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2010, Vol.13, No.2

  • 1.

    The Meaning and Characteristics of Death from a Traditional Korean Perspective

    이국봉 | 2010, 13(2) | pp.91~106 | number of Cited : 7
    Abstract PDF
    Recent advancements in medical treatment have led to a new understanding of death, which diverges from the understanding of death in traditional Korean culture. As human life can now be prolonged through new medical treatments and technologies, such as respirators, the distinction between death by nature and death by human means has become blurred. This has resulted in public interest and debate in Korea concerning “death with dignity” and a patient’s “right to die.” This article contends that the concept of “death with dignity” actually undermines a patient’s dignity and the concept of a “right to die” reduces a patient’s rights. Furthermore, it is argued that there is a need to redefine the legal definition and meaning of “natural-death” and “artificialdeath” in the context of Korean ethics, which cannot be decoupled from Korean thought and culture with its deep roots in Confucianism. This article sheds light on the meaning and characteristics of death from the point of view of Korean Confucianism. An account is also given of the associated notion of “sympathy” as developed by the philosopher Mencius. This account is intended to provide an understanding of death from a traditional Korean perspective.
  • 2.

    Justifying the Information on Hospice Care that octors should provide to Terminally Ill Patients

    정하윤 | Myong-Sei Sohn | Heo, Dae Seog and 1other persons | 2010, 13(2) | pp.107~122 | number of Cited : 1
    Abstract PDF
    This article identifies the two key functions that doctors should perform prior to accepting erminally ill patients’ requests for hospice care. In the first place, doctors caring for terminally ill atients should inform relevant family members of the patient’s condition, provide patients and family members with information on hospice care, and offer patients an opportunity to choose to receive hospice care or not. Secondly, doctors should consult with other medical professionals concerning patients’ choices and, when appropriate, provide hospice care needs for terminal patients and their families. In order to perform these two functions effectively, doctors caring for terminally ill patients should be provided with due information on hospice care. This article reviews the relevant moral justifications for providing hospice care and argues that it not only satisfies both medical and ethical objectives but is also in terminal patients’ best interests.
  • 3.

    Medical Futility in Decision-making concerning the Withdrawal of Life-Sustaining Treatment

    김진경 | 2010, 13(2) | pp.123~136 | number of Cited : 10
    Abstract PDF
    Most discussions about medical futility focus on the determination of when continued medical treatment is futile. However, there are no simple answers to this question, despite best efforts to define medical futility. Decisions concerning medical futility should involve not only physicians,but also patients and their family members, since value judgments are also relevant to the determination of medical futility. This raises the question of who actually holds the authority to make final decisions concerning medical futility. In this article we argue that shared decisionmaking should occur between patients, physicians, and family members. Even if disagreements arise in the decision-making process, each party’s opinions should be voiced and taken into consideration in reaching a resolution. Furthermore, we argue that, for the purposes of establishing a futility standard, what is needed is not a fixed and invariable law, but a process, which assists patients, physicians, and family members to debate, consult, and reach a resolution. In other words, communication skills as well as policy guidelines are required in order to optimize decision-making concerning medical futility.
  • 4.

    Legal and Ethical Issues concerning the Fair Competition Code on Pharmaceutical Trade

    Hyoung Wook Park | 2010, 13(2) | pp.137~151 | number of Cited : 2
    Abstract PDF
    In 2007 the Korean Research-based Pharmaceutical Industry Association (KRPIA) developed a Fair Competition Code on Pharmaceutical Trade, and in 2010 the Korean Pharmaceutical Manufacturers Association (KPMA) revised its Code of Fair Competition. Prior to 2007, the KRPIA and KPMA made voluntary agreements on pharmaceutical trade. This article examines the three codes in terms of the limits they set on various forms of gift-giving, donations, the funding of academic conferences inside and outside of Korea, the provision of drugs for clinical studies, market surveys, and post-market surveillance studies. The results of this examination show that the KPMA 2010 Code reflects a moral bias against donations to healthcare organizations and grants an exclusive power to the KPMA regarding sponsorships to participate in academic conferences.
  • 5.

    Residents’s perspectives on ethical conflicts and professional boundaries: a vignette-based survey

    LEE, Young-Mee | LEEYOUNGHEE | 이미정 and 4other persons | 2010, 13(2) | pp.153~174 | number of Cited : 2
    Abstract PDF
    Background The importance and recognition of medical ethics and professionalism has been growing. However, in Korea it is widely thought that there is still an insufficient amount of medical ethics education during resident training. The purpose of this study was to identify residents’ ethical sensitivity and coping strategies on ethical conflicts that can occur in clinical practice and research settings. Method The survey was conducted in 16 university-based or affiliated hospitals; a total of 1,187 residents participated in the survey. A questionnaire was developed consisting of 18 questions including 7 question areas concerning residents’ perspectives on ethical conflicts and professional boundaries in clinical practice or research. The seven question areas were as follows: coping and reporting mistakes (2 items), responding to impaired colleagues (2 items), relationship with colleagues, senior residents, and faculty (4 items), balancing personal and professional life (2 items), family (relatives) and friends’ requests (2 items), relationships with patients and their family members (3 items), clinical research ethics (3 items). For each item, a vignette was developed on the basis of situations derived from the authors’ educational and clinical experiences. To facilitate the participants’ response, 4 or 5 answer options, as well a space to for open responses, were provided for each question. Results A total of 1,072 samples (male 65.9%, female 34.1%) were analyzed. The majority of the respondents answered that if a medical mistake happens, they will report it to a faculty member and follow their instructions. Regarding impaired colleagues who may threaten patient safety, more than 70% of respondents answered that they will resolve the problem among residents themselves rather than notify a faculty member or resolve it officially. More than half of the respondents also said that if they observe non-professional or unethical conduct by either faculty members or residents, they will solve the problem by consulting with colleagues. However, more than 60% of the residents responded that they would put priority on patient care when facing conflicts between medical services and personal life. In questions about research ethics, the majority of respondents answered that they would maintain truth in managing data and research results. Conclusion The results of this study suggest that medical ethics and professionalism curricula during residency should be strengthened to develop residents’ ethical sensitivity and coping strategies concerning ethical conflicts in either clinical practice or research.