• 중환자간호학회지
• /
• 제11권3호
• /
• pp.1-11
• /
• 2018

Purpose : This study compares experiences of ethical dilemma between nurses working in intensive care units and those in general units under specific situations of treatment decisions and confidentiality. Method : This cross-sectional descriptive study utilizes the self-report survey method. The survey questionnaires were completed by 50 and 52 nurses working in intensive care units and general units, respectively. The instrument, which consisted of 16 items of ethical dilemma situations about treatment decision and confidentiality, was used. The mean scores for each item were compared between the two groups. Results : The study found no differences in terms of age, gender, education level, clinical experience in years, and being educated on healthcare ethics. For 9 out of 16 items, the mean scores of nurses in intensive care units were significantly higher than those of nurses in general units. Conclusions : Nurses in intensive care units experienced ethical dilemmas regarding treatment decisions and confidentiality more often than those in general units. This study emphasizes the need to establish strategies for improving the ethical competence of critical care nurses.

• 한국가금학회지
• /
• 제50권2호
• /
• pp.81-90
• /
• 2023

국내의 동물복지 개념의 도입은 해외 선진국에 비해 늦었으나 정부 주도에 의해 비교적 적극적인 동물복지정책들이 도입되고 있다. 그러나 축산업 현장에서 동물복지 인식이 충분치 못하기 때문에 자발적인 개선이 아닌 정부의 정책수단에 의하여 동물복지를 추진하고 있는 실정이다. 본 연구에서는 국내 산란계 농가를 중심으로 최근 5년간 도입된 동물복지 관련 정책이 현장에서 유발하는 갈등을 유형화하여 파악하기 위하여 산란 농장 운영자들의 동물복지 관련 의식수준 및 동물복지 관련 규정 준수여부를 조사하였다. 산란 농가 현장방문을 통하여 설문조사를 진행하였으며, 산란양계농장 운영자(소유자 혹은 관리 책임자)를 대상으로 53가구의 산란양계 농가를 조사하였다(2020년 산란양계농가 수 797가구 수 기준 90% 신뢰수준(Z-score: 1.65) 10.18% 허용 오차). 현장에서의 갈등을 윤리적 고려 수준에 따라 소극적, 중도적, 적극적 3가지로 유형화하였다. 또한 윤리적 고려 수준에 따라 동물복지 관련 규정 준수 여부와의 상관관계를 조사하였다. 결과적으로, 축산 현장에서의 동물복지 관련 규정 준수 여부는 축산 농장 운영자의 윤리적 고려수준의 영향을 받는 것을 확인할 수 있었다. 다만 예외적으로 농장 운영자의 동물복지 의식수준이 높음에도 동물복지 관련 규정은 준수하지 못하는 갈등상황이 확인되었는데, 이는 현장에서 인지하고 있는 규정과 정책의 충돌로 인해 발생한 갈등 상황임을 확인할 수 있었다. 이처럼 정책 수단에 의해 추진되는 동물복지가 효과적일 수는 있지만, 아직은 현장에서 갈등을 유발하고 있음을 확인할 수 있었다.

• 아동학회지
• /
• 제37권6호
• /
• pp.185-200
• /
• 2016

Objective: This study examined the code of ethics, which offers guidelines for early childhood teachers' ethical decisions and practices. Results and Conclusion: In the second section of this paper, the meaning of the code of ethics is reviewed. The issues of the code of ethics are also investigated to resolve moral and ethical dilemmas and to maintain high standards of professional conduct in early childhood care and education. In the third section of this paper, a comparison of the ethical codes in South Korea, Japan, the United Kingdom, and the United States is conducted. Based on the results raised in relation to the code of ethics principles and the results of comparing domestic and international ethics codes, the fourth section of this paper focuses on three topics in the current and future direction of the Korean code of ethics: (a) concreteness and clarity, (b) switching from the viewpoint of least harm to the viewpoint of maximum benefit, and (c) the range of benefits of the code of ethics. Then, including the existence of the last two codes of ethics, we discuss the direction of future difficulties currently associated with the situation in Korea.

• 간호행정학회지
• /
• 제1권2호
• /
• pp.268-284
• /
• 1995

This study was designed to test effects of nursing ethics education (NEE) on moral reasoning and ethical decision making of subjects. This NEE that was teached for 10 hours course was composed of these : Nurses' ethical code, moral responsibility, Moral value and professional accountability, Respect for human life, General ethics, Theory and Norms of biomedical ethics, Ethical decision making model and Discussion about hypothetical ethical dilemmas Twenty-five senior student nurses were sampled from four year college of nursing from Nov. 3rd, 1993 to Nov. 24th, 1993. Data were collected through self-reported questionnaires included two kinds of tests. Rest's Defining Issues Test was adopted to measure the stage of moral development, which was classified with the stage 2 (instrumental relativist orientation), the stage 3 (interpersonal concordance), the stage 4 (law and order), the stage 5A (societal consensus), and the stage 5B (intuitional humanism), the stage 6 (universal ethical practice). In particular, the level of principled thinking (P) was measured by summing these scores of the stages 5A, 5B, and 6. The possible range of P is 0 to 95. As for measuring the levels of morality and nursing dilemma, Crisham's Nursing Dilemma Test was adopted. This test generated the morality score(MS) and the dilemma score (DS). The data were analyzed by t-test, ANOVA, Kruskal-Wallis test, Mc Nemar's test and Pearson correlation coefficients. The results were as follows ; 1. For the Moral Reasoning both before and after NEE, The Mean score of the stage 5A was significantly higher than that of other stages.(P=0.0001) Before NEE, the mean score of the stage 4 was significantly different from stage 2, 3, 5A, and after NEE, different from stage 2, 5B,6. 2. The analysis of change of moral development level revealed that the score of stage 4 increased after NEE.(P=0.0004) 3. The Effect of NEE for the mean score of 5A, 6, P after education was significantly different by birth place. 4. With regard to the five dilemmas postulated such as forcing medication performing cardiac pulmonary resuscitation, reporting a medication error, informing diagnosis to terminally ill adult, and providing new-nurse orientation, the mean score of the MS and the DS was no significant difference with general characteristics of the students. Effect of NEE morality score and dilemma score after education was no significant difference. 5. As for the correlations between moral reasoning and decision making, the score of the stage 2, 5A, 6, DS was positively correlated with the scores of before and after. Positive correlation was also observed between the scores of stage 2 and stage 4, stage 3 and 6. On the other hand, the score of P was negatively correlated with the scores of stage 2 and of stage 4 and of stage 5A. The score of the stage 5A was also negatively correlated with the score of the sge 6.

• International Journal of Advanced Culture Technology
• /
• 제12권1호
• /
• pp.85-93
• /
• 2024

In this paper, focusing on Oscar Wilde's novel "The Picture of Dorian Gray," we explore the protagonist's lack of conscience and unethical attitude, emphasizing its relevance to our self-development and growth. The primary goal is to interpret the impact of Dorian Gray's actions and choices on personal development and growth, highlighting the importance of a specific mindset and attitude to the reader. It dissects how Wilde navigates the intricate layers of Dorian's character, exposing the ethical dilemmas and transformative moments that contribute to the profound changes within him. The examination sheds light on the depth and complexity of Dorian Gray's character, offering readers a nuanced understanding of the forces at play in his moral and psychological journey. Interpretation of Wilde's intent to impart lessons on the reader's personal growth and development through Dorian's story is undertaken. The discussion also explores the impact of Dorian's unethical attitude on contemporary readers and its influence on our daily lives and values.

• 보건행정학회지
• /
• 제14권3호
• /
• pp.97-121
• /
• 2004

Recently, human embryonic stem cell research raises exciting public expectation on medical possibilities as well as ethical debate. Embryo management has become an integral part of the management of infertility treatment, researches on embryo and human embryonic stem cells and so on. Britain has permitted the research on stem cells derived from human embryo which made the first nation to allow the cloning of human embryo for the stem cell research. However, new technologies such as the assisted reproductive technologies and human embryonic stem cell research continue to pose an increasing source of ethical dilemmas for physician, scientists, legislators, religious authorities and the general publics to deal with. None the less, the United Kingdom has adopted the most liberal policies regarding human embryo and human embryonic stem cell research. The implication of the British embryo management system are as follows: 1) the development of reproductive technologies and new stem cell research technologies continue to pose legal and ethical debates, since those involve several parties; 2) the UK has taken the legal and institutional approaches to cope with those serious issues; 3) the UK adopted most liberal policies regarding embryonic and human embryonic stem cell researches; 4) the British HFE Act is consistent with the existing Acts related to human embryo management and researches; 5) through amending the HFE Act to accomodate the changes of technologies, the UK try to minimize the legal and ethical burden on undertaking research regarding embryo. The debates about the researches on human embryo and human embryonic stem cells is likely to continue in the Korean society. Because of the controversy and competing ethical values, as well as the evolving technologies, so far no consensus exists in our society. It suggest that it is premature to bring closure by ruling out any particular approaches. Thus our society needs to make an efforts to find a basis which could resolve the societal controversies through enriching the societal conversation about the profound ethical issues regarding embryo management.

• 한국산학기술학회논문지
• /
• 제19권6호
• /
• pp.240-251
• /
• 2018

본 연구는 요양병원 간호사의 도덕적 고뇌와 도덕적 민감성의 정도, 상관관계, 도덕적 고뇌에 영향을 미치는 요인 및 도덕적 고뇌의 경험상황을 파악하기 위해 시행되었다. 연구대상자는 G도에 소재한 6개의 요양병원에 근무하는 간호사 180명으로, 자료수집은 2016년 3월 21일부터 4월 8일까지 시행하였으며 SPSS win 23.0 프로그램을 이용하여 분석하였다. 대상자의 도덕적 고뇌정도는 평균 3.57점, 도덕적 민감성정도는 평균 4.82점이었으며, 도덕적 고뇌와 도덕적 민감성 간에는 유의한 정적 상관(r=.494, p<.001)이 있었다. 요양병원 간호사의 도덕적 고뇌에 영향을 주는 변인은 도덕적 민감성과 윤리적 딜레마 경험여부로 나타났다. 대상자의 도덕적 고뇌 상황 경험은 간호의 질이 보장되지 않은 부적절한 간호행위와 관련된 상황, 비윤리적인 인권문제와 관련된 상황, 부족한 간호 인력과 관련된 상황, 조직 및 국가 차원의 지원 부족과 관련된 상황 등에서 경험한 것으로 나타났다. 따라서 요양병원 간호사의 도덕적 고뇌를 감소시키기 위해서는 도덕적 민감성과 윤리적 문제해결능력을 함께 향상시킬 수 있는 중재방안이 마련될 필요가 있다.

• 대한간호학회지
• /
• 제24권2호
• /
• pp.190-205
• /
• 1994

Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

• 대한간호학회지
• /
• 제30권1호
• /
• pp.183-193
• /
• 2000

This main purpose of this study was to assess the effects of two different types of ethics education on the moral judgement of clinical nurses. One type was free discussions among nurses with given specific moral issues and the other type was discussions guided by experts on specific moral issues. The study employed a quasi-experimental, nonequivalent pre test-post test design using two different control groups. The conceptual framework of the study was derived from the Kohlberg′s Moral Development Theory (1969) and the Greipp′s Ethical Decision-Making Model (1992). The data was collected during the period of October 14 through December 15, 1998. Sample consists of 32 nurses working in the ICU who met research criteria. 16 nurses were assigned to the free discussion group and 16 nurses to the group for the guided discussion with experts group. For the pre-test, the DIT which was developed by Rest (1984) and JAND by Ketefian (1998) were used with some modification by the author. After the education, only JAND was used to assess the changes in moral judgement. The collected data was analysed using SPSS PC program. The findings are as follows: 1. There was no significant difference between two groups in their general characteristics. Only difference which was statistically significant between two groups was that realistic score on Case 3/Medical Research and Autopsy was higher in the free discussion group. 2. Hypothesis 1: "There will be a difference on the moral judgement of nurses before and after they receive an ethics education". This hypothesis was supported partially. Those who had low scores on moral judgement before the education tended to have higher scores after the education on the same issues. And, after the education, the nurses tend to give lower scores on the dilemmas they had experienced frequently at work; while giving higher scores on those dilemmas they had no prior experience. 3. Hypothesis 2: "The effect of education may differ depended upon the moral development index [P(%)] score of nurses". The effect of education was different depend on moral development level. The group who′s P(%) scores was low at the pretest has higher scores in realistic moral judgement after the education, while the groups with middle or high P(%) scores went down after the education. These changes were statistically significant in some cases, thus, the Hypothesis 2 was partially supported 4. Hypothesis 3: "The method of ethics education will have different effects on the moral judgement of nurses". Even though several nurses attended the guided discussion stated that the education program broadend their perspectives the difference between two groups was not significant and this hypothesis was not supported. In conclusion, both types of ethics education had helped the nurses to acquire the skills to deal some nursing dilemmas. The effects of ethics education may differ according to the moral development index - P(%) score. However, because of some of the limitations of this study, mainly small sample size, short term education, unable to control other variables which may affect moral judgement of nurses, further research is warranted.er research is warranted.

• 간호행정학회지
• /
• 제1권1호
• /
• pp.5-21
• /
• 1995

This study purports to investigate moral reasoning and ethical decision making among student nurses in the hypothetical moral dilemmas. The subjects consisted of 25 senior nursing students attending at a four-year college. Data were collected through self-reported questionnaires in November, 1993. The questionnaires included two kinds of tests. Rest's Defining Issues Test was adopted to measure the stage of moral development, which was classified with the stage 2 (instrumental relativist orientation), the stage 3 (interpersonal concordance), the stage 4 (law and order), the stage 5A (societal consensus), and the stage 5B (intuitional humanism). In particular, the level of principled thinking (P) was measured by summing those scores of the stages 5A, 5B, and 6. The possible range of P is 0 to 95. As for measuring the levels of morality and nursing dilemma, Crisham's Nursing Dilemma Test was adopted. This test generated the morality score(MS) and the dilemma score (DS). The data were analyzed by t-test, ANOVA, Kruskal-Wallis test, and Pearson correlation coefficients. The findings are following. 1. The mean score of P was 52.93 (SD=12.82). The mean score of the stage 5A was significantly higher than the scores of other stages (17.92, p=.0001). 2. The mean score of P was not significantly different by general characteristics of the students. Of the scores of each stage, only the mean score of the stage 3 revealed significant difference by the status of living with parents(p=.0283). The score was highest when "living with both parents"(15.22), which was followed by "living with no parents"(10.0), "living with father only"(9.0), and "living with mother only"(7.50). 3. With regard to the five dilemmas postulated such as forcing medication, performing cardiac pulmonary resuscitation, reporting a medication error, informing diagnosis to terminally ill adult, and providing new-nurse orientation, most students perceived them as moral dilemma rather than nonmoral one. Most students made a positive decision according to moral reasoning in the above situations except for providing new-nurse orientation. 4. The mean score of the MS was 3.30 and that of the DS was 3.32. These scores did not show significant difference with general characteristics of the students. 5. As for the correlations between moral reasoning and decision making, the score of the stage 5A was positively correlated with the scores of P(.74, p<.0001) and DS(.56, p<.001). Positive correlation was also observed between the scores of stage 2 and stage 4(.68, p<.0001). On the other hand, the score of P was negatively correlated with the scores of stage 3(-.47, p<.05) and of stage 4(-.55, p<.001). The score of the stage 5A was also negatively correlated with the score of the stage 6(-.42, p<.05).