• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.309-341
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• 2009

According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

• Journal of Hospice and Palliative Care
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• v.19 no.1
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• pp.34-44
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• 2016

Purpose: The purpose of this paper is to identify a theoretical basis of end-of-life care by examining attributes of the concept of the nurses' acceptance of patient deaths. Methods: Walker and Avant's approach to concept analysis was used. A literature study was performed to check the usage of the concept. To identify the attributes of the concept and come up with an operational definition, we analyzed 16 qualitative studies on nurses' experiences of death of patients, published in a national science magazine from 1999 to 2015. Results: The nurses' acceptance of death of patients was identified as having four attributes: acceptance through mourning, attaining insight on life and death while ruminating life, facing with fortitude and practicing human dignity. Antecedents of the concept were experiences of patient's death, confusion and conflict, negative emotions, passive responses, denial of patients' death. The consequences of the concept were found as the holistic end-of-life care and active pursuit of life. Conclusion: This study on the attributes of the concept of the nurses' acceptance of death of patients and it's operational definition will likely lay the foundation for applicable end-of-life care mediations and theoretical development.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1156-1169
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• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• The Korean Journal of Air & Space Law and Policy
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• v.32 no.1
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• pp.355-384
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• 2017

In Korea, a Law on Airport Noise Prevention and Noise Control Area Support has been in effect since 2010. And also, airport noise measures project and residents support project conducted following the Law on Airport Noise Prevention and Noise Control Area Support. However, a Law on Airport Noise Prevention and Noise Control Area Support does not apply to military airfield. Many city residents already complain about military airport noise, but there are no countermeasures. They claim the noise from the military airfield is an intrusion on their lives, and some people brought a class action against the government. In the 20th National Assembly, some congressmen already proposed some legislations that aims to support residents adjacent to the military airfield. Nevertheless, relevant legislations are currently pending at the 20th National Assembly. Legislation preventing aircraft noise and providing support measures is essential to residents life who near by military airfield. At first, this study looked at legislations proposed by congressmen in the 20th National Assembly. And also, this study looked at A Law on the Improvement of Living Environment around the Defence Facilities of Japan. Based on this study, we did an analysis of the problem of legislation and proposed improvement suggestion. I hope so that this study could someday help congressmen make a legislation about military airfield noise. We hope the 20th National Assembly will pass the legislation finally to help the residents who near by military airfield relieve their pain by noise and restore their human dignity.

• Journal of Fashion Business
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• v.15 no.1
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• pp.185-204
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• 2011

The purpose of this study is to take into consideration the formative and aesthetic characteristics of wedding dresses that existed during the periods of Neo-Classicism and Romanticism which appeared as a reaction toward Neo-Classicism. The method of the research was mainly focused on precedent research data and general references. Furthermore the data on wedding dresses was mainly collected from British, French, and American library and museum web sites. The result of the research is the following. The Neo-Classicism art, which appeared along with the enlightenment in the beginning of the 19th century, pursues beauty based on associations and imitations of ancient Greek and Roman arts. In addition to aforementioned pursuits, the Neo-Classicism art also pursued universal beauty and social usefulness through law and order. This aesthetic value was also applied to the wedding dresses, so classical beauty, natural beauty and universal beauty were expressed as follows: corsets of the previous era were removed from general clothing and Empire style that imitated natural Greek style became predominant. Also, muslin replaced high quality clothes which were used as the main materials of the dressing during the previous era. Empire style's wedding dress became popular and simple colors and styles of the wedding dress expressed the beauty of the human body and emphasized civility at the same time. Romanticism art and costumes opposed rationalism and pursued sentimentalism. Moreover, it pursued diversity, exotic tastes and accepted diverse reactionism unlike Neo-Classicism's simplification and standardization. These aesthetic characteristic were applied to the wedding dress of this period; wedding dress of romanticism pursued feminine and elegant beauty with "X" silhouettes and various decorations, like general costumes. And they were decorated with a variety of excessive accessories, details and trimmings to express romantic sentimentalism. Exotic tastes which included Chinese, Egyptian, Indian influence and other diverse tastes were expressed through hair style, accessories and patterns of shawl. However, the white color in the wedding dress revealed purity and sanctity which cannot be found from general costumes regardless of whether the dress expressed Neo-classicism or Romanticism. As a formal dress worn during wedding ceremonies, the wedding dresses of the royalty revealed dignity and authority and significantly influenced later wedding dress designs.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.105-138
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• 2017

This is case comments of several representative legal cases regarding self- determination right of patient. In a case in which an intoxicated patient attempted suicide refusing treatment, the Supreme Court ruled that the medical team's respect for the patient's decision was an act of malpractice, and that in particular medical situations (medical emergencies) the physician's duty to preserve life supersedes the patient's rights to autonomy. Afterwards, at the request of the patient's family, and considering the patient's condition (irrecoverable death stage, etc.) consistent with a persistent vegetative state, the Supreme Court deduced the patient's intention and decide to withdraw life-sustaining treatment. More recently, regarding patients who refuse blood transfusions or other necessary treatment due to religious beliefs, the Supreme Court established a standard of judgment that can be seen as conferring equal value to the physician's duty to respect patient autonomy and to preserve life. An empirical study of legal precedent with regard to cases in which the physician's duty to preserve life conflicts with the patient's autonomy, grounded in respect for human dignity, can reveal how the Court's perspective has reflected the role of the patient as a decision-making subject and ways of respecting autonomy in Korean society, and how the Court's stance has changed alongside changing societal beliefs. The Court has shifted from judging the right to life as the foremost value and prioritizing this over the patient's autonomy, to beginning to at least consider the patient's formally stated or deducible wishes when withholding or withdrawing treatment, and to considering exercises of self determination right based on religious belief or certain other justifications with informed refusal. This will have a substantial impact on medical community going forward, and provide implicit and explicit guidance for physicians who are practicing medicine within this environment.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.87-111
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• 2002

The hospice activities in Korea have still stood in the premature stage, although the contemporary hospice program, which professionally accommodates terminally ill patients, appeared in the history 35 years ago. Especially, the availability of the facility hospice is not only poor in number, but also lack of a guideline for the conduct of the facility. Saemmul Hospice has keenly felt the necessity of more facility hospices and has interchanged experiences and informations with people interested in hospice. However, the number of facilities has fallen short of one's expectations, and many problems have been revealed in order to maintain the operation. This paper was written in order to improve these atmospheres and to help more terminally ill cancer patients properly. This paper clarifies in detail the principle of management, the method of practice in each departments of Saemmul Hospice, expected effects and supplemental items. We try to provide concrete and practical informations and to help extensively for all peoples who are to begin or currently working. 1.Facility: It secures, maintain, and manage the hospice environment for all around care of patients effectively. 2.Education and Volunteer: It trains and manages hospice volunteers devoted to hospice. 3.Financial: It manages donation by healthy soul with an effective method. 4.Administration and Organization: It executes the administration efficiently and constitutes the organization to operate. 5.Medical and Nursing: It offers the maximum professional supports to a hospital. 6.Medicine and alternative medicine: It improves the quality of life of patients by medical and pharmaceutical approach and by other possible methods available. 7.Nutrition: It helps patients to have diets in accord with the order of the creation. 8.Belief: It offers spiritual care which allows the profound relationship with God. 9. Funeral ceremonies: Funeral ceremonies may heal grieves of families faced with their deaths. 10. Bereaved families: It supports the families after the deaths of patients. 11.Reception and consultation: It seeks to help the patients who meet the purposes for which Saemmul Hospice is established. 12.Publication: It allows publicity activities for Saemmul Hospice. Facility hospice programs are able to overcome the disadvantages that the other type of the hospice possess, like as the economic burdens of the families, and the patients' losses of comforts of home after being transferred to a hospital. Facility hospice can provide home atmosphere with professional manpower and facilities like hospital to the patients. Therefore, it can also improve patients' qualities of life and make them comfortable death. We anticipate that the hospice program in Korea would be more active to let more people be indebted to maintain the nobel human dignity and to cross beautifully in the most painful process of dying in the journey of their lives.

• Journal of Digital Convergence
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• v.12 no.2
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• pp.391-396
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• 2014

This study was conducted to be helpful to the expansion and development of hospice and to provide the basic data for Hospice palliative care by identifying the general characteristics of curriculum of hospice perception, level of perception, practice experiences, routes, times, meanings, needs, targets, supply, types, organizations, experiences, use of hospice and physical, emotional, social and spiritual aspects of hospice services. Study tools which were used in this study were composed of three sections. Survey paper is 3-point Likert scale which is composed of 6 questions of general characteristics, nominal scale of 24 questions about hospice perception and hospice service contents. Respondents can reply with 3 answers of Necessary (1), Mediocre (2), and Not necessary (3), in physical, emotional, social and spiritual aspects. Score ranges of this tool are from minimum of 24 points to maximum of 72 points and higher scores mean higher perception of Hospice. Hospice is a behavior to take care of terminal patients who are waiting for death and their family and it should be conducted physically, emotionally, socially and spiritually in order that the patients could meet their last moments of life by maintaining a high quality of life, human dignity and peace for the rest of their lives. Hospice could be mentioned to be a comprehensive care to relieve the pains and grieves of bereaved family.

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.221-254
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• 2015

The amendment of the Korea Civil Code will take place July 1, 2013. One of the most import issues related to adult guardianship system is a part. Though more than 100 new provisions, the revised Civil Code fundamentally reformed the guardianship system to establish a system to meet the diverse and complex needs of those who need a guardian and ensure due process. The new adult guardianship system intended to respect dignity and human right of mentally incapacitated adults, to guaranee their autunomy and to minimize the public interventions for assisting them. The new guardianship system for vulnerable adult has three kinds of legal guardianship system (adult guardianship, limited guardianship and specific guardianship). Mental patients forced the hospitalization of the mental health code and will be treated as an agreement incapable person. In principle an agreement incapable person has capacity of consent. The consent of the mental patients are admitted first. It is advisable to medical care only by the consent of the guardian when the the mental patient do not agree ability. If the mental patient do not agree with the mentally ill, but there should be a supervisory capacity for a guardianship of the couple guardian supervision. In conclusion, it not lost the capacity to consent to inpatient mental illness called. Therefore, we must discuss in detail the scope of the agreement for the mental patients. Mental Health Act amendments are necessary in accordance with the amended Civil Code.

• Journal of Home Health Care Nursing
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• v.12 no.1
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• pp.1-40
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• 2005

This study investigated the relationship among home care nurses' perception of ethical values and conflicts and job satisfaction. The subjects of the study were 257 home care nurses working at 101 institutions involved in home care practice, the data were collected between December 28, 2004 February 14, 2005. The instruments were perception of ethical values, ethical conflicts, and job satisfaction and it was revised by the author. The reliability of Cronbach's a was .74, .93, .85, respectively. SAS 8.0 program was used to analyze the data, and frequency, percentage, unpaired t-test, ANOVA, $Scheff\`{e}$ test, and Pearson's Correlation Coefficient were calculated for data analysis. Followings are the results of the study: The scores of home care nurses' perception of ethical values were average 3.8points (5points scale). There was no significant difference between the groups according to general characteristics such as age (P=.001), religions (P=.001), ethical standard (P=.018), and current job satisfaction (P=.000). The scores of home care nurses' ethical conflicts were average 2.9points (5points scale). There was significant difference according to pay (P=.008) and employment status (P=.001) of general characteristics; conflicts was showed to go up with higher pay and temporary employment status. The scores of home care nurses' job satisfaction were average 3.3points (5points scale). There was significant difference among the groups according to age (P=.023), pay (P=.001), job career of home care (P=.030), and current job satisfaction (P=.000) of the general characteristics. There was significant positive correlation between subject's perception of ethical values and ethical conflicts (P=.004) and perception of ethical values and job satisfaction (P=.005). However, ethical conflicts and job satisfaction (P=.772) showed negative correlation, but it was not significant. With the results, home care nurses showed firm perception of ethical values and relatively higher job satisfaction. However, they showed ethical conflicts regarding the lack of administrative support and dignity of human life. In conclusion, It requires some alternative measures to solve the ethical conflicts and to enhance job satisfaction of home care nurses through the support in policy, continuous ethics education, rewarding system, and introducing laws to protect individual home care nurses.