• Title/Summary/Keyword: Medical Ethics

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Nurses' Understanding and Attitude on DNR (DNR에 대한 간호사의 인식 및 태도조사)

  • Han, Sung-Suk;Chung, Soon-Ah;Moon, Mi-Seon;Han, Mi-Hyun;Ko, Gyu-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.3
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    • pp.403-414
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    • 2001
  • The study was intended to identify the nurses' experiences, understanding, and attitudes on DNR. Also, the study was to provide the data base for a standard of DNR decision-making and practice. The sample consisted of 347 nurses in eight general hospitals. The data were collected between August 1 and August 31, 2000. The data were analyzed using descriptive statistics and $x^2-test$. The results of the study were as follows : 1. Regarding DNR-related experience, 74.6 percent of the participants experienced DNR situations. Eleven percent of the participants received DNR education. DNR was most frequently (81.5%) requested by family members and relatives of patients. The decision-making on DNR was most frequently (76.8%) made by agreement between family members and medical staff. The DNR order was recorded at 81.9 percent on charts. Problems after DNR order were negligence in treatment and nursing care (30.6%) and guilty feelings due to doing the best (22.1%). CPR (cardiopulmonary resuscitation) was performed about 49.8 percent of DNR cases. 2. Regarding understanding and attitude on DNR, most of the participants (93.1%) thought DNR was necessary. The major reasons for the necessity of DNR were impossible recovery (44.4%) and death with dignity (41.1%). The decision-making on DNR was most frequently made by patient and family members (47.8%) and followed by agreement between family members and medical staff (25.6%), and patients themselves (16.4%). Most of the participants thought that medical staff must explain DNR to critical and end-of-life patients and their family members. Forty four percent of the participants thought that the most appropriate time for DNR explanation was when patients with critical disease were admitted to hospitals. Most of the participants (90.2%) thought a guide book for DNR is necessary to be made in hospitals. 3. There were significant differences in the participants' understanding and attitudes on DNR according to religion career education and experience of DNR. Of the participants those who have religions and education experience on DNR thought that there would be more DNR requests after DNR is explained to patients and family members (p<.05). In addition, there was higher understanding on the necessity of DNR in those who have more career and DNR experience(p<.01). The findings of the study suggest that a guide book for DNR need to be made with inclusion of legal, ethical, and cultural aspects. Also, there needs to be more education on DNR in medical ethics to health care professional and to provide more information on DNR to the general public.

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Recognition and Attitudes on Ethical Issues for DNR of 119 Rescue Party (119구급대원의 심폐소생술 비 시행(DNR)과 관련된 윤리문제 인식 및 태도)

  • You, Soon-Kyu;Jung, Ji-Yeon;Shin, Sang-Yol;Choi, Yoo-Im;Choi, Hea-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.12
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    • pp.3931-3942
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    • 2009
  • This study as a descriptive survey was to investigate recognition and attitudes on ethical issues for DNR of 119 rescue party who are working on the field, and to develop an objective framework which helps rescue team to manage DNR patients. Data were collected from the structured questionnaire, and subject were 226 rescue party in Jeollabuk-do area in Korea. Study was practiced from May 6 through June 20, 2009, and the data were analyzed by frequency, percentage, $x^2$-test, crosstabs using SPSS Win 12.0. The results indicated that ethical attitudes on subjects' factors(sex, age, religion, marital status, clinical working career, current working area, current position, educational experiences for ethics and values, DNR education places, DNR implication experience, and DNR consulting demands) were statistically significant. Therefore, following researches will be necessary in order to consider measures about DNR based on this study.

Current Status of Face Transplantation: Where Do We Stand in Korea? (안면이식에 대한 최근 동향: 한국에서의 안면이식은 어떤 단계에 있는가?)

  • Hong, Jong Won;Kim, Young Seok;Yun, In Sik;Lee, Dong Won;Lee, Won Jai;Roh, Tai Suk;Lew, Dae Hyun;Kim, Yong Oock;Rah, Dong Kyun;Tark, Kwan Chul;Yun Park, Be-Young
    • Archives of Craniofacial Surgery
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    • v.13 no.2
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    • pp.85-94
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    • 2012
  • The world's first face transplantation was performed in France, in 2005. Since then, 21 cases of face transplantation have been performed. Face transplantation is one of the most prominent part of composite tissue allotransplantation (CTA) along with hand transplantation. Since these fields are not deal with life-saving organs, there are many arguments about immunosuppression therapy. Recent paradigm of face transplantation shows that surgical ranges are expanded from partial face transplantation to full face transplantation. Most immunosuppression protocols are triple therapy, which consists of tacrolimus (FK-506), mycophenolate mofetil and prednisolone. Anatomical researches, immunosuppression, and immunotolerance take great parts in the researches of CTA. The medical fields directly related to face transplantation are microsurgery, immunology, and transplantation. Nowadays, each field is performed widely. Therefore people, even medical teams think face transplantation could be easily realized, sooner or later. But there are lots of things that should be prepared for not only practice and immunosuppression therapy but also for the cooperation with relevant fields. That's the reason why only 21 cases of face transplantation have been done, while more than 70 cases of hand transplantation have been done in the past years. Especially in Korea, brain death patients are not enough even for organ transplantation and furthermore there are some troubles in taking part in the society of transplantation. Face transplantation has lots of problems concerning variable medical fields, administration, society, ethics, and laws. Therefore, for the realization of face transplantation in Korea, not only medical skills but also political powers are needed.

A Comparative Law Study on the Professional Work of Nurses: Focusing on Legal Basis and Standardization (간호사의 전문적 업무에 대한 국가 간 비교법적 연구: 법적 근거와 업무 범위 표준화를 중심으로)

  • Jayoung You;Jiyong Park
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.117-148
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    • 2024
  • This study attempted to examine the ambiguity of work from the legal, social perspective, and actual performance differences in domestic nursing work compared to foreign countries. We compared the historical background of nurses' expanded work through overseas situations, compare and analyze the legal basis for nurses' qualifications and work in each country, and what changes they have undergone to clarify their work. Through this, we would like to consider the current status of the absence of a legal basis for professional work of domestic nurses and seek a direction for the development of domestic medical care. This study applied the case study method as one of the comparative institutional research methods. Among OECD countries, developed countries such as the United States, Australia, and Japan were selected and compared among developed countries that are solving medical gaps using nurses. In the United States, Australia, Japan, and Korea, nurses' professional work has been created by changes in the medical environment due to an aging society, chronic diseases, and lack of doctors. We looked at the start of their professional work, the establishment of legal grounds, the timing of qualification recognition, the development of the credential system and scope of work. Foreign countries have legal grounds for their roles and tasks, but domestic countries are before legislation. The country still has not narrowed the gap between the position of the legislative and judicial branches and actual work, and the current status of the domestic healthcare system has been measured through overseas development cases.

A Study on improvement of curriculum in Nursing (간호학 교과과정 개선을 위한 조사 연구)

  • 김애실
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.1-16
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    • 1974
  • This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

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Intravenous Injection of Saeng Maek San - A Safe Method of Treatment in Rats

  • Choi, Min-Ji;Kim, Sung-Chul;Cho, Seung-Hun
    • Journal of Pharmacopuncture
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    • v.17 no.2
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    • pp.67-72
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    • 2014
  • Objectives: This study evaluated the single-dose toxicity of Saeng Maek San (SMS) in rats. Methods: All experiments were conducted at Biotoxtech (Chungwon, Korea), an institute authorized to perform non-clinical studies under the regulations of Good Laboratory Practice (GLP). A single-dose intravenous toxicity study was carried out on 40 6-week-old Sprague-Daley rats. The animals were randomly divided into the following four groups of ten animals each: Group 1 (G1) was the control group, with each animal receiving an intravenous injection of 1.0 mL of saline, and Groups 2, 3 and 4 (G2, G3 and G4) were the experimental groups, with the animals in the groups receiving an injection of 0.1, 0.5 and 1.0 mL of SMS, respectively. Mortality, clinical signs, body-weight changes and gross pathological findings were observed for 14 days following a single administration of SMS or saline. Organ weights, clinical chemistry and hematology were analyzed at 14 days. This study was conducted with the approval of the Institutional Animal Ethics Committee. Results: No deaths occurred in any of the four groups, indicating that the lethal dose of SMS in rats is greater than 1.0 mL/animal. Some changes in weights of male rats between the control group and the experimental groups were observed, but no significant changes in the weights of female rats were noted. To identify abnormalities in organs and tissues, we stained representative sections of each specified organ with hematoxylin and eosin for examination with a light microscope. No significant abnormalities were observed in any of the organs or tissues. Conclusion: The results suggest that intravenous injection of SMS is a safe method of treatment.

A Study on DNA Degeneration by Comet Assay & Pathological Observation for Mouse Which were Exposed HCN Gases from Fire (화재로 인한 HCN 가스에 노출된 마우스의 병리학적 관찰 및 단세포 전기영동법을 사용한 DNA 변성 추적에 관한 연구)

  • Cho, Nam-Wook;Oh, Eun-Ha;Hwang, Sung-Kwy
    • Journal of the Korean Institute of Gas
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    • v.16 no.6
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    • pp.7-16
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    • 2012
  • Combustion Toxic Effects among several factors of risk encountered during fire are important in the evacuation and final survival, and they are broader and fatal than the direct damages caused by flame. Most studies on fire toxicity until the present are limited to fatality, mainly deaths by fire through pathological research. In this study, it is conducted as a fundamental experiment to address 3 principles of animal experiment and to provide an alternative test to animal testing that is regulated by national building codes and it was conducted through approval by the animal testing ethics committee. Hence, in this study average time of activity stop was measured after directly inhaling toxic gases (HCN) to laboratory animals (mice) through gas toxicity test (KS F 2271) for major asphyxiating gases(HCN) which are produced during fire combustion. effects of Combustion toxic gases on body were quantitatively analyzed through changes in internal organs and hematological analysis, and electrophoresis of a single cell of these laboratory animals. Biological conclusion of combustion toxicology is drawn through approaches (pathological examination, blood test, blood biochemical test, electrophoresis analysis of single cell) which could not confirmed in existing gas toxicity test.

Official Nursing Education of Korea under Japanese rule (일제시대 관공립 간호교육에 관한 역사적 연구)

  • Yi, Ggod-Me;Park, Jung-Ho
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.317-336
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    • 1999
  • Official nursing education of Korea under Japanese rule began in order to make the communication possible among Japanese medical men and Korean patients. It could generate high standard nurses from the beginning. Nurses licensure began in 1914 and the graduates of official nursing schools could get nurses licensure without further test. Official nursing education became the standard of R.N. education. The curriculum emphasized on Japanese and ethics first, and in order to produce nurse, practice second. In 1920 the shortage of nurse became serious problem, so the Japanese colonial authorities set up 5 official nursing school in large scale. In 1922 they revised the relevant laws and regulations to make the nursing licensure pass all over Japanese ruling area. 8-year preliminary education and 2 year curriculum became standard of official nursing education after then. Other nursing schools should satisfy this standard to let their graduate get nurses licensure without further test. Curriculum was revised to satisfy the dual goal of 'good housewife' and 'good nurse'. Every official nursing school tried to raise educational standard Nursing science was specialized and more emphasis was put on the occupational education. From the late 1930s, Japanese desperately needed additional manpower to replenish the dwindling ranks of their military and labor forces. They tried to produce more nurses by increase nursing school. Students had to do wartime work instead of study. Younger students could enter nursing school, and general school could produce R.N. In conclusion, nursing education of Korea under Japanese rule was determined by the official nursing education. The Japanese colonial authorities lead the official nursing education. It made nursing education fixed early and produced high standard R.N. But it made nursing education withdraw in late Japanese rule period. Nursing education of Korea began quite weak in the need of nursing and Korea herself. The weakness became a subject of nursing education of Korea after Japanese rule to produce better R.N..

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A Determining System for the Category of Need in Long-Term Care Insurance System using Decision Tree Model (의사결정나무기법을 이용한 노인장기요양보험 등급결정모형 개발)

  • Han, Eun-Jeong;Kwak, Min-Jeong;Kan, Im-Oak
    • The Korean Journal of Applied Statistics
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    • v.24 no.1
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    • pp.145-159
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    • 2011
  • National long-term care insurance started in July, 2008. We try to make up for weak points and develop a long-term care insurance system. Especially, it is important to upgrade the rating model of the category of need for long-term care continually. We improve the rating model using the data after enforcement of the system to reflect the rapidly changing long-term care marketplace. A decision tree model was adpoted to upgrade the rating model that makes it easy to compare with the current system. This model is based on the first assumption that, a person with worse functional conditions needs more long-term care services than others. Second, the volume of long-term care services are de ned as a service time. This study was conducted to reflect the changing circumstances. Rating models have to be continually improved to reflect changing circumstances, like the infrastructure of the system or the characteristics of the insurance beneficiary.

A study on the professional ethical relationship between librarian and library work (도서관 업무와 전문사서간의 윤리적 관계에 관한 이론적 고찰)

  • 손연옥
    • Journal of Korean Library and Information Science Society
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    • v.24
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    • pp.485-517
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    • 1996
  • The purpose of this study is to investigate typical ethical problems found in the technical and public services areas. The followings are the summary of the study. There are three distinct elements that govern ethical problems. One element is legal laws. The copyright law and the privacy act are exact examples. The copyright law has strong influence on the inter library loan service where the majority requests from the users are reproduction of copies. The privacy act also creates difficulties for librarians. Most requests for circulation records infringe on the privacy of library user. And advance online access systems also violates the privacy of library users. The second element is the code or rules that private organization has created. American Library Association created many statements that regulate the conduct of librarians. The bill of right, the professional code of ethics and policy on the confidentiality of library records have strong implications in the obligation of librarian. In the case of censorship at the selection of library materials, the code is a defensive tool against intellectual freedom. Yet self-censoring are prevailing practice among librarians. The thirds element is the competence of librarians. The analyzed table 3 showed that beside two elements, the rest of matters are competence required by librarians. The one aspect of it is humaneness and the other one is technical aspects. Technical aspect of competence are:(l) managerial and operational ability (2) communication skill (3) leadership (4) structure of knowledge and (5) self developing professionalism. Humanity aspect of competence are:(l) trust(fiduciary relationship) gained by diligence, objective judgement, ability, belief, rationality, integrity, kindness) (2) objectiveness (free from bias) (3) user-oriented consideration (need, interest, equal treatment, information gap) (4) caution in providing information (5) pride and (6) ability to distinguish advice and guidance specially in medical and law library.

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