• Journal of agricultural medicine and community health
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• v.31 no.1
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• pp.35-46
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• 2006

Objectives: In recently. the management and protection on individual information in patient's medical & nursing records have been very important, and that need a guideline. The purpose of this study was to investigate the status of using the patient's nursing records of nursing students in clinical practice, to find and discuss the patient's informed consent, and status of education and management concerned to patient's nursing records. Methods: This study used a mailing survey. data collected from September 24th to October 31th in 2002. The subject were 333 professors who are major in adult nursing, pediatric nursing, psychological nursing of 111 university of nursing department and nursing college. And then we received the survey mail from 103 professors that respondent rate was 30.9%. Results: The characteristics of study subjects showed 49.0% of university. 51.0% of college of nursing. 50.0% of the subjects practiced point the patient by oral approval in clinical practice. But when the decision of the patient was very difficult, 21.6% of the subjects take to informed consent from his or her families. During the clinical practice, 49.0% of the subjects were explain to patient about clinical practice and contents of the nursing student, only 7.8% of the subjects were explain to patient with nursing records. 52.0% of the subjects were took out records from the hospital, only 17.6% of the subjects had standard of the patient's informed consent and standard of handling practice records. 17.6%-92.2% of the subjects that educate and manage concern to patient's nursing records.

• The Korean Society of Law and Medicine
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• v.20 no.2
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• pp.43-82
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• 2019

In Korea surrogate medical decision makings happen without legal grounds. The purpose of this article is to research the issues in preparing policies for decision-making on behalf of unrepresented patients. As aspects of comparative law, there are two approaches. One of them is to regulate default surrogate list. If no agent or guardian has been appointed, some legislatures provide that members of patient's family who is reasonably available, in descending order of priority of not, may act as surrogate: (1) the spouse, unless legally separated; (2) an adult child; (3) a parent; or (4) an adult brother or sister. If none of them is eligible to act as surrogate, some legislatures allow close friends to make health-care decisions for adult individuals who lack capacity. On the other hand there are other legislatures which provide no surrogate decision maker list but oblige the responsible authority to determine with advice of family members or friends of the patient. In the end the first approach can not guarantee that the surrogate decision maker like family members or friends will determine in the best interest of the patient.

• Korean Journal of Medical Ethics
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• v.21 no.4
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• pp.344-359
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• 2018

The purpose of this study was to identify how patients with chronic kidney disease understand informed consent and related factors for clinical trials. Data from a paper-based survey was collected from July 1, 2017 to April 30, 2018. The subjects for this study were 85 adult patients with chronic kidney disease who were participating in clinical trials. Surveys were conducted by a tool modified from QuIC as designated by Joffe in 2001. The QuIC consists of two parts: objective and subjective cognition. These tools were modified for this study. The average score for the objective understanding (OU) of informed consent for clinical trials was 69.56; the average score for the subjective understanding (SU) of informed consent for clinical trials was 3.28. It was found that health literacy predicted OU (F=27.709, p<.001) while SU was predicted by additional information (F=-3.095, p<.003), question (F=13.603, p<.001), and informed consent (F=-4.833, p<.001). In conclusion, the results of this study indicate that the understanding of informed consent for clinical trials among patients with chronic kidney disease is relatively low. Accordingly, alternative methods that consider each patient's health literacy levels and related factors need to be considered in order to improve their understanding of informed consents during the clinical trial process.

• Journal of Sasang Constitutional Medicine
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• v.10 no.1
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• pp.41-54
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• 1998

연구목적 : 사상의학(四象醫學)은 인간을 태양인(太陽人), 태음인(太陰人), 소양인(少陽人), 소음인(少陰人)으로 구분하여 동일한 병증에 대해서도 치료를 달리하는 의학이다. 즉 인간을 동일한 원리로 설명하는 것이 아니라 각 체질에 따른 차등성을 통해 각 체질 취약점의 보완을 추구하는 의학이다. 그러면, 무엇이 이러한 인간 구분의 단서가 되었으며 이것이 의학으로까지 적용되는 과정 즉, 사상의학의 성립 과정을 살펴 보는 것을 연구 목적으로 한다. 연구방법 : 동무(東武) 이제마(李濟馬)의 저술로 인정되는 "격치고(格致藁)", "동무유고(東武遺藁)", "동의수세보원(東醫壽世保元)"의 문헌적 자료와 각 편의 저술시기를 통해 동무(東武) 이제마(李濟馬)의 사고의 흐름과 변화를 통해 사상의학이 성립되는 과정을 살펴 보는 문헌적 조사방법을 이용하였다. 연구 결과 및 결론 : 이상의 결과를 통해 아래의 연구 결론을 구하였다. 1. 동무(東武)는 "맹자(孟子)"의 사부지심(四夫之心)을 근거로 인간을 심욕에 따라 비인(鄙人), 박인(薄人), 탐인(貪人), 나인(懦人)으로 구분하였고 인의예지의 사단을 장부에 배속하여 심욕을 몸에 적용하였다. 그러나 "격치고(格致藁)"의 비인(鄙人), 박인(薄人), 탐인(貪人), 나인(懦人)과 "동의수세보원(東醫壽世保元)"의 태소음양인(太少陰陽人)의 직접 연결은 동무 사고의 시간적 흐름을 고려하지 않은 것이며, 동무는 "동의수세보원(東醫壽世保元)" "사단론(四端論)"과 "확충론(擴充論)"을 통해 비박탐라인(鄙薄食懦人)의 심욕(心愁慾)과 태소음양인(太少陰陽人)의 정기(情氣)를 매개로 하여 비인(鄙人)은 태양인(太陽人), 탐인(貪人)은 태음인(太陰人), 박인(薄人)은 소양인(少陽人), 나인(懦人)은 소음인(少陰人)으로 설명함을 확인할 수 있었다. 2. "격치고(格致藁)" "독행편(獨行篇)"과 저술 연도가 동일한 "동무유고(東武遺藁) 교자평생함(敎子平生箴)"을 통해 의학적 사고의 성립을 살펴보면, 동무(東武)의 차등적 장리(臟理)는 희노애락의 성정(性情) 구분이 장리(臟理)의 차이로 발전한 것이 아니라 장부(臟腑) 강약(强弱)에 대한 인식이 선행되고 이를 희노애락(喜怒哀樂)으로 설명하였으며, 또한 "동의수세보원(東醫壽世保元)"의 장부(臟腑) 대소(大小)는 강약(强弱)에 근거한 개념임을 알 수 있었다. 3. 사상의학(四象醫學)의 의학적 설명 도구는 희노애락(喜怒哀樂)이다. 희노애락은 비박탐라(鄙薄貪懦)와는 달리 선악(善惡)의 가치 판단이 들어있지 않으면서 기의 승강을 나타낼 수 있는 중용적 설명 도구로 동무가 의학을 설명하기 위한 최선의 도구였다. 사상의학(四象醫學)에서의 희노애락(喜怒哀樂)은 증치의학(證治醫學)의 음양오행(陰陽五行)의 역할과 같은 것이다. 4. 희노애락(喜怒哀樂)은 "동의수세보원(東醫壽世保元)"에서 성(性), 정(情), 기(氣)로 설명되는데 희노애락의 성(性)과 정(情)은 장부 대소를 설명하는 근거로 체질마다 다른 장국 형성을 가능하게 하고 또한 각기 표기(表氣)와 리기(裏氣)를 손상(損傷)하는 것으로 설명되었다. 희노애락(喜怒哀樂)의 기(氣)는 기(氣)의 승강(升降)을 설명하는 근거로 애기(哀氣)와 노기(怒氣)는 양(陽)으로 직승(直升)과 횡승(橫升)하고 희기(喜氣)와 락기(樂氣)는 음(陰)으로 방강(放降)과 함강(陷降)한다. 이러한 희노애락은 순동역동(順動逆動)의 특성과 상성상자(相成相資)의 특성을 지니는데 희노애락(喜怒哀樂)의 상성상자(相成相資)는 사상의학 고유 개념으로 사상인병증론(四象人病證論)에서 언급하고 있는 성정(性情)과 심욕(心慾)의 편급까지 영향을 미치는 중요한 단서이다.

• Journal of the Korean hospital association
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• v.22 no.3 s.202
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• pp.31-43
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• 1993

• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.145-173
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• 2016

A patient's Right to Self-Determination or his/her Right of Autonomy in the Republic of Korea has traditionally been understood as being composed of two elements. The first, is the patient's Right to Know as it pertains to the physician's Duty to Report [the Medical Situation] to the patient; the second, is the patient's Right to Consent and Right of Refusal as it pertains to the physician's Duty to Inform [for Patient's Consent]. The legal and ethical positions pertaining to the patient's autonomous decision, particularly those in the interest of the patient's not wanting to know about his/her own body or medical condition, were therefore acknowledged as passively expressed entities borne from the patient's forfeiture of the Right to Know and Right to Consent, and exempting the physician from the Duty to Inform. The potential risk of adverse effects rising as a result of applying the Informed Consent Dogma to situations described above were only passively recognized, seen merely as a preclusion of the Informed Consent Dogma or a denial of liability on part of the physician. In short, the legal measures that guarantee a patient's 'Wish for Ignorance' are not currently being understood and acknowledged under the active positions of the patient's 'Right Not to Know' and the physician's 'Duty to Consideration' (such as the duty not to inform). Practical and theoretical issues arise absent the recognition of these active positions of the involved parties. The question of normative evaluation of cases where a sizable amount of harm has come up on the patient as a result of the physician explaining to or informing the patient of his/her medical condition despite the patient previously waiving the Right to Consent or exempting the physician from the Duty to Inform, is one that is yet to be addressed; that of ascertaining direct evidence/legal basis that can cement legality to situations where the physician foregoes the informing process under consideration that doing so may cause harm to the patient, is another. Therefore it is the position of this paper that the Right [Not to Know] and the Duty [to Consideration] play critical roles both in meeting the legal normative requirements pertaining to the enrichment of the patient's Right to Self-Determination and the prevention of adverse effects as it pertains to the provision of [unwanted] medical information.

• The Korean Society of Law and Medicine
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• v.23 no.1
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• pp.37-80
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• 2022

By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

• The Korean Society of Law and Medicine
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• v.20 no.2
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• pp.111-140
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• 2019

The Bioethics and Safety Act provides a set of rules to regulate biobanks and research activities using human biological material, but the law seems to be defective in several folds. The law requires that, prior to collection or use of human biological materials, researchers should obtain the informed consent of the donors, but the law does not obligate biobanks to do so. Even in cases where the law requires informed consent, the ordinance of the Ministry of Health and Welfare allows open (or blanket) consent. In addition, a new article in the Act, Article 42-2 which will take effect from October 24, 2019, allows medical institutions to provide biobanks with remaining biospecimens collected in the course of diagnosis and treatment, unless the donors express their intent to opt-out, without obtaining specific consent from them. Given the need to protect the autonomy of donors and the unique characteristics of biobanks and research activities that use human biological materials, this paper concludes that such open consent-based law may not be suitable to protect the autonomy of the donors and that the broad consent requirement may be a desirable policy option. The paper acknowledges that the international community has long questioned whether broad consent (as well as open consent) is an effective choice to regulate the use of human biological materials. The paper stresses that the baseline requirement in designing the law is that the secondary use of human biological materials should be based on informed consent of the donors; the core value of the law should be a governance structure that promotes transparency and protects donor participation.

• Proceedings of The Korean Society of Health Promotion Conference
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• 2010.05a
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• pp.176-176
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• 2010

알코올연구자, 보건정책연구자, 입법관련전문가, 관련 NGO단체 전문가 등을 중심으로 전문가 집단을 2배수(60명) 선정한 후 확률적으로 30명을 선정하였다. 전문가 핵심 집단연구를 위하여 전문가 패널 국내 전문가 30명에게 목적과 취지를 설명한 후 동의를 구한 후 전자메일을 보내 일정기간 내에 응답하도록 한 후 수거하는 방식을 취하였다. 국내 전문가 조사대상자의 특성은 남성이 19명(61.2%)로 여성 12명(38.8%)보다 많았으며, 40대(64.5%)가 주로 응답을 하였고, 대학교수(67.7%)가 가장 많이 응답하였다. 전문가 집단은 한국인 음주문제에 대한 3문항의 모든 문항에 동의를 하였으며, 동의하지 않은 문항은 없는 것으로 나타났다. '인간관계를 술로 해결하는 관습', '업무상 술자리 많은 사업환경'의 경우 모든 전문가가 매우동의 혹은 동의로 응답하였다. '스트레스 많은 경쟁사회' 83.9%, '저렴한 알코올 가격' 64.5%, '술을 쉽게 접할 수 있는 지역 환경' 80.6%, '생활 대소사에 자주 노출되는 음주환경' 93.6%, '과음 통제할 사회적 통제수단 부족한 점' 90.3%의 경우 모두 매우 동의 혹은 동의로 응답하였다. 이 중 동의율이 가장 높은 문항은 '생활 대소사에 자주 노출되는 음주환경'(93.6%)으로 나타났다. '술을 좋아하는 국민기질' 61.3%, '여가활동을 할 수 없는 사회환경' 77.5%로 다른 문항에 비하여 동의율이 낮았고, 동의 안 한다는 응답도 각각 3.2%, 9.7%가 있는 것으로 나타났다.

• Journal of the korean veterinary medical association
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• v.42 no.11
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• pp.1045-1049
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• 2006