This article explores some of the ethical issues associated with the fourth industrial revolution and suggests new directions for bioethics education in Korean universities. Some countries have recently developed guidelines and regulations based on the legal and ethical considerations of the benefits and social risks of new technologies associated with the fourth industrial revolution. Foreign universities have also created courses (both classroom and online) that deal with these issues and help to ensure that these new technologies are developed in an ethically appropriate fashion. In South Korea too there have been attempts to enhance bioethics education to meet the changing demands of society. However, bioethics education in Korea remains focused on traditional bioethical topics and largely neglects the ethical issues related to emerging technologies. Furthermore, Korean universities offer no online courses in bioethics and the classroom courses that do exist are generally treated as electives. In order to improve bioethics education in Korean universities, we suggest that (a) new course should be developed for interprofessional education; (b) courses in bioethics should be treated as required subjects gradually; (c) online courses should be prepared, and (d) universities should continually revise course contents in response to the development of new technologies.
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.
Objectives: This study was carried out to analyze the single dose toxicity of ShinEumHur (SEH) pharmacopuncture injected into the muscles of Sprague-Dawley rats. Methods: The SEH pharmacopuncture was made in a clean room at the Korean Pharmacopuncture Institute (K-GMP). After the mixing process with sterile distilled water had been completed, the pH was controlled to between 7.0 and 7.5. All experiments were conducted at Biotoxtech, an institution authorized to perform non-clinical studies under the Good Laboratory Practice (GLP) regulations. Sprague-Dawley rats were chosen for the pilot study. Doses of SEH pharmacopuncture, 0.25, 0.5 and 1.0 mL, were administered to the experimental groups, and a dose of normal saline solution, 1.0 mL, was administered to the control group. We examined the survival rate, weights, clinical signs, mean hematology parameters, mean clinical chemistry, necropsy and histopathological findings. This study was conducted under the approval of the Institutional Animal Ethics Committee. Results: No deaths or abnormalities occurred in any of the four groups. No significant changes in weight, hematological parameters or clinical chemistry between the control group and the experimental groups were observed. To check for abnormalities in organs and tissues, we used microscopy to examine representative histological sections of each specified organ; the results showed no significant differences in any of the organs or tissues. Conclusion: The above findings suggest that treatment with SEH pharmacopuncture is relatively safe. Further studies on this subject are needed to yield more concrete evidence.
Background: The aim of this study was to determine the predictors of health promoting lifestyle behaviour among medical students attending seven of the medical schools in Turkey. Materials and Methods: This crosssectional descriptive study was performed during the second semester of the first and last (sixth) years of study from March to May 2011. A questionnaire with two sections was specifically designed. The first section contained questions on demographic characteristics; the second consisted of the Health Promoting Lifestyle Profile II (HPLP) Scale. From a total of 2,309 medical students, 2,118 (response rate 91.7%) completed the questionnaire. Data were analyzed using descriptive statistics, t, Anova, Tukey test and binary logistic regression analysis. The research was approved by the Ethics Committee of Erciyes University. Results: The mean age was $20.7{\pm}2.9$ years and it was found that 55.1% were men, 62.3% were in the first year. The overall prevalence of smoking was 19.1%, and for drinking alcohol was 19.4%. HPLP point averages of the first year students were $129.2{\pm}17.7$, and for last year $125.5{\pm}19.0$. The overall mean score for the HPLP II was $2.5{\pm}0.4$. They scored highest on the spiritual growth subscale ($2.9{\pm}0.5$), interpersonal relations ($2.8{\pm}0.5$), health responsibility subscale ($2.3{\pm}0.5$), nutrition subscale ($2.3{\pm}0.5$), stress management subscale ($2.3{\pm}0.4$), and the lowest subscale physical activity ($2.0{\pm}0.5$). It is established that student's grade, educational level of parents, economic status of family, marital status, smoking and general health perception of the students resulted in a significant difference in HPLP Scale total score average and the mean score of majority of subscales. There was no statistically significant difference between the total HPLP when evaluated for gender, chronic disease, alcohol drinking status and BMI. Conclusions: Based on these results, particularly in the curriculum of medical students in order to increase positive health behaviours including physical activity, health promotion issues, and giving more space to aim at behaviour change in these matters is recommended.
Objectives: This study was performed to analyze the single-dose oral toxicity of the super key (processed sulfur). Methods: All experiments were conducted at Medvill, an institution authorized to perform non-clinical studies, under the Good Laboratory Practice (GLP) regulations. In order to investigate the oral toxicity of super key. We administered it orally to Sprague-Dawley (SD) rats. The SD rats were divided into four groups of five male and five female animals per group: group 1 being the control group and groups 2, 3, and 4 being the experimental groups. Doses of super key 500 mg/kg, 1,000 mg/kg and 2,000 mg/kg were administered to the experimental groups, and a dose of normal saline solution, 10 mL/kg, was administered to the control group. We examined the survival rates, weights, clinical signs, gross findings and necropsy findings. This study was conducted under the approval of the Institutional Animal Ethics Committee. (Approval number: A01-14018). Results: No deaths or abnormalities occurred in any of the four groups. Although slight decreases in the weights of some female rats were noted, no significant changes in weights or differences in the gross findings between the control group and the experimental groups were observed. To check for abnormalities in organs, we used microscopy to examine representative histological sections of each specified organ; the results showed no significant differences in any of the organs. Conclusion: The results of this research showed that administration of 500 - 2,000 mg/kg of super key did not cause any changes in the weights or in the results of necropsy examinations. Neither did it result in any mortalities. The above findings suggest that treatment with super key is relatively safe. Further studies on this subject are needed to yield more concrete evidence.
Objectives: The purpose of this preliminary study was to identify the nurses' perception regarding disclosure of patient safety incidents (DPSI) and to evaluate the effectiveness of education for DPSI. Methods: DPSI education was conducted for nurses majoring in clinical nurse specialist at an university. Before and after the education, the nurses made a questionnaire to evaluate the perception of DPSI. The questionnaires were divided into four categories: first, overall perception of the DPSI; second, recognition evaluation of the DPSI using hypothetical case, third, opinion on legal and nonlegal measures for facilitating the DPSI; and fourth, socio-demographic factors. The Wilcoxon signed rank test was performed on the DPSI questionnaire response to compare the perceptions before and after the education. Results: A total of 10 nurses participated in the education. DPSI education showed the possibility of improving the overall perception, necessity, effect, obstacle, and promotion method of DPSI, although there were also several responses where there was no statistical significance. In particular, DPSI education led to statistically significance change in the perception of obstacles for DPSI. For example, the number of respondents who agreed to the item "DPSI will increase the incidence of medical lawsuits." was 7 before education but decreased to 3 after education (P-value: .025) Furthermore, nurses' perception of DPSI from this study was generally positive regardless of education. Conclusion:In the future, it will be necessary to carry out DPSI education and training and to evaluate its effectiveness for more nurses.
Objectives: In this study, we investigated the 4-week repeated-dose oral toxicity of gami-jakyak gamcho buja decoction (Mecasin) to develop safe treatments. Methods: In order to investigate the 4-week oral toxicity of Mecasin, we administered Mecasin orally to rats. Sprague-Dawley (SD) rats were divided into four groups of five male and five female animals per group: group 1 being the control group and groups 2, 3, and 4 being the experimental groups. Doses of Mecasin of 500, 1,000, and 2,000 mg/kg of body weight were administered to the experimental groups, and a dose of normal saline solution of 10 mL/kg was administered to the control group. We examined the survival rate, weight, clinical signs, and gross findings for four weeks. This study was conducted under the approval of the Institutional Animal Ethics Committee. Results: No deaths occurred in any of the four groups. No significant changes in weights or food consumption between the control group and the experimental groups were observed. Serum biochemistry revealed that some groups showed significant decrease in inorganic phosphorus (IP) (P < 0.05). During necropsy on the rats, one abnormal macroscopic feature, a slight loss of fur, was observed in the mid dosage (1,000 mg/kg) male group. No abnormalities were observed in any other rats. In histopathological findings, the tubular basophilia and cast of the kidney and extramedullary hematopoiesis of the spleen were found. However, those changes were minimal and had occurred naturally or sporadically. No other organ abnormalities were observed. Conclusion: During this 4-week, repeated, oral toxicity test of Mecasin in SD rats, no toxicity changes due to Mecasin were observed in any of the male or the female rats in the high dosage group. Thus, we suggest that the doses in a 13-week, repeated test should be 0, 500, 1,000, and 2,000 mg/kg respectively.
This article analyzes two leading Korean cases which led to opposite conclusions: the Boramae Hospital Case (Korean Supreme Court 2002 Do 995) and the Shinchon Severance Hospital Case (Korean Supreme Court 2009 Da 17471). In doing so, it pays particular attention to the acceptance, modification, and rejection of paternalism, specifically 'physician paternalism' and 'familial paternalism', both of which have long and strongly influenced the Korean medical environment. In Boramae Hospital, the Court emphasized the obligation of the physician in terms of the life of the patient (eg: protecting and preserving the life and welfare of the patient). Its position seemed to be based on the traditional physician paternalism which presupposes the ability of physicians to identify right and wrong choices according to natural laws. However, the Court saw itself as the final arbiter of who identifies and determines the real world content and consequences of that natural law. In short, the Court elevated itself to the supreme guardian of the patient, and held that its decision cannot be overruled by that of the patient's family. So without specifically referring to the importance of the family and the role of familial decisions, both long-observed traditions in medical decision-making in Korea, the Court shifted away from familial paternalism. In Shinchon Severance Hospital, the Court explained the meaning of the patient's powers of self-rulemore concretely, explaining its scope and substance in greater detail. The Court held that one can exercise the right of self-rule, even over issues such as death, in the form of 'previous medical directions'. However, this case does not represent a wholesale acceptance of medical autonomy (ie: it does not accept self-rule unconditionally). Rather, the Court accepted the importance of the opinions and decision of physicians and of the Hospital Ethics Commission, and the Court still retained to itself the authority to review and make alterations to 'material' decision. The Court did not overlook the importance of the decision of the patient's family, but it also did not relinquish its status as supreme guardian, emphasizing the 'objective' nature of a decision from the court.
While traditionally threatening human infectious diseases are decreasing, chronic diseases such as cancer and diabetes, including cardiovascular diseases, are spreading rapidly. Reflecting the characteristics of chronic diseases that are difficult to treat, the management of risk factors and the preparation of health promotion policies corresponding to them have emerged as important concerns around the world. Providing so-called multi-sector approach such as health promotion and disease prevention policy and solution for community response, The value of primary care is once again highlighted in the changed medical environment. As the existing medical delivery system has become difficult to cope with the people's desire for rapid aging, disease paradigm change, and quality of life improvement, European Union countries have made various efforts to improve the quality of their primary medical system, which provides continuous, com- prehensive and coordinated management. This paper examines the current status and problems of the healthcare delivery system in Korea, draws implications from the European Union examples related to the strengthening of primary care, and discusses the plans for establishing a patient-centered future medical delivery system.
Journal of Korean Library and Information Science Society
/
v.47
no.1
/
pp.199-216
/
2016
This study aimed to investigate the current uses of subheadings that appear in medical science journal abstracts and to discuss its potential implications for medical science from the perspectives of library and information science. To conduct this study, the following nine sub-fields in medical science were selected: cancer, ethics, genetics, infectious disease, neurology, pediatrics, immunology, psychiatry, and cardiology. Random sample data were drawn based on the years 2010 to 2015 from the PubMed database. This study investigated the extent of the uses of subheadings, variants of subheadings, and common formation of subheadings with the help of a frequency analysis. The specific findings of this study are summarized as the following: 1) more traditional abstracts are used across almost all sub-fields of medical science; 2) on average, 4.1 subheadings were used in the sample dataset; and 3) the most frequently used set of subheadings is OBJECTIVES, METHODS, RESULTS, and CONCLUSIONS. This subheading set appears to be the de facto standard across all medical science journals. The analysis of subheadings in structured abstracts and the issues raised in this study can be beneficial for journal editors and other academics in medical science as well as library and information science.
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