KJCKorea
Journal Central

This article examines the problem of ghost surgeries in South Korea, which gained national attention following the death of Kwon Dae-hee and led to revisions in the Medical Service Act, including a government mandate for video surveillance in operating rooms. While ghost surgeries have been discussed in legal and academic circles, there has been a lack of analysis from the perspective of actual clinical practice. In South Korea, ghost surgeries vary widely depending on the type of hospital, the person replacing the primary surgeon, and the underlying motivation. In teaching hospitals, surgeries performed by residents or fellows during training can be misinterpreted as ghost surgeries, creating a legal and ethical gray area. Despite stricter training regulations, there are still no clear, standardized guidelines for surgical education. Accordingly, this article argues that the relevant authorities—such as the Ministry of Health and Welfare, surgical societies, and medical education institutions—should examine international models and develop clear principles for resident and fellow participation in surgery. This would help ensure informed patient consent, protect medical trainees, promote ethical practices, and ultimately contribute to greater transparency, enhanced surgical education, and a safer healthcare environment for both patients and providers.

This article critically evaluates Korea's current mandatory, time-based clinical trial education system in light of the rapidly changing global clinical trial landscape and international best practices. It identifies key limitations and proposes a strategic shift towards a Competency-Based Education (CBE) model to enhance the quality, safety, and national competitiveness of clinical trials. By analyzing the new competencies required by technological innovations such as Decentralized Clinical Trials (DCTs) and Artificial Intelligence (AI), as well as the latest ICH GCP E6(R3) guideline, and by comparing Korea's system with the educational frameworks of the United States, United Kingdom, and European Union, this article diagnoses the shortcomings of the current system, including its rigidity, emphasis on compliance over competence, and misalignment with global trends. As a solution, the article explains the necessity of adopting a CBE model and offers specific policy directions based on the internationally recognized Joint Task Force (JTF) for Clinical Trial Competency framework. The proposals presented here aim to improve the quality of clinical trials in Korea, enhance participant safety, and ultimately contribute to building an ethical, efficient, and globally competitive clinical trial ecosystem.

This descriptive correlational study aimed to examine the impact of moral courage and ethical climate on moral distress among clinical nurses. Data were collected from August to September 2024, through an online survey distributed to nurses working at two tertiary hospitals and one general hospital in a city in South Korea. The results indicate that the mean moral courage, ethical climate and moral distress were 3.20 ± 0.58, 3.42 ± 0.52, and 78.22 ± 53.89, respectively. Multiple regression revealed that factors affecting moral distress among clinical nurses included years of clinical experience (β=.23, p=.014), moral courage (ß=.40, p<.001) and ethical climate (β=-.44, p<.001). These variables explained 22% of the variance in moral distress. These findings suggest that there is a need for institutional strategies to improve the ethical climate and to support nurses' moral courage in order to alleviate moral distress.