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한국의료윤리학회지 update

Korean Journal of Medical Ethics

  • : 한국의료윤리학회
  • : 의약학분야  >  기타(의약학)
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수록정보
13권1호(2010) |수록논문 수 : 5
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13권1호(2010년) 수록논문
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KCI등재

1우리나라 일부 병원에서 환자, 보호자, 의료진의 연명치료 중지 관련 의사결정에 관한 태도 연구

저자 : 권복규 ( Ivo Kwon ) , 고윤석 ( Youn Suck Koh ) , 윤영호 ( Young Ho Yun ) , 허대석 ( Dae Seog Heo ) , 서상연 ( Sang Yeon Seo ) , 김현철 ( Hyeon Chul Kim ) , 최경석 ( Kyung Suk Choi ) , 배현아 ( Hyun A Bae ) , 안경진 ( Kyung Jin Ahn )

발행기관 : 한국의료윤리학회 간행물 : 한국의료윤리학회지 13권 1호 발행 연도 : 2010 페이지 : pp. 1-16 (16 pages)

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A survey was conducted from September to December 2008 to examine the attitudes of patients, family members, and physicians toward the withdrawal of medical treatment for terminal patients and other related issues. The subjects for the study were 91 cancer patients, 96 family members of cancer or other terminally ill patients, and 140 physicians. Most subjects acknowledge the need for an appropriate regulatory framework for the withdrawal of treatment for terminal patients. However, some discrepancies were found among the different groups (patients, family members, physicians) in this study. Patients showed a stronger preference for the withdrawal of treatment than did family members. Also, most patients claimed they wanted to receive the diagnosis of a terminal illness from their physician, while most family members seem to think it is their own duty to convey such a diagnosis to the patient. Both groups prefer co-decision-making about the withdrawal of treatment over individual decision-making by the patient. However, most family members admit that they do not know much about the patient`s wishes and lack the time for sufficient conversation with the patient. Physicians are skeptical of the authenticity of the decisions made by family members, and some physicians also regard hospital ethics committees as being ineffective for resolving these issues. The results of this study paint a unique picture of clinical culture in Korea, where family members still exert strong influence on clinical decision-making and little information is shared between patients, family members, and physicians. The study points to a need for greater public education in Korea on the practical and ethical issues surrounding the withdrawal of treatment for terminal patients.

KCI등재

2무의미한 연명치료 중단 결정에서 의료의 한계

저자 : 안용항 ( Yong Hang Ahn ) , 김혜정 ( Hye Joung Kim )

발행기관 : 한국의료윤리학회 간행물 : 한국의료윤리학회지 13권 1호 발행 연도 : 2010 페이지 : pp. 17-28 (12 pages)

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On May 21, 2009, the Supreme Court of Korea ruled that patients have the right to terminate medically meaningless treatment upon confirmation that their terminal illness is indeed irreversible. The Supreme Court`s decision thus makes proof of the irreversibility of a patient`s condition an important process in legitimatizing a patient`s decision to terminate life-sustaining treatment. However, since medical practice rejects explanations in terms of "essences" and is affected by issues of subjectivity, we argue that physicians cannot give indisputable confirmation of the irreversibility of a patient`s terminal illness, as required by the Supreme Court`s ruling.

KCI등재

3사전의사결정(Advance Directives)의 속성-대리인 지정을 중심으로

저자 : 김신미 ( Shin Mi Kim )

발행기관 : 한국의료윤리학회 간행물 : 한국의료윤리학회지 13권 1호 발행 연도 : 2010 페이지 : pp. 29-42 (14 pages)

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The purpose of this study was to explore the main features of proxy decision-making in advance directives. Fifty-three advance directive documents from the US, New Zealand, and Korea were retrieved through database searches and then analyzed. The following eight distinctive categories concerning proxy decision-making were identified: 1) establishment of proxy authority; 2) certification of proxy authority; 3) extent of proxy authority; 4) qualifications for proxies; 5) legal validity of proxy documents; 6) period of proxy authority; 7) revocation of proxy authority; and 8) exceptional regulations. It is pointed out in this article that prior to the regulation of proxy decision-making in Korea, relevant experts should consider each of the eight elements listed above and articulate clear guidelines for proxy decision-making.

KCI등재

4임상연구에서 피험자 서면동의의 질 평가

저자 : 정인숙 ( Jeong Ihn Sook ) , 손지홍 ( Shoh Ji Hong ) , 신재국 ( Shin Jae Gook )

발행기관 : 한국의료윤리학회 간행물 : 한국의료윤리학회지 13권 1호 발행 연도 : 2010 페이지 : pp. 43-58 (16 pages)

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This study was designed to assess the quality of the informed consent process in clinical research by measuring subjects` understanding of informed consent. A convenience sample of 188 subjects aged 20 and above participated in bioequivalence studies at the Inje regional clinical trial center in Busan (South Korea). The study instruments were self-reported questionnaires, which were modified versions of the Quality of IC (QuIC) questionnaire developed by Joffe et al. (2001) and the Informed Consent Questionnaire-4 items (ICQ-4) developed by Guarino et al. (2006). The data were collected from February to May, 2007 and analyzed with descriptive statistics to assess the quality of the informed consent process and also with a t-test, X2 test, and paired t-test to identify correlates of increased understanding of informed consent. Prior to the subjects` participation in these clinical trials, the mean QuIC objective knowledge score (QuIC-A) was 68.7 points (maximum: 100 points) and the perceived (subjective) understanding score (QuIC-B) was 78.7; after the clinical trials were completed, the mean scores for (QuIC-A) and (QuIC-B) were 68.7 and 80.4 respectively. The general quality of informed consent (ICQ-4) was measured after the clinical trials were completed; the score was 78.3 points (maximum: 100 points). Higher objective knowledge (QuIC-A) scores were associated with age (25 years old and above, p=0.043), and education (college and above, p=0.001). Higher QuIC-B scores were associated with previous experience with clinical trials (p=0.028) and memorization of the date of the signed consent (p=0.037). The quality of informed consent measured in this study is significantly lower than that reported in similar studies conducted in the US and Australia. Thus, this study suggests that it is there is a need to develop strategies to improve subjects` understanding of informed consent.

KCI등재

5지구촌 생명윤리정책 개발의 전제조건들: 어떤 목적, 태도, 노력 및 체계가 필요한가?

저자 : 최경석 ( Kyung Suk Choi )

발행기관 : 한국의료윤리학회 간행물 : 한국의료윤리학회지 13권 1호 발행 연도 : 2010 페이지 : pp. 59-71 (13 pages)

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혹자는 <생물학 및 의학 적용에 있어 인권과 인간존엄 보호를 위한 EU 협약>의 한계를 지적하며, 생명윤리 쟁점들에 대한 지구촌 정책은 모호함과 비일관성을 지니고 있다고 주장한다. 그러나 의·생명과학 연구의 세계화와 그에 따른 생명윤리 쟁점의 세계화로 인해, 지구촌 차원의 생명윤리정책을 개발할 필요성이 대두되고 있다. 지구촌 생명윤리정책은 중첩적 합의에 기초하여 개발될 수 있다. 중첩적 합의는 모든 사회 구성원들 사이에서 의견의 일치를 보이는 견해로서 생명윤리문제를 다룸에 있어 최소한의 기준을 제공해 준다. 뿐만 아니라 지구촌 생명윤리정책은 생명윤리에서 우리가 추구하는 이상과 가치가 무엇인지 알게 해 준다. 이런 점에서 지구촌 생명윤리정책은 윤리적 관점에서 일종의 구속력을 행사한다. 이러한 지구촌 생명윤리정책을 개발하기 위해서는 관용과``이성적임(reasonableness)``이란 태도를 요구한다. 이것들은 이성적 불일치가 종종 목격되는 다원주의 사회에서 우리들이 견지해야 할 덕으로 간주된다. 생명윤리정책의 개발에 있어 토론과 토의는 필수적이다. 왜냐하면 토론과 토의는 무엇이 이성적 불일치를 야기하는지 알려주고 이견을 지닌 사람들 서로를 이해하는 데 도움을 주기 때문이다. 또한 우리는 하나의 학제적 학문 분야로서``생명윤리정책``을 연구하고, 문화적 차이를 고려하며 생명윤리문제를 연구하는 문화 생명윤리학 연구를 증진해야 한다. 새로운 학문분야로서의 생명윤리정책은 생명윤리의 쟁점에 대한 개인적 차원의 윤리적 해답을 얻는 데 그치지 않고, 사회적 차원의, 나아가 지구촌 차원의 해답으로서 무엇이 바람직한지 연구한다. 아울러 지구촌 생명윤리정책 개발을 위해 우리는 국제적 의사결정기구, 국가간 전문가들 사이의 네트워크, 토론을 위한 정기회의 개최 등의 협력 체계를 구축해야 한다.

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