2020, Vol.23, 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

Experts have been warning of a second wave of COVID-19 infections that is expected to occur within the next two months. If this prediction comes true, the demand for ventilators, intensive care units, and other healthcare resources may be greater than the supply, raising questions of distributive justice and the rationing of scarce healthcare resources. This article summarizes some of the theoretical issues associated with distributive justice, examines the ethical basis of the rationing principles that have been adopted by certain hospitals in the United States, and attempts to identify common ground that might facilitate broad agreement concerning the principles that should guide resource-allocation decisions during this pandemic. The article aims to show, firstly, that from the perspective of a non-utilitarian, rights-based theory, it is fair or just to allocate life-saving resources in ways that save the greatest number of lives. Nevertheless, it is also argued that there are several other factors need to be considered in the rationing of healthcare resources, including a patient’s age, disability status, health condition, occupation, time of admission to a health care facility, and whether the patient’s disease is COVID-19.

Despite the significant implications of doctors’ strikes for public health, little research has been done on the effects of doctors’ strike on patient mortality. In this study, we attempted to assess the effects on patient mortality of a strike that was carried out by doctors in South Korea in June 2000. The data for this study came from Statistic Korea (KOSTAT)’s ‘Causes of Death Statistics’ for the period 1997 to 2003. The data was analyzed with the four methods most commonly used in international studies on doctor strikes. The analysis shows that there is no significant difference between the disease-related death rate for June 2000 and that for the same month in other analyzed years. Similarly, there is no significant difference between the disease-related death rate for June 2000 and the rates for May and July, either in 2000 or in other analyzed years. However, the disease-related death rate during the strike in June 2000 is slightly lower than the rates for the six-day period immediately prior to and immediately following the strike. This suggests that, contrary to what many people believe, the disease-related death rate did not increase during the doctor’s strike in June 2000. This study is the first to provide statistical evidence concerning the effects of doctors’ strikes on hospital mortality rates in South Korea.

With the increasing use of assisted reproductive technologies (ART) and the expansion of health insurance coverage and support for treatment costs, human reproduction is changing rapidly. Visualization of the process of treating germ cells and embryos in vitro and the physical and temporal separation of germ cell collection, embryo generation, implantation, and birth are expanding the possibilities and scope of planning or control over reproduction. Within this context, the freezing of germ cells to preserve fertility has also been increasing, a trend that is likely to continue since the preservation of fertility is now seen more as a lifestyle choice than a medically necessary procedure. However, the storage of oocytes for non-medical purposes is ultimately a source of artificial infertility as it presupposes medical pregnancy and birth using ART. Therefore, it is important to examine the current status and consequences of egg fertility preservation and to prepare appropriate management measures and guidelines. Management measures include the sharing of information transparently, including information on the uncertainties with ART technology, the promotion of careful decision-making procedures based on autonomy, and the establishment of monitoring systems. The guidelines should be aimed at securing the autonomy and safety of the parties involved in these procedures. In addition, the introduction of ART for non-medical purposes calls for discussions on the targets of reproductive cell collection and utilization, the various actors in future pregnancies and childbirths, new predictions about reproduction, and appropriate preparation or management measures. Taking cultural perceptions and public opinion into account, this article explains how and why current laws and policies related to ART should be improved.