation, as a current legislative bill stipulates. This article also reviews the problems associated with the burden of proof in such cases.

On December 29, 2003, the Korean National Assembly passed the Bioethics and Biosafety Act, which came into effect in 2005. While many organizations—governmental, scientific, civic, ethical, and religious—participated in the public discussions leading up to the enactment of the Bioethics and Biosafety Act, none of these organizations was satisfied with the result once it was enacted. Many criticisms were raised, including criticisms of the National Bioethics Committee, which was established to enable all interested parties to voice their concerns concerning the bioethics legislation, to promote mutual understanding among the various parties, and to ensure that the pending legislation would be ethically sound. However, for reasons presented in this article, the Committee did not, and could not, fulfill its proper role of mediating disagreements and promoting consensus; instead, it enabled each of the various organizations concerned with the Bioethics and Biosafety Act to claim their own interests. The function of a committee is very much determined by its composition. So to understand why the National Bioethics Committee failed to function properly, one must look to its composition or organization. This article examines how the National Bioethics Committee was organized, describes its agendas and operational problems during a two-and-a-half year period, and presents a proposal for resolving those problems.