2016, Vol.19, No.4

Korean Journal of Medical Ethics 2023 KCI Impact Factor : 1.21

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

The privatization of medicine raises a number of empirical, philosophical, and ethical issues that are best approached from an interdisciplinary perspective. In this paper, I approach the problem from philosophical-ethical viewpoint and argue as follows. Health care is an atypical commodity that can be privatized through imperfect or partial marketization. Additionally, while altruism is compatible with a certain kind of medical commercialism, a just health care system is one which accommodates equity, efficiency, and public accountability. Market instrumentalists hold that markets are the means to achieve the objective of a just health care system, whereas market fundamentalists regard markets as ends in themselves. I argue that while market instrumentalism is the superior view, when a market is implemented it should fulfil quite strict criteria.

A series of recent medical scandals in South Korea has led to calls for stricter regulation of medical licensing in this country. While the Korean government has recently revised its regulations, disagreements remain among the various stakeholders. This article explores the regulatory systems in Japan, the USA, the UK, and Canada to identify the most appropriate principles for self-regulation based on medical professionalism. The Japanese Medical Association has been working to improve its certificate system for specialists since 2011. The USA, the UK, and Canada have independent regulatory bodies to protect patients and improve medical professionalism and practice. This article explains how the licensing system for Korean physicians should be regulated.

This article examines the ethical justification for medical paternalism. After defining paternalism and distinguishing between the weak and the strong versions of that concept, this article considers two common justifications for paternalism: an argument from consent and a consequentialist argument. While weak paternalism is justified significantly by these two arguments, I claim that strong paternalism cannot be justified by the consent argument and also that there are limitations with using the consequentialist argument to justify strong paternalism. I defend a limited concept of paternalism by appealing to the diminished autonomy argument. Since a patient’s autonomy is diminished by illness, physicians have a limited moral obligation to prevent or at least to minimize harm to their patients, as expressed in the Hippocratic Oath.