• Journal of Korean Neurosurgical Society
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• v.42 no.2
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• pp.135-140
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• 2007

It is not the best way to treat a hopeless patient with life-sustaining medical devices until the heart beats stop. Advanced medical technology may prolong the life for a significant period without recovery from the disease. However, it would give an unbearable economic burden to the family and the society. In 2006, we decided not to operate 9 patients with traumatic intracranial hematomas. We examined those patients with special references to possible legal and ethical problems. It is reasonable to withhold a treatment after documentation that the family never wants any life sustaining treatment when the treatment does not guarantee the meaningful life.

• Proceedings of the Korean Society of Computer Information Conference
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• 2019.07a
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• pp.195-198
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• 2019

연명의료결정법의 정식 명칭은 '호스피스 완화의료 및 임종 과정에 있는 환자의 연명의료 결정에 관한 법'이다. 이 법은 호스피스 완화의료에 대한 것과 환자의 연명의료 결정에 대한 것을 규정하고 있다. 특히, 후자의 연명의료결정에 관한 부분은 법제정 과정에서 법 종교 의료 윤리 등 다양한 분야에서 논박이 있었지만 2018년 2월 4일부터 시행되고 있다. 법학에서는 이 법이 생명이라는 법익과 관련되어 있어 형사법적, 민사법적으로 중요한 의미를 갖는다. 이 법이 탄생되기 위해 두 번의 변곡점이 있었다. 첫째, 1997년 '보라매병원 사건'에서 의사를 작위에 의한 살인방조죄로 판결한 사건 둘째, 2009년 '김 할머니' 사건에서 회생할 수 없을 경우 가족 등이 진술한 환자 의사에 따라 연명 의료를 중단할 수 있다는 대법원 판결이다. 연명의료결정법은 헌법상 생명권과 자기운명결정권이라는 기본권 충돌이 발생한다. 두 기본권이 서로 상충 할 때에는 어떠한 기본권을 우선해야 하는지가 실질적으로 문제되는데, 이익형량을 통한 규범의 조화로운 해석을 통해 해결해야 한다. 또한 이 법의 흠결과 문제점을 고찰하여 개정작업이 진행되어야 한다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.3
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• pp.429-437
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• 2019

This study was a descriptive study to investigate the factors influencing on attitude toward withdrawal of life-sustaining treatment of nursing students' consciousness of biomedical ethics, good death recognition and meaning of life. The subjects of this study were 293 nursing students attending college at P city. Data were collected for two weeks from May 1, 2018 to May 11, 2018. The statistical method was performed with SPSS WIN 22.0 using a complex sampling analysis, pearson's correlation coefficients, and a multiple regression analysis. The result of this study was significant positive correlation between attitude toward withdrawal of life-sustaining treatment and consciousness of biomedical ethics(r=.266, p<.001), good death recognition(r=.373, p<.001), meaning of life(r=.122, p=.037). The meaning of life was significant positive correlation consciousness of biomedical ethics(r=.294, p<.001), good death recognition(r=.230, p<.001). The good death recognition was significant positive correlation consciousness of biomedical ethics(r=.306, p<.001). Factors Influencing on the attitude toward withdrawal of life-sustaining treatment was good death recognition(${\beta}=.32$, p<.001) and consciousness of biomedical ethics(${\beta}=.16$, p=.004). These factors explained about 16% of the variance. Therefore it is necessary to develop an educational program to positively raise the attitude of consciousness of biomedical ethics and good death recognition.

• The Journal of Korean Society for School & Community Health Education
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• v.22 no.1
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• pp.55-72
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• 2021

Objectives: The aim of this study was to construct and verify a structural equation model of advance directive intent among a Korean group in their middle-age. Methods: Data were collected between May 1 and 30, 2017, from 398 people. The endogenous and exogenous variables of the hypothetical model consisted of elderly parents' care burden, health status, attitude towards withdrawal of life sustaining treatment, advance directive efficacy, and advance directive intent. The collected data were analyzed using the SPSS/WIN 24.0 and Mplus 7.4. Results: The hypothetical model demonstrated a good fit: χ2=223.79(df=109, p<.001), CMIN/df=2.05 CFI=.96, TLI=.96, RMSEA=.05, SRMR=.06. Elderly parents' care burden and health status showed statistically significant direct effects with attitude toward withdrawal of life sustaining treatment(β=.17, p=.001; β=.21, p<.001) and advance directive efficacy(β=.11, p=.040; β=.19, p=.002), respectively. Attitude toward withdrawal of life sustaining treatment and advance directive efficacy showed statistically significant direct effects on advance directive intent(β=.15, p=.007; β=.48, p<.001). Elderly parents' care burden and health status had a significant indirect effect on advance directive intent through attitude toward withdrawal of life sustaining treatment(β=.01, p=.041; β=.05, p=.036) and advance directive efficacy(β=.06, p=.049; β=.16, p=.006), respectively. The variables accounted for 26.1% of advance directive intent of the Korean group in their middle-age. Conclusion: It is necessary to develop an advance directive education program based on variables affecting advance directive intent for individuals in their middle-age.

• Journal of Hospice and Palliative Care
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• v.15 no.4
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• pp.193-204
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• 2012

Purpose: This correlation study was performed to examine Korean adults' perceptions and attitudes towards death with dignity and the withdrawal of life sustaining treatment and to identify factors that predict their attitude towards death with dignity. Methods: The study was conducted using convenience sampling of 291 adults from three towns of a metropolitan city in Korea. Data were collected using structured questionnaires which surveyed people's perception about and attitudes towards withdrawal of life sustaining treatment and scaled their attitude towards death with dignity. Data were analyzed by using descriptive statistics, Pearson correlation coefficients and multiple regression. Results: The attitude towards the withdrawal of life sustaining treatment and death with dignity showed a significant positive correlation (r=0.49, P<0.001). For attitudes towards death with dignity, significant predictors were attitudes towards the withdrawal of life sustaining treatment, age, religion, a proper withdrawal process and advanced medical directives, which explained 49.3% of total variance. Conclusion: The results of this study may contribute to development of a new medical decision-making system including nurses' appropriate roles in the process of withdrawing life sustaining treatment and advanced medical directives.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.139-161
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• 2017

In this paper, The Supreme Court of Korea 2016. 1. 28. 2015Da9769 was reviewed. In the previous case, Korean Supreme Court 2009Da17417 for the element to requirement for permission of the withdrawal of life-sustaining treatments, the patient's consent for withdrawal of life-sustaining treatments was assumed a declaration of intention to terminate the contract. But the consent for withdrawal of life-sustaining treatments corresponds not to those. The consent for medical treatments is not the juristic acts but the real acts. If the presumptive intention about these withdrawal regards as the termination of medical contract, the contract must be up to the starting the civil proceedings. According to this case, although the partial cancellation of medical contract is admitted, on the other hand medical expenses obligation ist exempted only after the final decision. At the withdrawal of life-sustaining treatments the medical obligation ist exempted because of the inability to providing the medical payment, which confirmed by the final decision about the withdrawal of life-sustaining treatments. Therefore the judgement of this case ist appropriate in that sense, the medical obligation ist waived only after the final decision. However that legal basis lies not at the partial cancel but at the partial inability.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.413-459
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• 2008

The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.

• The Journal of the Convergence on Culture Technology
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• v.7 no.3
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• pp.71-78
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• 2021

The purpose of this study was to investigate the effect of good death recognition, self-esteem, attitude toward withdrawal of life-sustaining treatmenton the consciousness of biomedical ethics in nursing students. Data were collected from 154 nursing students in B city and analyzed by t-test, ANOVA, Pearson correlation coefficient, and multiple regression using SPSS/WIN 22.0. The degree of consciousness of biomedical ethics in nursing students was 2.87±0.26. There were significant differences in consciousness of biomedical ethics with respect to religion(t=-2.90, p=.004). There was positive correlation between consciousness of biomedical ethics and good death recognition(r=.27, p=.001), self-esteem(r=.36, p<.001), negative correlation between consciousness of biomedical ethics and attitude toward withdrawal of life-sustaining treatment(r=-.29, p<.001). The factors affecting consciousness of biomedical ethics of the study subjects were good death recognition(β=.26, p<.001), self-esteem(β=.29, p<.001), attitude toward withdrawal of life-sustaining treatment(β=-.30, p<.001), religion(β=-.20, p=.004), with an explanatory power of 28.7%. Through this research requires the fellow study to determine the factors affecting consciousness of biomedical ethics of nursing students.

• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.92-103
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• 2018

Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

• Journal of the Korea Convergence Society
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• v.10 no.8
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• pp.335-344
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• 2019

This study is a descriptive research to measure the awareness and attitude toward withdrawal of life-sustaining medical treatment (WLSMT) among medical and nursing students. The data collection was conducted between 8 October and 15 November 2018, and the responses of 240 students were analyzed. The analysis results are as follows. More than 95 percent of medical and nursing students said the WLSMT was necessary. The medical students answered that 'patient's will' is important and nursing student answered that 'patient and family's will' is important. The nursing student showed that "family will and decision" was more important than the medical student in deciding to discontinue life care. Based on the results of the study, continuous discussion on the development and application of education programs to form attitudes and awareness of the discontinuation of life-saving treatments based on correct values is needed for prospective medical students and nursing students.