Korean Journal of Medical Ethics 2021 KCI Impact Factor : 1.27

Korean | English

pISSN : 2005-8284 / eISSN : 2234-3598

Home > Explore Content > All Issues > Article List

2017, Vol.20, No.2

  • 1.

    The Decision-Making Process Regarding Life-Sustaining Treatment in Four Countries: Taiwan, Japan, the US, and the UK

    Choi Eunkyung , HONG, Jinui , KIM, MinSun and 4 other persons | 2017, 20(2) | pp.131~151 | number of Cited : 4
    Abstract PDF
    The “Act on Life-Sustaining Treatment Determination” was passed in Korea in 2016 and will take effect after the enactment of certain ordinances and rules. In this study, we analyzed the decision-making process regarding the withholding and withdrawal of life-sustaining treatment in four countries: Taiwan, Japan, the US, and the UK. Each country introduced advance directives either through legal forms (Taiwan, the US), limited legal forms (the UK), or arbitrary forms (Japan). Japan takes a guideline-centered approach, whereas Taiwan takes law-centered approach. And while a patient’s will about life-sustaining treatment (LST) is respected as part of a patient’s self-determination in the US, physicians can refuse treatment if its benefits are extremely uncertain. On the other hand, in the UK, if a patient has lost decision-making capacity, physicians can make decision regarding the patient’s best interests. In this article, it is argued that minimal standards should be established in Korea to prevent possible abuse as well as to respect patients’ right to self-determination; however, it is desirable to support good decision-making processes between physicians and patients (and their family members) rather than to over-regulate current practice.
  • 2.

    A Comparative Study of Korea, America, and British Codes of Ethics for Dentists

    HEO, SoYun | 2017, 20(2) | pp.152~162 | number of Cited : 2
    Abstract PDF
    This article evaluates the codes of ethics for dentists in the United Kingdom, the United States, and Korea. Differences in the historical backgrounds, dental health care agendas, and social atmosphere of these three nations have given rise to different codes of ethics for dentists in these countries. In the UK, codes of ethics are bound by legislation since the health care system is run by the British government. On the other hand, codes of ethics in the US are considered to be virtues that are voluntarily drafted and implemented by autonomous organizations. In this article it is argued that codes of ethics in Korea should not merely imitate those of other countries but should rather reflect the unique circumstances of this country. Dentistry requires a team approach involving dentists, dental hygienists, and dental technicians; therefore, in order to obtain public trust in each of these professions, their common principles and values should be reflected in a comprehensive dental code of ethics. Social consultation and discussion are recommended to establish common ideas and values; furthermore, dental associations should partner with government bodies to best serve the public interest.
  • 3.

    Toward Effective Human Research Protection: The Current Status and Limitations of the Human Research Protection Program in Korea

    Junho Jung , Jeong-Hyun Kim , JUNG,SeHee and 1 other persons | 2017, 20(2) | pp.163~175 | number of Cited : 1
    Abstract PDF
    Korea has witnessed rapid growth in the clinical trial industry in past 10 years. Public concern regarding the rights and safety of human research participants has been a major issue in the field. As the need for a more effective system of protection for human subjects grows, one which surpasses the scope of the Institutional Review Board (IRB), the Korean Ministry of Food and Drug Safety (MFDS) has issued its “Operation Guidelines for Human Research Protection Program (HRPP)” in 2014. It is the first government- initiated adoption of a HRPP in the world. This study shows that there is great deal of variation in clinical trial institutes in terms of their size and systems of operation and that many small- to mediumsized clinical trial institutes are not willing to adopt HRPP. The current MFDS HRPP policy does not reflect the differences in the various clinical trial institutes, which leads to a low adoption rate in HRPP in Korea. Furthermore, the government-initiated HRPP policy may puts more burdens on smaller organizations. Despite the limitations of the current HRPP policy, it is argued in this article that strong leadership to promote HRPP by the Korean government can improve clinical trial participant protection and the quality of clinical trials in Korea. Future policy for establishing and promoting HRPP in Korea should encompass considerations of the variability in the characteristics of clinical trial institutes as well as measures for enhancing the understanding of HRPP in the research community.
  • 4.

    Problems and Alternatives of the Decision-Making for Organ Donation in Korea

    Song, Yoonjin | 2017, 20(2) | pp.176~192 | number of Cited : 3
    Abstract PDF
    This article examines the issue of decision-making for organ donation, a necessary precondition of organ transplantation, from the perspective of the donor. As the organ donation rate in Korea is significantly lower than that of other countries, the causes for this phenomenon are reviewed. The decision-making in relation to organ donation and transplantation in Korea seems to be a closed family-centered decision type. The organ transplant system also consolidates this conventional family-centered decision-making model, contrary to the basic principles and intentions of the original organ transplantation law, which respects donor’s voluntary intentions. The organ transplant system in Korea should respect the donor’s will and ensure that the voluntary and noble sacrifices that donors make extend beyond the fence of the family to the society as a whole. This article argues that rather than strictly regulating the donor’s decision-making process, a cooperative decision-making system should be established, one that provides substantial support to the donor. Such a strategy should help to raise the voluntary donation rate by increasing levels of public trust in a healthy medical culture.
  • 5.

    Ethical Issues in the Distinction between Discarded and Created Embryos: The Nothing Is Lost Principle

    LEE, Hyang-Yeon | 2017, 20(2) | pp.193~205 | number of Cited : 1
    Abstract PDF
    Stem cell research raises many ethical issues, including the possible harms that are done to early embryos in the process of deriving stem cells. There are two basic stances concerning human embryonic stem cell research: one supports the research and regards the destruction of embryos as an acceptable cost; the other rejects the research and foregoes the potential benefits that the research might offer. In this article, I examine each of these stances and consider a flexible middle-ground position. Additionally, I introduce the Nothing-is-Lost Principle as one element of this middle-ground position and examine whether or not it justifies the discarded-created distinction. I suggest that there is a need for improved guidelines and regulations concerning stem cell research.
  • 6.

    The Ethical Issues in Genome Editing and a Review of Korea’s Bioethics and Biosafety Act

    KIM, Hyunseop | 2017, 20(2) | pp.206~218 | number of Cited : 3
    Abstract PDF
    This article, which is written in response to the recent development of genome editing technologies, examines the ethical issues of gene therapy and genetic enhancement as well as the justifiability of the relevant clauses of Korea’s Bioethics and Biosafety Act. I argue that somatic genome-editing therapies should be regulated in the same way as other gene therapies, that the regulations should be individualized in light of the advantages and disadvantages of each technology, and that these regulations should be multiphased such that the risk-benefit analysis at each stage should be taken into account in deciding whether to proceed to the next stage of research. Furthermore, I argue that the current regulation of research on redundant human embryos from in vitro fertilization (IVF) should be revised, that new regulations on the gene editing of human eggs and sperms should be set up, that gene-editing research on relevant somatic cells and animal models should precede preclinical studies on heritable human gene editing, and that the results of preclinical studies should be taken into account in considering whether to allow clinical trials of human germline editing. I conclude by calling for regulations on human genome editing for enhancement and describing the role of Korea’s National Bioethics Committee in reforming existing regulations.
  • 7.

    How Can Doctors Understand Patients’ Pain?: A Study on Wittgenstein’s Concept of Pain Behavior

    PARK,JeongSik , Jeong Chang-rok | 2017, 20(2) | pp.219~233 | number of Cited : 2
    Abstract PDF
    Since pain is an internal or subjective experience, it is not possible for a doctor to experience a patient’s pain directly or to understand it fully. However, patients do describe or express their pain using language, which Wittgenstein considered to be a public phenomenon. It is primarily through language that a doctor understands a patent’s pain. This article examines the issue of pain within the context of medical care from the perspective of Wittgenstein’s philosophy of language. It is argued that Wittgenstein’s thinking illuminates what pain is and also how it should be understood by doctors.