2005, Vol.8, No.1

Korean Journal of Medical Ethics 2023 KCI Impact Factor : 1.21

pISSN : 2005-8284 / eISSN : 2234-3598
https://journal.kci.go.kr/medethics

The main moral dispute on human embryonic research lies in the status of embryo. Embryo means actually pre-embryo here. Proponents for the research argue that an pre-embryo is not an human being because it does not have any personality. But I argue that this argument is too weak to fall down because it must be applied to a new-born baby. But we consider a new-born baby as an human being. A strong argument for the research is to claim that a human life begins at the formation of primitive streak because this streak indicates the establishment of an individual identity. Proponents for the research based on this argument claims that there is no person to hold any rights because there is no entity to establish any individual identity. They consider this argument to fall down the view that human life starts at the conception. But I argue that the above argument only shows when an individual identity is established, rather than when an human life starts. The reasons are as follows. First, biological identity, that is, genetic identity as an human species is formed in zygote at the conception. Second, the potentiality to grown up into an adult is developed from the conception while the same genetic identity is kept. The reason we think that human life is respected lies in the potentiality. The numbers of individuals is not important in considering this potentiality. Therefore, despites discontinuity in individual identity we have to think that human life begins at zygote from which genetic identity and potentiality to build up an individual or individuals are continuously kept. The same view can be applied to cloned human embryo through implanting the nuclear of a somatic cell. So, the research of cloned human embryo is not morally justified. The current Korean law to allow this research should be reconsidered.

The following research has examined ethical dilemmas regarding denial of resuscitation by patients. The articlealso suggests several proposals for optimized solutions. First of all, the history and nature of CPR & DNR have been discussed. Second, mutual interactions during making decisions on DNR have been introduced. Because physicians do not exclusively conduct the decision on DNR, patients, family members, and other related siblings should be involved in the process. If necessary, the ethics committee may be applied for making appropriate decisions. Thirdly, in order to locate the nature of ethical dilemma on DNR decisions, the relationship between patients and physicians, full understanding the importance of CPR necessity, and defining the method of DNR would need to be well explained. Finally, through the ethical discussion on DNR, following conclusions have been suggested. In all situations, DNR must let physicians make decision on futility of CPR for patients' current or future conditions, and the decision must be made only after patients are fully aware of the consequences. Under the law of respecting patients' opinions, patients must have the ability to make decisions on DNR. The proper moments for deciding DNR should depend on behaviors regarding his/her conditions or diseases. Because a health care institution play an important role in making decisions as well, all opinions must be reviewed for the best outcome. It is important to remember that the main decision makers on DNR are patients. Following discussions have concluded that an agreement among people nationwide is quite essential for the appropriate DNR decisions. The research may serve as a supplement for the process of establishing the DNR guideline.

This study discusses how paternalism in ethics should be estimated legally by main issues, summary of decision, and reasoning of the Supreme Court Decision. This Decision delivers that the duty to protect a patient's life is prior to the duty to respect a patient's rights of self-determination. According to the autonomy principle, patients have the right to determine whether they allow the medical professionals to treat their disease or not and the medical professionals must follow the patients' decision. But the concept of paternalism restricts the autonomy principle. However, I assert that the medical professional is not liable for the patient's death when he or she rejects medical treatments(gastrolavage) strongly making a disturbance as this case. We should examine how serious the patient's rejection of medical treatments was and how difficult the medical professional's paternalistic intervention was. Although medical law is different from medical ethics, paternalism in medical area can be expected legally as far as a medical professional can overcome a patient's continuous and strong rejection. So, this study reviews the relation between medical professional and patient, and lays stress on the limitation of paternalism in medical area.