2019, Vol.22, No.3

Korean Journal of Medical Ethics 2023 KCI Impact Factor : 1.21

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

Institutional Ethics Committees are responsible for reviewing, consulting, and educating about matters related to life-sustaining treatment, these committees should play a substantial role in implementing the Act in each hospital. However, there are few such committees and their operations have been limited in many respects. In this article we report on a survey that was carried out to assess the difficulties faced by 63 committee administrators. We also conducted focus-group interviews with seven medical professionals or administrators working in health care institutions in which a committee has been established. Subjects were asked about the difficulties these committees face in advising on foregoing life-sustaining treatment. The operational problems that were reported include the following: difficulties in accessing patients’ records of decisions concerning life-sustaining treatment, obstacles in using Shared Ethics Committees, legal and administrative complexities in diagnosing the end-of-life process, the lack of expertise of committee members and administrators, manpower shortages on the committees, and medical professionals’ negative views of the Act’s procedures for life-sustaining treatment decision-making. In order to deal with these problems, we suggest the following solutions: improving the accessibility of patients’ life-sustaining treatment decisions, encouraging the use of Shared Ethics Committees, defining the qualifications and training requirements for Committee members, establishing better communications among committee members; creating an educational system for medical professionals in order to improve their understanding of the committees’ role; and developing standard operating procedures for the committees.

This article reports on a study that was carried out to document and understand the experiences that nurses in intensive care units in South Korea have when dealing with Do-not-resuscitate (DNR) orders. The participants in the study were 13 intensive care units nurses, each of whom has at least four years of relevant experience with ethical decision-making concerning DNR orders. Data analysis was based on the content analysis method used in qualitative research. The study found that the ethical values of nurses concerning the treatment and death of patients with DNR orders are not fixed but rather change according to the patient’s situation. This result indicates that it is necessary to provide clearer guidelines for decisions regarding patient care in the context of DNR orders. In addition, further education or training programs concerning DNR orders should be provided to nurses working in intensive care units in South Korea.

Health data collected in various ways and forms is secondary use of scientific research purposes. Including Republic of Korea, several country’s Data protection law require the anonymity of data in addition to obtaining the consent of the data subject as a provisions relating to specific data processing situations. In the case of research related to the important objectives of public interest, the informed consent of the subject shall be exempt from that liability. In order to find such compatibility of purposes, consideration will need to be taken in terms other than the lawful processing of personal data. This paper starts with the fact that data is used to train artificial intelligence. First, artificial intelligence needs to focus on specifics on what data are used in the training of the artificial intelligence and how the algorithms are built, and the concerns arising from the mechanism of algorithms are discussed. The data used in the artificial intelligence system are considered as the subject of ethical debate and the ethical problems are discussed. And analyzed the legislative process and legal provisions for data processing principles of EU General Data Protection Regulation to find clues to solving that problems. The problems that can arise due to the characteristics of artificial intelligence technology, which are hard to prepare and interpreter through legislation, are explains to informed consent and responsibility, the myth of data anonymity and, risk scores and algorithmic discrimination. As a conclusion, I suggested about data processing to removes ‘poison’ from the data, harmonization with legal system as an ex ante procedure, and transparent design of the algorithm for human judgment as a whole.