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2011, Vol.14, No.4

  • 1.

    Medical Unprofessionalism, De-professionalization, and Virtue Ethics

    Dongik Lee | 김수정 | 최숙희 | 2011, 14(4) | pp.401~412 | number of Cited : 3
    Abstract PDF
    Medical unprofessionalism and the deprofessionalization of medicine have of late become serious concerns to physicians, medical educators, and the public. Medical professionalism, which signifies a set of values, behaviors, and a relationship that underpins the trust the public places in physicians, is a core feature of medical practice. Commercialism and consumerism in medicine are among the main factors currently contributing to medical unprofessionalism and the deprofessionalization of medical practice. The unprofessionalism and deprofessionalization of physicians produce negative images of physicians. In this article we argue for a virtue-ethics approach to solving the problems of medical unprofessionalism and deprofessionalization. We argue for the promotion of certain virtues among physicians and the need for virtuous role models. Furthermore, we claim that since physicians are also members of society,the nurturing of virtue within the medical profession both promotes and requires the nurturing of virtue within society at large.
  • 2.

    Death Anxiety and Preferences Regarding End-of-life Medical Care

    KIM Shinmi | Soon-Yi Kim | 김기숙 | 2011, 14(4) | pp.413~426 | number of Cited : 8
    Abstract PDF
    A survey was conducted to examine death anxiety and preferences regarding end-of-life care among adults aged 40 years or older. A total of 352 subjects were recruited from two areas in South Korea by trained research assistants, who used structured questionnaires consisting of demographic characteristics, Templer’s Death Anxiety scale, and the Korean version of the Preference of Care at the End of Life. The data were analyzed using descriptive statistics, a t-test, an ANOVA, and Pearson’s correlation coefficient. Subjects reported a moderate level of death anxiety. Furthermore, while a gender effect was detected, an age effect was not. There was a low preference for life-sustaining treatment with no significant differences among the various demographic groups including age. This study suggests that in order to promote clients’ self-determination and end-stage quality of life, health care providers need to be aware of clients’ attitudes toward death and their preferences regarding end-of-life care.
  • 3.

    A Factor Analysis of the Impediments to End-Stage Medical Decision-Making as Perceived by Nurses and Physicians in South Korea

    JO Kaehwa | An, Gyeong Ju | 김균무 | 2011, 14(4) | pp.427~442 | number of Cited : 4
    Abstract PDF
    Purpose: This study was designed to identify the impediment factors for end-stage medical decisionmaking as perceived by nurses and physicians in Korea. Method: The subjects in this descriptive exploratory study were 82 nurses and 61 physicians working in university hospitals in the Korean cities of Daegu and Busan. Principal component analysis was implemented in the exploratory factor analysis study, where the eigen value 1 was used for the basis of factor extractor and Varimax rotation was used to divide the factors. The data were analyzed by a SPSS/WIN 15.0 program. Result: The analysis of the impediment factors for end-stage medical decision-making revealed 15 statements and 5 categorized factors: legal compliance, prescriptive health professionals, interpersonal preparation, hospital systems, and ethical belief. These factors explained 66.84% of the total variance. Legal compliance was requested excessive roles and responsibilities of healthcare providers. Prescriptive health professionals were indicated reflection of paternalistic decision making type. Interpersonal preparation was claimed for readiness toward appropriate medical decision making issues among patient,families and healthcare providers. Hospital systems were showed inappropriate management of hospice palliative wards. Ethical belief was determined as an impediment factors for end stage medical decision making. Conclusion: We divided impediment factors for appropriate end stage medical decision-making into 5 separate categories. There is a need for a formation of a decision making system that includes the patient - health professional - family which is based on promoting the free choice of the patient while providing an atmosphere of open communication between health professionals which will facilitate the decision making process. The results of this study may contribute to the development of a new endstage decision-making system that is appropriate for medical care in Korea.
  • 4.

    Controversial Ethical Issues and the Current Progress of Stem Cell Research

    SangMok Lee | 2011, 14(4) | pp.443~455 | number of Cited : 1
    Abstract PDF
    While stem cell research offers great hope for the development of the life sciences and the discovery of medical treatments for a variety of diseases, it also raises many controversial ethical issues. The ethical issues raised by stem cell research can be divided into two broad categories. The first category consists of the controversies relating to the destruction of human embryos during the process of stem cell extraction. The second category involves the ethical questions surrounding the use of adult stem cells or induced pluripotent stem cells. This article provides an overview of the current state of stem cell research and an analysis of some of the associated ethical issues. Furthermore, on the basis of the analysis provided in this article, suggestions are offered concerning the best direction for future stem cell research.
  • 5.

    Research Ethics and Bioethics Education in Biomedical Science

    Kim, Sang Deuk | 2011, 14(4) | pp.456~467 | number of Cited : 3
    Abstract PDF
    The purpose of this article is to inquire into the nature of research ethics in biomedical science and argue for the necessity of bioethics education. The article examines extrinsic problems, such as research misconduct (“FFP”), as well as intrinsic problems that arise in the process of carrying out biomedical research. Since bioethics refers to the moral problems that arise in biomedical science, there is an essential connection between research ethics and bioethics. In particular, this article argues that bioethics should be treated as a core component of research ethics education and, furthermore, that it is a violation of research ethics not to teach research ethics and bioethics within the field of biomedical science.
  • 6.

    Experiences with Case-based Small Group Discussions in Medical Ethics Education during Residency Training

    오혜영 | CHEONG Yoo-Seock | 유상호 | 2011, 14(4) | pp.468~481 | number of Cited : 1
    Abstract PDF
    Background: Residents struggle with the evaluation and management of inpatient clinical ethical dilemmas. However, few residency programs include medical ethics education as part of their graduate medical training. This study aims to explore the perceived effectiveness, benefits, and learning experiences of residents with small group discussions about ethical dilemmas. Method: We instituted weekly residency ethical conferences to clarify residents’ understanding of medical ethics and to improve their medical ethics competence. Six to nine residents and two or more professors attended the ethical conferences and participated in the discussions. Each participant was given at least five minutes to share their thoughts and reasoning concerning a designated ethical dilemma. In the course of these meetings we also surveyed participants’ self-confidence, level of satisfaction, communication skills, moral motivation, attitudes, reasoning, and moral sensitivity. Result: Teaching residents by means of small group discussions on ethical dilemmas can enhance their ability to address these issues directly and to resolve clinical ethical dilemmas appropriately. Additionally, these group discussions were found to improve participants’ level of satisfaction and ability to communicate. Conclusion: Our experience with small group discussions based on cases involving moral dilemmas shows that discussion can be an effective and practical method of ethics education for residents. The results of this study may have implications for the future improvement of graduate medical education.
  • 7.

    The Development and Evaluation of a Research Ethics Course for a Graduate-level Educational Program in Nursing

    EUI GEUM OH | 김상희 | Sosun Kim and 3other persons | 2011, 14(4) | pp.482~498 | number of Cited : 3
    Abstract PDF
    Purpose: This study was conducted to develop and evaluate a research ethics course in a graduatelevel educational program in nursing. Methods: This study consisted of three major parts. First, an initial course was developed based on a review of the existing literature regarding research protocols and the ethical issues involved in research. Second, this initial course was delivered to the graduate students in one nursing program and a quasiexperimental study was applied to evaluate the course. Third, based on an analysis of quantitative responses from the participating nursing students, as well as input from a panel of experts, a final research ethics course was developed for this graduate program in nursing. Results: The initial course involved the following six content areas: the concept of research ethics,bioethics and research ethics, research ethics for the protection of human subjects, statistical analyses in research ethics, ethical issues in publishing and intellectual property, and research ethics in nursing. The quantitative research reports showed a significant increase in the nursing students’ perception, self-efficacy, and knowledge regarding research ethics. Further analyses show that graduate nursing students still need structured course work in order to increase their ability to carry out good research. Additionally, a course in research ethics in nursing was designed as a 1-credit, pass/fail official course consisting of the following five content areas: the concept of research ethics, the protection of human subjects in nursing, data management and research ethics, statistical management and research ethics, and publication and research ethics. Conclusion: This study was carried out to develop and evaluate a course in research ethics for a graduate-level educational program for nursing students.