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2014, Vol.17, No.1

  • 1.

    Another Understanding of Autonomy in Biomedical Ethics : Focused on Relational Autonomy

    LEE EUNYOUNG | 2014, 17(1) | pp.01~13 | number of Cited : 8
    Abstract PDF
    Informed consent focuses on personal rationality and only accepts the choices of an individual. Thus, if the family of an incompetent patient makes decisions on behalf of the patient, those decisions are not regarded as autonomous. This article argues that a new approach is needed, one that strengthens patient autonomy and reflects the fact that in countries such as South Korea, a patient’s family memberscan act as proxy decision-makers for patients. This article proposes a new concept—relational autonomy—as an alternative to the flawed concept of liberal autonomy. Relational autonomy, which is an umbrella term focusing on social relationships and interdependent networks of relational selves, considers emotional aspects, interactions in relationships, and the attribute of patient dependency in medical practice. In relational autonomy, the self is not something that is fixed, but rather changes continuously. On this view, the self is a relational and innately social self with mutual relationships that continually develop and transform. A patient’s self is different from the rational self of a physically and mentally healthy person in that a patient must rely on others and is no longer fully independent. In order for a patient to have real autonomy, the concept of relational autonomy requires that certain social conditions, including improvements at the political and legal levels, are met.
  • 2.

    A Legal Perspective on a Fetus’s Capacity for the Enjoyment of Rights

    Yoo, Ji HOng | 2014, 17(1) | pp.14~33 | number of Cited : 12
    Abstract PDF
    Although biotechnology plays an important role in modern medicine, it does give rise to a host of legal and ethical issues. This article examines the legal status of unborn life in order to establish the proper future direction of biotechnology. When Civil Law was first legislated, an “unborn life” was considered to be a fetus in a mother’s body and something generated by sexual intercourse. However, biotechnology has since changed the scope of that term. For instance, an embryo can now be created in number of ways in addition to sexual intercourse, such as in vitro fertilization and somatic cell cloning. Furthermore, biotechnology allows for the detection of the genetic identity and growth potential of a fertilized egg, which arguably supports the view that the legal status of an artificial embryo is equal to that of a fetus. The author of this article examines the legal status of fetuses in Civil Law. It is claimed that clauses of Civil Code for the protection of fetuses should be interpreted as exceptional provisions. It is also argued that a fetus acquires the capacity for enjoying private rights in utero and that Article 3 of the Civil Code should be revised to state that a human being is the subject of rights and obligations from fertilization and throughout survival.
  • 3.

    Factors Influencing Nurses’ Ethical Decision-Making Regarding End-of-Life Care

    Doo Ree Kim | Eun Kyoung Han | SANGHEE KIM and 2other persons | 2014, 17(1) | pp.34~47 | number of Cited : 6
    Abstract PDF
    The ethical decision-making abilities of nurses are essential in enhancing the quality of life and death for patients and their family members. The purpose of this study was to describe the extent of nurses’ ethicaldecision-making abilities regarding end-of-life (EOL) care and to identify the factors that influence nurses’ ethical decisions. A cross-sectional descriptive survey was applied at two university-affiliated hospitals in South Korea using self-reported questionnaires concerning knowledge, attitudes, and ethicaldecision-making procedures regarding EOL care. A total of 192 nurses participated in the survey. Data were collected in December 2012 and analyzed with descriptive statistics, a Pearson correlation coefficient, and multiple regressions. Nurses’ ethical decision-making abilities regarding EOL care was positively correlated with nurses’ knowledge (r=0.27, p<0.001) but there was no correlation between attitudes (r=0.14, p=0.062). Knowledge and job satisfaction explained 25.3% of variance in nurses’ moralpractice as the result of ethical decision-making. The findings of this study suggest that it is necessary for nurses who care for EOL patients to improve their knowledge and positive attitudes in order to enhancetheir competency in ethical decision-making.
  • 4.

    An Integrative Review of Clinical Ethics Support Services for Clinical Nurses

    SANGHEE KIM | Doo Ree Kim | Seo, Minjeong and 1other persons | 2014, 17(1) | pp.48~71 | number of Cited : 4
    Abstract PDF
    The purpose of this study was to review existing literature regarding clinical ethics support services for clinical nurses. An integrative review method with five steps was applied. In the step of problem identification, three issues were identified, including the characteristics of previously published research, research subjects and interventions, and major concepts regarding clinical ethics support services for clinicalnurses. Relevant reports were searched from databases including PubMed, Cochrane library, and JoannaBriggs Institute with key words regarding clinical ethics. Finally, 50 articles published between 2002 and 2012 were selected. It was found that most of the existing research was empirical with descriptive study designs. Over 60% of this research focused on nurses as research subjects. Only two interventional studies were retrieved. Major concepts related to clinical ethics support services were ethical dilemmas, ethical issues, and ethical decision-making. On the basis of these results, this study recommends that more interventional research is needed in support of ethics training for clinical nurses.
  • 5.

    The Role of Virtue Ethics in the Study and Teaching of Medical Professional Ethics

    유호종 | 2014, 17(1) | pp.72~84 | number of Cited : 9
    Abstract PDF
    This article examines the ethics of duty and virtue ethics in the teaching and study of professional ethics,with a focus on medical professional ethics. Because of the nature of the profession, medical practitionersshould have expertise in moral decision-making and a strong moral will. This article argues that the former concept can be investigated and taught effectively in terms of the ethics of duty, whereas the latter concept is better understood in terms of virtue ethics. Additionally, this article describes in more detail the role of virtue ethics in professional ethics, claiming that medical practitioners should strive, not only to meet their moral duties, but also to flourish in their profession. Virtue ethics shows the method for achieving this.
  • 6.

    A Survey of Emergency Healthcare Workers’ Views about Child Abuse

    이승원 | 차원철 | SHIN, TAE GUN and 5other persons | 2014, 17(1) | pp.85~93 | number of Cited : 4
    Abstract PDF
    Child abuse is a serious social problem in contemporary Korean society. Health care providers have an important role to play in combatting this problem. However, the reality is that the reporting rate of child abuse among health care providers is very low. This survey, which was conducted during two weeks in June 2013 sought to investigate the knowledge, attitudes, and experiences about child abuse among workers in hospital emergency rooms. A total of 103 out of 112 people (92.0%) targeted subjects answered a questionnaire concerning subjects’ characteristics, education concerning child abuse, awareness,knowledge, attitudes in reporting suspected cases, and the ability to recognize signs of abuse. Approximately 54.4% of subjects reported they did not receive enough training concerning child abuse, only 26.2% claimed to know how to report child abuse, and 4.9% had any experience in reporting abuse. The reason cited most often (75.7%) for not reporting suspected abuse was the fear of asking the child’s parents. Approximately 67.9% of respondents did not know that they can be punished for failingto report suspected abuse. This study found that there are many obstacles to the proper reporting of child abuse. Health care providers working in emergency rooms must uphold their ethical and legal responsibilities when they suspect that abuse has occurred. For this purpose, education as well as legal and social support is needed.