• Title/Summary/Keyword: Ethics of Care

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Investigating the Requirements of Good Teaching from Medical Students' Perspectives (의과대학생이 인식하는 좋은 수업의 요건 탐색)

  • Choi, Son-Hwan;Ahn, Hyo-Jin
    • Korean Medical Education Review
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    • v.18 no.3
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    • pp.156-166
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    • 2016
  • Medical school students learn a lot about medical knowledge and clinical experience in the classroom. Teaching is a main focus in medical schools; therefore, it is necessary to identify the characteristics of good teaching. The aim of this study is to analyze the characteristics of high-quality education in medical schools. In this study, in-depth interviews were conducted over two weeks on twelve fourth-year medical students. Participants were asked to define high-quality education, list the general ways in which high-quality classes are delivered, mention cases where they have experienced high-quality teaching, and describe the attitude required of students to make high-quality education possible. The results showed that students want to be taught in an interactive way on the core content needed in an actual clinical setting for the goal of cultivating primary care physicians. They want their education to include not only medical knowledge, but also liberal art subjects such as politics, economics, sociology, culture and ethics education to help instill a sound value system. In particular, students stressed the importance of instructors delivering appropriate post-evaluation feedback, and they also emphasized that learner mindset and attitude is important in supporting high-quality teaching in class. This paper also summarizes the elements of high-quality teaching in terms of educational goals, content, and method, and examines cases of instructors who have delivered high-quality classes.

Stakeholders' Opinion on the Desired Characteristics of Nursing School Graduates and Factors Concerning Nursing Curriculum Development in Thailand

  • Kittiboonthawal, Prapai;Siriwanij, Wareewan;Ubolwan, Kanyarat;Maneechot, Munthana
    • Asian Journal for Public Opinion Research
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    • v.5 no.4
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    • pp.319-345
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    • 2018
  • Effective higher educational management in undergraduate nursing programs is an important issue from the viewpoint of stakeholders. This qualitative research aimed to examine the characteristics of nursing students and curriculum development of undergraduate nursing education from the opinions of Boromarajonani College of Nursing Saraburi, Thailand stakeholders. The population included 4 groups: 1) the alumni who have graduated within the past 5 years and currently work in primary, secondary, and tertiary care units, 2) the supervisors and colleagues of the alumni, 3) nursing lecturers, and 4) the current nursing students. The respondents who are the alumni, nursing lecturers, and current nursing student were selected using a purposive sampling, for the supervisors and colleagues were selected using snowball techniques. Semi-structured interview questions were used for data collection. Group discussions were conducted until saturation on 55 key informants. The qualitative data was analyzed using content analysis. Results showed the viewpoints of stakeholders on the characteristics of future nurse graduates were comprised of four elements: knowledge that meets standards; essential skills for self-development and lifelong learning process; good morals and professional ethics in providing nursing care; and nurse competencies in teamwork, communication, language, research, management, IT, life skills, and global literacy. The viewpoints on the development of the nursing curriculum focus on four elements: the learner, teaching and learning, course content, and instructor tasks. For learners, the admission criteria should include a minimum not only of knowledge, but also positive attitude, science, and art skills, since the nursing profession is both a science and the art of caring. Teaching and learning elements should be authentic, including exposure to real situations, an integrated network, and activities that improve nursing care. Course content was comprised of an updated curriculum, humanized nursing care, student center, theory and practice with moral integration, case-based study, critical thinking, multidisciplinary work, and love for the nursing profession. Instructor tasks are to elicit student ideas, provide opportunities to learn, support infrastructure, support technology use, and extra-curricular activities to develop the competencies of nursing students. Recommendations were that the curriculum administration should review the selection process of student candidates and instructional management to achieve expected outcomes of nursing characteristics in the future. The nurse lecturer should provide authentic and integrated instruction, decrease lecturing, cultivate a lifelong learning process, and sustain the nursing characteristics.

Defining the Core Competencies of the Nurses in A Tertiary Hospital and Comparing Different Units based on Their Respective Characteristics (일 종합전문요양기관 간호사의 핵심역량 도출 및 근무지 특성별 중요도 인식 비교)

  • Sung, Young-Hee;Jeong, Jeong-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.1
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    • pp.76-93
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    • 2006
  • Purpose: The purpose of this study was to define the core components required of nurses to provide quality nursing care to patients and analyze the significance of these components in the hospital's various units to maintain a high level of competence among nurses. Method: The study evaluated 3 categories included 35 subcategories with 148 core components that were derived from literature review and interviews of nursing professionals. The nursing professional category included 18 subcategories with 98 components, the organizational culture category included 4 subcategories with 16 components, and the temperament-attitude category included 13 subcategories with 34 components. The study included 335 nurses with more than one year of hospital experience and measured disparities among different hospital units. The data was analyzed with SPSS-Win 10.0, differing perceptions of the importance of general traits among the participants were measured using standard deviation, and differing perceptions of the importance of professional traits among the participants were assessed using ANOVA and subsequently with the Bonferroni Test. The reliability of the aforementioned research tools were evaluated using the Cronbach's ${\alpha}$. Result: The results of the study were as follows: 1. Among the three categories, temperament-attitude category was perceived to be the most important, followed by nursing professional category and organizational culture category. Among the ten most important subcategories within the three categories, safety and infection prevention as well as responsibility were perceived to be the most important, followed by promotion of physiologic adaptation, document management and presentation, self-control, ethics, observance law, coping with emergency, humanity, and medication. 2. The relative importance of category associated with the core competencies within the hospital unit were as follows : 1) The units that rated nursing professional category as being the most significant were: internal medicine, surgical unit, mother-child unit, emergency room, intensive care unit, and operating room, in that order. 2) The units that rated the organizational culture competencies as being the most significant were: mother-child unit, internal medicine, surgical unit, emergency room, operating room, and intensive care unit, in that order. 3) The units that rated temperament-attitude category as being the most significant were: internal medicine, surgical unit, emergency room, mother-child unit, operating room, and intensive care unit, in that order.

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Development of Bachelor Nursing Programme (일 대학 간호학과 교육 과정 개발 연구)

  • Chung, Bok-Yae;Kim, Mi-Ye;Suh, Soon-Rim;Hong, Hae-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.9 no.2
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    • pp.298-309
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    • 2003
  • The educational preparation of nurses has been the focus of considerable debate globally. It is needed the change of the basic nursing education for professional nurse to prepare the trends of the health care needs of clients for coming new generation. And also it is believed that educational preparation for being nurses is to be responsible to clients' needs. The purpose of the study was to develop a baccalaureate program in nursing. This study were implemented through three stages from April 2001, to April 2002.: preparation stage which were consisted of reviewing of the literatures, interviewing the fellow nurses in a variety workplace, and consulting professors who were concerned with the nursing education to identify the present educational problems, and analyzing the contents of seven major courses in nursing education, evaluation stage about a new developed curriculum with the directors of the five nursing schools, and confirmation stage of new developed education programme. The developed education programme was designed as a four year program with 126 credit hours including 39 credit hours of liberal arts, 34 credit hours of supplementary courses, and 53 credit hours of nursing major based on the four basic nursing dimensions of human, health, environment and nursing. Nursing majors were consisted of Nursing Ⅰ(oxygenation), Nursing Ⅱ(nutrition elimination), Nursing Ⅲ(activity rest), Nursing Ⅳ(neurologic- endocrine protection), Nursing Ⅴ(fluids electrolytes/sex reproductive), Nursing Ⅵ(psycho-social), Community Health Nursing, Fundamental Nursing, School Health, and Emergency care. This new nursing programme was focused on the nursing education for prevention and rehabilitation nursing care as well as the acute and chronic nursing care at hospital, on the integrated nursing programme to become effective, and the nursing process to encourage the critical thinking. The new education programme focused on the professional nurses who are responsible the nursing ethics, communication skills, and professional beliefs to suit the future trends in health. And also it will be needed for faculties to manage the integrated curriculum, to analyze the contents of each subject, and to communicate with each other before a new education programme apply to their education programme in future. This research was supported by the Han Kok Medical Science Foundation

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A Study on the Clinical Nurse's Ethical Value (인간생명에 대한 간호사의 윤리의식)

  • Moon, Young-Im;Tak, Young-Ran;Kim, Myoung-Ae;Kim, Seon-Ae;Park, Kyung-Sook;Im, Dong-Sik;Park, Ho-Ran
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.4
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    • pp.541-557
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    • 2003
  • Purpose: This descriptive study was designed to explore the clinical nurse's ethical value regarding human life. Method: Data were collected from September to October, 2002. Study subjects were 527 clinical nurses working in General Hospital as tertiary located in Seoul. Ethical value was measured with questionnaire developed by researchers and consisted on items regarding ethical value on human life. Result: Among the items, most nurses highly agree with the item, "When a patient requests his/her health care provider to keep his/her personal secret, the health care provider is obliged to do so." and "When a patient asks for information on his/her medicinal and dietary contents, his/her wish must be granted." Most clinical nurses mainly agree with the item. "Health care providers must always be honest to the patient and/or his/her family". However, most nurses disagree with the item, "When a patient is on the verge of death after an accident, it is justifiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them". Most clinical nurses mainly disagree with the items, "When a patient is on the verge of death after an accident, it is justiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them" and "It is justiable that various new ways of treatment should be applied to patient at his/her terminal stage to prolong his/her life, even for the purpose of research". There were significant differences in some items of ethical value according by clinical nurse's age and professional experience, current position, religion, education, marital status, continued education on ethics, and the experience of holing on life saving treatment. Conclusion: It is intensifying the notion of ethical underpinning for human rights, truthfulness is essential to a trust relationship under what circumstances. Also most clinical nurses agree with that It is essential to trust in the nurse-patient relationship, patients have the right to know and it is the ethical thing to do as health care provider.

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A Legal Analysis on the Absence of Provisions Regarding Non-relative Patients in the Act of Decisions-Making in Life-Sustaining Medicine (연명의료결정법에서 무연고자 규정미비 등에 관한 법적 고찰)

  • Moon, Sang Hyuk
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.103-128
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    • 2023
  • According to the current act of Decision-Marking in Life-Sustaining Medicine, the decision to withhold or discontinue life-sustaining treatment is primarily based on the wishes of a patient in the dying process. Decision-making regarding life-sustaining treatment for these patients is made by the patient, if he or she is conscious, directly expressing his/her intention for life-sustaining treatment in writing or verbally or by writing an advance medical directive and physician orders for life-sustaining treatment. It can be exercised. On the other hand, if the patient has not written an advance medical directive or physician orders for life-sustaining treatment, the patient's intention can be confirmed with a statement from the patient's family, or a decision to discontinue life-sustaining treatment can be made with the consent of all members of the patient's family. However, in the case of an unrelated patient who has no family or whose family is unknown, if an advance medical directive or physician orders for life-sustaining treatment are not written before hospitalization and a medical condition prevents the patient from expressing his or her opinion, the patient's will cannot be known and the patient cannot be informed. A situation arises where a decision must be made as to whether to continue or discontinue life-sustaining treatment. This study reviewed discussions and measures for unbefriended patients under the current law in order to suggest policy measures for deciding on life-sustaining treatment in the case of unbefriended patients. First, we looked at the application of the adult guardian system, but although an adult guardian can replace consent for medical treatment that infringes on the body, permission from the family court is required in cases where death may occur as a direct result of medical treatment. It cannot be said to be an appropriate solution for patients in the process of dying. Second, in accordance with Article 14 of the Life-Sustaining Treatment Decision Act, we looked at the deliberation of medical institution ethics committees on decisions to discontinue life-sustaining treatment for patients without family ties.Under the current law, the medical institution ethics committee cannot make decisions on discontinuation of life-sustaining treatment for unbefriended patients, so through revision, matters regarding decisions on discontinuation of life-sustaining treatment for unbefriended patients are reflected in Article 14 of the same Act or separate provisions for unbefriended patients are made. It is necessary to establish and amend new provisions. In addition, the medical institution ethics committee must make a decision on unbefriended patients, but if the medical institution cannot make such a decision, there is a need to revise the law so that the public ethics committee can make decisions, such as discontinuing life-sustaining treatment for unbefriended patients.

Artificial Intelligence In Wheelchair: From Technology for Autonomy to Technology for Interdependence and Care (휠체어 탄 인공지능: 자율적 기술에서 상호의존과 돌봄의 기술로)

  • HA, Dae-Cheong
    • Journal of Science and Technology Studies
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    • v.19 no.2
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    • pp.169-206
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    • 2019
  • This article seeks to explore new relationships and ethics of human and technology by analyzing a cultural imaginary produced by artificial intelligence. Drawing on theoretical reflections of the Feminist Scientific and Technological Studies which understand science and technology as the matter of care(Puig de la Bellacas, 2011), this paper focuses on the fact that artificial intelligence and robots materialize cultural imaginary such as autonomy. This autonomy, defined as the capacity to adapt to a new environment through self-learning, is accepted as a way to conceptualize an authentic human or an ideal subject. However, this article argues that artificial intelligence is mediated by and dependent on invisible human labor and complex material devices, suggesting that such autonomy is close to fiction. The recent growth of the so-called 'assistant technology' shows that it is differentially visualizing the care work of both machines and humans. Technology and its cultural imaginary hide the care work of human workers and actively visualize the one of the machine. And they make autonomy and agency ideal humanness, leaving disabled bodies and dependency as unworthy. Artificial intelligence and its cultural imaginary negate the value of disabled bodies while idealizing abled-bodies, and result in eliminating the real relationship between man and technology as mutually dependent beings. In conclusion, the author argues that the technology we need is not the one to exclude the non-typical bodies and care work of others, but the one to include them as they are. This technology responsibly empathizes marginalized beings and encourages solidarity between fragile beings. Inspired by an art performance of artist Sue Austin, the author finally comes up with and suggests 'artificial intelligence in wheelchair' as an alternative figuration for the currently dominant 'autonomous artificial intelligence'.

The Systematization of Personality Education Contents in the 7th Curriculum for Home Economics (제7차 가정과 교육과정에 따른 학교 인성교육 내용 체계화 방안)

  • 왕석순
    • Journal of Korean Home Economics Education Association
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    • v.16 no.2
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    • pp.13-26
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    • 2004
  • This study tried to suggest teaching and learning activities which can be effectively utilized in Home Economics Education by analyzing and suggesting “The objective and contents of personality education” in Home Economics Area in the curriculum of 7th Technology & Home Economics. As a result, Personality education can be implemented in all areas of Home Economics Education. Especially in Home Economics Education, the following personality education can be implemented. First of all, it can teach the equality among family members by teaching the values of equality and respecting human rights. Secondly, it can teach to recognize and implement various values related to environmental protection. Thirdly, it can teach the ethics related to care which was claimed by Gilligan and other people - in other words, charity, forgiveness, friendship, love, sacrifice, concession, conversation, compromise and etc. Especially these kind of values are extended to also the ethics of care for others, neighborhood, and community not only for family care which was the traditional Home Economics education criticized as family selfishness. On the other hand, personality education in Home Economics Education is different from other subjects. It enables students to act through experiences not just emotion or knowledge by learning actual relationships among family members in daily life. This kind of feature is proving the fact that Home Economics Education can play a very effective role in achieving the objective of moral behavior The results of this study proves that Home Economics Education is an effective subject which can conduct personality education by the objectives and contents that are different from other subjects. This provides the reasonable cause for Home Economics Education to be an required subject in school curricula. Future study should be conducted as an empirical research to develop personality programs(activities for teaching & learning) which can be implemented in Home Economics Education and to accumulate empirical data of such programs.

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Ethical Argumants and Problems Analysis Related to Induced Abortion (인공임신중절과 관련된 윤리학적 논쟁과 문제 분석)

  • Um, Young-Rhan
    • Women's Health Nursing
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    • v.2 no.2
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    • pp.230-252
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    • 1996
  • Over one million cases of the induced abortion have been conducted annually in Korea. Among those cases, most of all were illegally done, but this has not been addressed in the literature. While Korean Nurse Association Code of Ethics presents the respect for life as one of the basic ideology, it was not dealt enough in nursing education. The purposes of the study were to activate the debate on the issues related to an induced abortion ; to introduce the related ethical theories ; and to seek the solution of the ethical problems, which will eventually result in establishing the morality of nursing practice. The ethical theories of an induced abortion have traditionally addressed two extreme perspectives ; the conservatives who emphasize the sanctity of human life and the right of life that will never ethically allow the killing fetus ; and the liberalists who insist the right to choice for women to control their body. Since these extreme theories has not been helpful to solve the ethical problems, the recent trend is leading to the modified theories both from conservative and liberal perspectives. The examples of the theories are the potentiality of fetus(Singer, 1993), the obligation of women to serve their body to fetus(Held, 1987), the Replacement theory (Callahan, 1987), and the Principle of Caring (Gilligan, 1982). The study conducted the indepth interviews with 17 women who experienced the induced abortion and the 6 cases were selected to be analyzed. The cases were analyzed and interpreted by using an integrated case method which was combined of the New Casuisty(Jonsen & Toulmin, 1988 ; Jonsen, 1991) and the Specified Principlism (Richardson, 1990 ; Degrazia, 1992). The result of analysis revealed three types of ethical problems ; (1) the responsibility of taking care of the baby to be born (2) the fear for the condition of the fetus, and (3) the choice of induced abortion as the method of birth control. The findings also revealed the related ethical principles for various situations ; the principle of caring was used for choosing an induced abortion by the subjects ; the principles of the potentiality of fetus and the obligation of women to serve their body were for the consideration for the life of fetus ; and the principle of replacement was utilized for the right to choice for women. The ethical principles related to an induced abortion introduced in the study provided the way to solve the moral problems by applying to the clinical situations for nurses. The study also revealed the possibility of modifying the current ethical theories from the method of applying the principles to the various situation in the study. The modified theories would be more useful to guide the clinical practice with similar ethical problems.

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A Study on Medical-criminal Problem of Withdrawing Life-Sustaining Treatment (치료중단행위에 대한 의료형법적 고찰 -의학적 충고에 반한 퇴원 사례를 중심으로-)

  • Cho, In-Ho
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.319-382
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    • 2008
  • As a withdrawing care's study, the purpose of this study is searching about withdrawing care's acceptance and circumstances through Bora-mae hospital case(chapter 1). Withdrawing life-sustaining treatment has various forms. Though the meaning of euthanasia, death with dignity, natural death, physician assisted suicide are duplicated, the meaning of those are different slightly. Firstly, this study looks about the difference of the those meaning and acceptance range(condition) by withdrawing care's forms(chapter 2). Bora-mae hospital case sentenced guilty about physician who discharged incompetent patient who was after surgery by patient's wife determination. This Bora-mae case that sentenced guilty about discharge against medical advise(DAMA) that is regarded to custom has brought intensive confliction of legal, social, medical aspect, Bora-mae hospital case has many legal problems. First, as to criminal law rule 250(murder), the problem is whether discharge and withdrawing life-sustaining treatment is commission or omission. this study concluded omission(district court: omission, appeal, supreme court: commission). Because legal denounce point of discharge and medical treatment withdrawing is omission that physician who is obligatory on patient to cure. If physician's act is regarded omission, it is necessary to determine whether he has guardian status and obligation. Without guardian status and obligation, omission crime can't exist. This study decided that physician had guardian status and obligation and foundation of guardian status was pre-action or acceptance of emergency patient. Physician's medical treatment duty finished when patient(or patient's guardian) demands discharge. But when patient death is foreseen and other possible treatment does not exist, his duty of life prolonging treatment does not finish. This originate from physician's social responsibility and public status that limits patient's private liberty. This study regarded physician's action as accomplice about whether physician's discharging action is accomplice or the principal offender(district court: the principal offender, appeal, supreme court: accomplice). Though the principal offender needs criminal determination and action, there is no this common determination and functional action control of physician in Bora-mae case(chapter 3). Bora-mae hospital case partly originated from deficiency of legal, institutive system including medical security system shortage, the instruction is 1. medical security system strengthening, 2. hospital ethical committee's activity strengthening, 3. institutionalization of withdrawing life-sustaining treatment, 4. acceptance of pre-decision making system, 5. sufficient persuasion of physician for patient and faithful writing of medical paper, 6. respect for patients' self-determination and rights, 7. consciousness's changing for withdrawing life-sustaining treatment and persistent education about medical ethics(chapter 4). Considering Bora-mae case, medical sector is not the dead ground of a criminal punishment. Intervention of criminal law in medical sector give rise to ill effect, that is, excess medical examination and treatment, safeguard treatment, delay of discharge from a hospital. Because sufficient guarantee of life becomes mere empty slogan under situation that impose a burden of heavy cost to family or hospital, public and systematic solution should be given(chapter 5).

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