KJC Korea
Journal Central

There was dispute on ‘baby box’ in the second half of 2011. In 2009, clergyman, Lee Jong-rak made a baby box on church wall. Actually, 26 new born babies were abandoned in the ‘baby box’. The babies who had disability were thrown out from the unmarried mothers with letters. If there was no baby box,the babies could die by hypothermia in the cold weather. But Ministry of health and welfare, and Gwanak Ward Office are requesting to remove baby box because it is illegal for non-authorized facility to look after baby. Baby box was installed to prevent from abandonment of baby in cold weather and risk. But it is on dispute between ‘protection of infant’ and ‘encouragement of abandonment’. Like dispute surrounding abortion or contraception, baby box is a complicated problem and it is not easy to conclude. It is a difficult subject that anybody cannot judge awkwardly. This is because the subject is related to human life. This thesis tried to evaluate this problem from ethical view. First, contradictory views are reviewed - the views are if baby box is for encouragement of abandonment, or if it is for protection of infant. Second, this problem is investigated from positions of Deontology and Teleology which are representative views of ethics. And this paper applies principles of modern medical ethics from the dispute to evaluate the problem. Finally, this subject is treated with from positions of personal ethic and social ethic.

In the era of personalized medicine, in which human biological materials are becoming more important,the demand for biobanks is increasing. However, as the research potential of biological materials made available through biobanks increases, concerns are growing over the processes and consequences of biobank technology. Accordingly, there are calls for the establishment of biobanks and the setting of ethical criteria for research involving biobanks. This article examines new ethical criteria for research involving biobanks using the concept of ethical responsibility presented by Hans Jonas.

Although informed consent was introduced as a method for respecting patient autonomy in the medical decision-making process, it fails to involve various contextual aspects of medical decisions. Informed consent presupposes personal rationality and only accepts choices made by the individual patient. Thus,if the family of an incompetent patient makes decisions on the patient’s behalf, those choices are not seen as autonomous. Accordingly, a new perspective is needed, one which strengthens patient autonomy and reflects the fact that, in countries such as Korea, a patient’s family members are properly regarded as proxy decision makers with the right to become involved in discussions and decisions concerning the patient’s medical treatment. Traditional shared decision-making is a collaborative process involving the patient and doctor. It excludes, not only the patient's family, but also ethical consultants that can act as mediators to help resolve any conflicts. This article critically analyzes the traditional shared decisionmaking process and then proposes a new shared decision-making model.

The study was conducted to develop and test a hypothetical model which explains Korean shared medical decision-making was established based on the King's theory. The participants were 580 adults who lived in one of 3 Korean metropolitan cities: Seoul, Daegu, and Busan. The data were collected using questionnaires from August 10 through October 25, 2011. The descriptive and correlation statistics were analyzed using the SPSS/WIN 15.0 and the structural equation modeling procedure was performed using the Amos 20.0 program. The results of this study showed that the attitude of dignified death were the strong factors influencing shared decision making in this sample. The attitude of withdrawal of life sustaining treatment didn't influenced to the shared decision making but the attitude of withdrawal of life sustaining treatment and the attitude of dignified death showed correlation between two factors. The proposed model was concise and extensive in predicting shared decision making of the participants. Findings may provide useful assistance in developing effective medical and nursing interventions for maintaining and promoting shared decision making in clinical situations.

The purpose of the study was 1) to examine the relationship between medical students’ attitudes toward death and their suicidal impulse control and 2) to investigate the effects of empathy on death attitudes and suicidal impulse control. A questionnaire was developed consisting of six death-attitude factors, a suicidal impulse control item, and two empathy related items. The questionnaire was administrated to medical students at one university in Pusan, South Korea. One hundred and six completed questionnaires were analyzed. The results show that the more often respondents think about death and consider death as liberation, the lower their ability is to control suicidal impulses. Respondents who avoided thinking about death or who thought the impact of their death on their family members would be high were more likely to have a higher level of control of suicidal impulses. The impact of their own death on family members was most strongly correlated with an attitude toward death as a natural part of life. Regarding the effects of empathy on suicidal impulse control, cognitive empathy had a stronger correlation with suicidal impulse control than affective empathy. The results of regression show that cognitive empathy has the strongest effect on suicidal impulse control compared to other significant factors. The results of this study imply that the causes of suicide are not limited to the conventional psychological factors, such as depression. Understanding attitudes toward death and empathy could enhance society’s continuing efforts to reduce suicide among college students generally and medical students in particular.

The aim of this study was to explore the ethical difficulties experienced by emergency department nurses in hospital settings. Data were collected using in-depth interviews with a purposive sample of 12 nurses working in emergency department. The interviews were transcribed and analyzed using inductive thematic analysis to identify ethical difficulties. Four themes were emerged from the qualitative data: difficulty of advocacy for patients’ good, ethical disagreement, ethical immaturity, and ethical stress. This study will provide a theoretical basis for developing ethical guidelines that enable emergency room nurses to make decision ethically.

This study investigated knowledge, attitude, and will for brain death organ donation (BDOD) of college students, and identified influencing factors on knowledge, attitude and will using structured questionnaire. The subjects of the research were 108 nursing students and 78 non-nursing students at N university. The data was analyzed with static analysis, t-test, χ2-test, ANOVA, pearson correlation coefficient,and Logistic regression. The mean score of knowledge toward BDOD of nursing students was 11.05 and non-nursing students scored 8.10 on average. The mean score of attitude toward BDOD of the nursing students was 3.39 and that of the non-nursing students was 3.28. There was a significant difference in knowledge according to sex, religion in nursing students. There was a significant difference in attitude according to the experience of blood donation in nursing students, and perceived health status in non-nursing students. For nursing students, there was a significant difference in the will for organ donation between students who have considered about organ donation and those who have not. There was a significant relation between the attitude and the knowledge of BDOD. However, in non-nursing students, attitude toward BDOD was not correlated with knowledge. Nursing students as future health professionals were aware of the roles and responsibilities of nurses to augment organ donation. Although nursing students scored higher in knowledge and attitude about BDOD than non-nursing students,more specifically structured education programs are needed. To promote BDOD, relevant policies and effective campaigns need to be developed.

This study aimed to identify the level of awareness, self-efficacy, and knowledge of research ethics among nursing graduate students. A descriptive survey design was used. A total of 102 nursing graduate students were recruited from one nursing school in Korea. Data collection instruments were developed based on the core instructional areas of Responsible Conduct of Research (RCR) from the Office of Research Integrity at the research team’s institution. Participants completed a self-reported questionnaire consisting of questions on research ethics. The data were analyzed with descriptive statistics using PASW Statistics 18.0 Window program. Participants (mean age=31 years) consisted of master’s (77.5%) and doctoral (22.5%) level students. Only 25.5% of participants had taken a course in research ethics, and 26.5% of participants had experience conducting research as principle investigators. The level of awareness (mean score 2.91 out of 5) and self-efficacy for good research practice (3.15 out of 5) were moderate. The level of knowledge regarding research ethics was low (10.59 out of 16). The area of lowest awareness was ‘protection of intellectual property and patents,’ followed by ‘justifying authorship’;the area of least knowledge was ‘writing research articles,’ followed by ‘criteria for authorship.’ Statistically significant correlations were found between awareness, self-efficacy, and knowledge of research ethics (all p<0.05). These results support the conclusion that educational programs for enhancing awareness, self-efficacy, and knowledge of research ethics for graduate nursing students are needed in order to help students conduct ethically sound research.

As information provided in pharmaceutical marketing brochures has the potential to change doctors’prescribing behavior, ongoing efforts to increase awareness about drug promotion are crucial. However medical information in journal advertising has been criticized in several studies for being of poor quality. To find out the accuracy and ethical status of pharmaceutical marketing brochures about proton pump inhibitors prescribed in one university hospital in South Korea, six brochures were collected from pharmaceutical representatives visiting the family medicine out-patient department of that hospital between May 2010 to March 2011. We examined these brochures for the types of claims that were made, the amount and type of evidence provided, the authenticity of the quoted references, and whether or not the brochures satisfied the “World Health Organization (WHO) criteria 1988.” We also ascertained the source of funding for the original research cited in the brochures. Upon analysis, none of the promotional brochures fulfilled all of the WHO criteria. All brochures used emotionally loaded language and made exaggerated claims about the efficacy of the medicine in question. A total of 61 references were found in these brochures, 86.8% of which were journal articles. Of the journal articles cited in these brochures, 73.6% were SCI level, most were based on randomized controlled trials (RCT, 53.8%), and 41.5% were sponsored by pharmaceutical companies. Additionally, 17.1% of the claims made in these brochures were incorrect according to the published articles cited in the brochures, and 10.4% contained vague descriptions. We conclude that some of the information provided in pharmaceutical brochures for physicians is incorrect. Accordingly, we suggest that physicians need to be cautious about the reliability of information provided in drug advertisements and should follow the principles of evidencebased medicine in assessing the validity of information provided by pharmaceutical companies.