New legislation on hospice-palliative care and end-of-life decision-making in Korea comes into effect in February 2018. Hospital Ethics Committees (HECs) will play a key role in deciding controversial cases.
HECs have existed in Korea for decades, but most of their work has been directed toward dispute mediation.
With the new legislation coming into effect, HECs will now concentrate on end-of-life issues.
However, since there are many other ethical issues that arise in clinical practice, the roles of HECs need to be reconsidered and perhaps reconfigured. Since HECs tend to convene on a monthly basis, they are illequipped to deal with end-of-life decisions, which often must be made within hours or a few days. Clinical ethics consultation teams can bridge the gap between the urgent demands of clinical practice and the slower and more formal activities of HECs. This article argues that it is necessary for HECs to delegate some of their roles or responsibilities to clinical ethics consultation teams.
This article addresses the question of what is an appropriate Korean translation of “clinical ethics consultation” and also interprets clinical ethics as a branch of medical ethics. Three models of clinical ethics consultation are introduced: an authoritarian approach, a pure facilitation approach, and an ethics facilitation approach. The author argues that an ethics facilitation approach is the most desirable one in a pluralistic society. Contemporary Korean society is moving in the direction of a pluralistic society, with both eastern and western influences as well as progressive and traditional forces. Where there is no single, dominant value system, it is desirable that consultants try to help relevant parties reach reasonable conclusions within moral boundaries rather than recommend one conclusion. In a pluralistic society, an ethics facilitation approach does not imply moral relativism. Hospital ethics committees established according to the current law should be organized to provide clinical ethics consultation. While the current law limits the role of hospital ethics committees to the withholding or withdrawal of life-sustaining treatment that their role should be broadened into fully-fledged hospital ethics committees that cooperates with a team taking multi-disciplinary approaches to the resolution of ethical issues.
The purpose of this study was to investigate the nature and number of ethical conflicts faced by physicians and nurses working at university hospitals in South Korea and also to assess the need for clinical ethics consultation services. Data collection was conducted from August 6 to 24, 2015 at three university hospitals in metropolitan areas; a total of 316 physicians and nurses participated in the study. The results showed that 85.1% of physicians and 76.6% of nurses answered that they had experienced ethical problems more than once a year during the course of their career, and about one third of respondents experienced such conflicts at least once every three months. For physicians, ethical dilemmas arose most often in the context of end-of-life care, mainly in terminating life-sustaining treatment (65.7%) and notifying patients of the end of medical treatment (63.6%). Ethical dilemmas experienced by nurses related primarily to difficult care decisions other than life-sustaining treatment (73.9%), impaired decision-making in patients (66.7%), and dealing with surrogate decision-makers (66.7%). When faced with ethical dilemmas, healthcare professionals usually made decisions informally by themselves or in consultation with close colleagues.
More than 97% of respondents answered that they needed a clinical ethics consultation service.
Future research should focus on how the ethics consulting services described in the Life-sustaining Treatment Decision-making Act of 2018 can be developed into an effective model for solving ethical problems that arise in medical practice.
While artificial intelligence (AI) offers the promise of liberating humans from mundane labor, it also has the potential to create an unemployment problem in various economic sectors, including the healthcare industry. Exactly how AI will or should be used within the context of healthcare has emerged as an important ethical question. This article shows how a surplus of human resources will arise from the introduction of AI in the healthcare system and explains how medical resource should be allocated. It is argued that the surplus of human resources caused by the introduction of AI in healthcare should be used for those patients that receive the fewest benefits from the healthcare system.
The purpose of this study was to explore the current state of nursing ethics research in Korea by analyzing original research articles published in the Korean Citation Index from 2009 to 2016. A total of 87 articles were analyzed and summarized in terms of topic, study respondent, design, publishing journal, and keywords. The three most frequently studied topics are (a) ethical awareness, (b) attitude and recognition about ethical issues, and (c) nursing ethics education, in order. Study respondents were mainly nurses (44.9%) and nursing students (42.7%). The most frequently used research design was survey (74.2%), and most articles were published in non-nursing journals. On the basis of these results, several recommendations concerning research topics, methodologies, and suggestions for the future nursing ethics research were made.
The globalization of healthcare is a multi-layered phenomenon in Korea. Medical tourism, which has emerged as a major trading resource and engine of economic growth, is receiving strong support from the government. At the same time, the number of multicultural patients with inadequate access to basic medical services is rapidly increasing. This article examines the ethical issues related to the globalization of healthcare in Korea as well as some of the ethical problems caused by insufficient clinical and cultural competence within the medical profession. Failure to understand the health-related differences between regions and cultures can compromise the quality of healthcare. Furthermore, language and cultural barriers can cause inequity by hindering access to health care. This article argues that in order to resolve the problems of polarization and inequality in a globalized healthcare system, efforts must be made to ensure the clinical and cultural competency of medical professionals in Korea.
This article examines special protection measures within international regulations and domestic laws for vulnerable subjects in research involving human subjects. An ethic of care that respects individuality and promotes altruism toward vulnerable subjects is proposed. In order to realize this ethic of care, four principles based on relational, mutual, and critical considerations are proposed. In research on human subjects, the four care principles can be realized as a dialogic interaction in the informed consent process, although dialogic interaction has limitations as a concrete guideline for the entire consent process. Finally, this article recommends a care checklist that researchers can write personally.