2022, Vol.25, 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

The Operating Room CCTV Act, which is subject to a two-year grace period for enforcement, was passed by the National Assembly of South Korea in 2021 in response to complaints from patients and civic groups concerning alleged medical practice cases involving surrogate surgery, unlicensed surgery, sexual harassment of anesthetized patients and the medical conflicts regarding surgical outcomes. This article reports on a survey of the opinions of medical specialists and trainees at two hospitals concerning the contents and expected effects of this bill. The majority of opinions collected reflect dissatisfaction with key elements of the bill; while those surveyed thought it was unlikely that the law would achieve its desired effects (i.e. the prevention of illegal activities, satisfying the right to know), they expressed concerns that the implementation of the bill would adversely affect medical treatment or education and infringe on professional freedom. Accordingly, this article argues that measures are needed to bring about a compromise between the patients and civic groups who support the Operating Room CCTV Act and the medical professionals who oppose it.

In response to a series of highly unethical incidents in operating rooms in South Korea, a social consensus has emerged on the need for surveillance of medical operations. This consensus has in turn motivated lawmakers to amend the Medical Service Act to require hospitals and medical clinics to install CCTV cameras in their operating rooms. While the rationale for this legislation is clear, there are also concerns that the law infringes on certain rights and freedoms of medical practitioners, including the right to privacy, the freedom of job performance, and the right to self-determination. This article argues for the need to find a proper balance between patient safety on the one hand and the rights and freedoms of medical practitioners on the other. Additionally, it is argued that the proposed law is in need of greater elaboration to reduce the possibility of unfair harms caused by video leaks and that patient safety cannot be fully protecting without addressing certain structural problems in South Korea.

The purpose of this study was to identify the factors that influence Hemodialysis patients’ in-tentions to write Advanced Directives (ADs). A questionnaire was used to collect data from 165 chronic renal failure patients receiving hemodialysis treatment at two general hospitals in South Korea. The variables that were found to have a significant influence on the intention to write an AD were education level, knowledge of Ads, and attitudes toward ADs. Patients with a university degree or high school education were significantly more likely (3.35 times and 3.62 times, respec-tively) to write an AD than were those without a high school education. In terms of knowledge of ADs, as the score increased by 1 point out of 21, the intention to write an AD increased by 1.12 times. Regarding attitudes toward ADs, as the score increased by 1 point, the intention to write an AD increased by 1.13 times. Patients that would choose to continue dialysis treatment during the end-of-life period were less willing to write an AD than those who would stop the dialysis treatment. However, 18.5% of those willing to write an AD indicated that they would continue hemodialysis treatment during the end-of-life period. The results of this study suggest that discus-sions between patients, family members, and healthcare providers are required from the beginning of dialysis treatment so that these patients have the right knowledge and attitudes about ADs and can confirm their values and beliefs about end-of-life care.