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pISSN : 2005-8284 / eISSN : 2234-3598

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2008, Vol.11, No.2

  • 1.

    Shared Decision-Making as a Model of Medical Decision-Making

    김진경 | 2008, 11(2) | pp.105~118 | number of Cited : 7
    Abstract PDF
    Matters related to human life and death and medical healing are the concerns of patients, physicians, and other related persons, including family members of the patients. Existing medical decision-making models include paternalism and informed consent. However, these models have the limitation of being one-sided or unidirectional. Accordingly, shared decision-making is now emerging as a superior model of medical decision-making. In this model, physicians, who have medical knowledge, patients, and family members, who may have the best understanding of the patients’ life, jointly participate in making medical decisions. As a medical decision-making model, shared decision-making is often regarded as a process based on mutual respect and partnership between physicians and patients. A goal of medicine is to remove pain brought about by disease. In making medical decisions for individual patients, not only physicians, but also the patients themselves and their family members can play an important role. Family members can play such a role because of their familiarity with the patient and knowledge of his or her values. This is especially true in times of medical crisis when individual patients may have difficulties in making reasonable decisions. Thus, shared decision-making is an ideal method of decision-making, one in which patients, physicians, and family members work together to choose the best course of medical treatment for the patient.
  • 2.

    Ethical and Legal Considerations Regarding the Confidentiality of Research on Illegal Activities

    CHOI Eun Kyung | Kim, Dokyun | Kim, Ock Joo | 2008, 11(2) | pp.119~138 | number of Cited : 2
    Abstract PDF
    Confidentiality has been regarded as one of the most important ethical principles for research on human subjects. Protecting research subjects’ confidentiality derives from the principle of respect for persons. As it is essential to maintain trust between researchers and subjects, research on human subjects cannot be conducted without protecting confidentiality, although it is not always easy to do so. Research that involves recording and observing illegal activities, including illegal drug studies, demands an especially high degree of confidentiality. Breach of research confidentiality can result in criminal or civil liability for the subjects in such research. When the researchers are subpoenaed, they are forced to provide information on their subjects. Most countries have no legal framework to protect both subjects and researchers from breaches of confidentiality. This paper discusses the ethical and legal considerations regarding the confidentiality of research on illegal activities. After examining domestic and international cases in which confidentiality and court orders were in conflict, the authors examine relevant policies and legal frameworks, including the Certificate of Confidentiality issued by the U.S. National Institute of Health (NIH). The authors argue that legal assurance to protect confidentiality should be provided to research subjects and researchers, especially considering the recent increase in research on illegal activities in Korea.
  • 3.

    Longitudinal DIT Study of the Moral Judgments of Student Nurses at One University in Korea

    Lee, Mi-Aie | 2008, 11(2) | pp.139~152 | number of Cited : 10
    Abstract PDF
    This study was performed to measure the moral judgment (P(%) and 4-stage) scores of student nurses four times over a three year period and to identify any statistically significant changes in participants’ scores. Data were collected through self-reported questionnaires from student nurses at one university in Korea from September 2005 to September 2008. The Korean version of the Defining Issues Test (DIT) was adopted to evaluate the moral judgment (P(%) and 4-stage) scores of participants. The results were as follows: 1) Participants’ consecutive P(%) scores were 45.81, 48.92, 42.69, 40.45, with of a mean of 44.74; and their consecutive 4-stage scores were 12.51, 12.78, 14.93, 17.08, with a mean of 14.15; and 2) the scores of P(%) rose until participants reached their 2nd grade, but then started to fall when they reached 3rd grade and continued to fall in the 4th grade, while the scores of 4-stage increased steadily during the study period. These moral judgment scores, especially those for 4th grade students, are very similar to the scores for Korean nurses. It is concluded that the moral judgment of student nurses is affected by nurses during their practical training. This study suggests that there is a need to develop the moral judgment of student nurses and nurses in nursing education and practice.
  • 4.

    Ethical Considerations in Articles Published in Nursing Journals

    Jeong Ihnsook | Young-Rhan Um | Kim, KeumSoon | 2008, 11(2) | pp.153~162 | number of Cited : 4
    Abstract PDF
    Purpose: The purpose of this study is to identify the presence/absence of ethical considerations in the published articles of nursing journals. Methods: The ethical considerations of 331 articles published in six nursing journals having ethical considerations in their “instructions for authors” were examined. The following ethical considerations were reviewed: compliance with the Helsinki Declaration, approval of an independent ethical review committee (IRB), informed consent, protection of privacy and confidentiality, and the notification of conflicts of interest. Results: Two hundred and seventy three of 331 (82.2%) articles had at least one ethical consideration, the most common of which was obtaining informed consent (80.1%). However, none of the articles included compliance with the Helsinki Declaration, and only 15.7% of the articles included obtaining written informed consent. The articles written in English showed more ethical considerations than those written in Korean in the aspects of IRB approval (p<0.0001) and obtaining written informed consent (p=0.050). For research methodology, qualitative studies had more ethical considerations than experimental studies or surveys in terms of protecting privacy and confidentiality (p=0.022) and obtaining written informed consent (p=0.011). Conclusion: The ethical considerations in the articles published in the nursing journals examined did not fully reflect the ethical considerations listed in the journals’ instructions for authors. This study suggests that editors should pay greater attention in determining whether or not articles published in their journals follow the ethical considerations in their instructions for authors.
  • 5.

    Amendment of the “Acceptable Limit for Abortion” in Article 14 of the Mother and Child Health Law

    이은영 | 강현희 | KIM Yun Deok and 2other persons | 2008, 11(2) | pp.163~182 | number of Cited : 5
    Abstract PDF
    Since its enactment in 1973 the Mother and Child Health Law in Korea has not properly reflected the rapid social changes that have taken place in Korea and has been enforced without appropriate legislative amendments. According to Henshaw and Simon, Korea posted a 19.6% rate of abortion, which is the highest among OECD countries. In Chapter 27 of the Criminal Law, established in 1953, before the passage of the Mother and Child Health Law, abortion was designated as a crime and was subject to punishment without exception. Although the Mother and Child Health Law has been revised six times, including an extensive amendment in 1986, Article 14 of the Law has not been revised due to possible ethical and social controversies. Accordingly, the Ministry of Health & Welfare and the Medical Law and Ethics Research Center at Yonsei University began studying an amendment of Article 14 in September 2007. These groups prepared an amendment bill for Article 14 based on existing research into the policies on abortion in other countries and ensured that the bill fully reflects the opinions of different social groups in Korea. This article summarizes the problem with Article 14 of the Mother and Child Health Law and the proposed amendments to it.
  • 6.

    The Development of a Clinical Ethics Core Curriculum for Medical Trainees in Korea

    CHEONG Yoo-Seock | Younsuck Koh | KWON Ivo and 6other persons | 2008, 11(2) | pp.183~190 | number of Cited : 4
    Abstract PDF
    In 2007, the Korean Society for Medical Ethics Education (KSMEE), with the support of the Korean Academy of Medicine (KAM), developed a clinical ethics core curriculum for medical trainees in Korea. This article provides a summary of the contents of the curriculum developed by the KSMEE. The curriculum consists of six main subjects: doctor-patient relationships, interpersonal relationships with colleagues and paramedical persons, ethics related health policy, withholding and withdrawing of treatment, research ethics, and professionalism. Each main subject has three to four sub-sections. All issues were generated by medical ethics experts by means of group discussions and a survey of medical trainees at various university hospitals in Korea. Each subtitle has four parts including a general overview, learning goals, and two to three relevant clinical cases with key references. This curriculum is primarily for medical trainees, who are not well prepared for the diverse ethical challenges and ethical dilemmas they may face during their daily clinical activities.
  • 7.

    Korean nurses’ awareness of patients’ rights in hospitals

    YongSoon kim | Yoo moon sook | 박진희 | 2008, 11(2) | pp.191~200 | number of Cited : 0
    Abstract PDF
    Patients’ rights and patient–nurse relationships in nursing practice have been viewed increasingly as essential aspects of nursing care. A cross-sectional questionnaire survey was conducted between August 1 and 30, 2005 to examine 618 Korean nurses’ awareness of patients’ rights regarding autonomy, informed consent, privacy, and confidentiality. Data were collected by means of a structured questionnaire. The results indicate that nurses have little awareness of the importance of patients’ rights regarding autonomy, privacy, and confidentiality. As an understanding of these rights is essential to good clinical practice, this study suggests that there is a need for education programs focused on understanding the legal and ethical rights of patients in the care of nurses.