• 제목/요약/키워드: Medical Ethics

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임신부에서 약물의 안전사용을 위한 연구의 필요성 (Necessity of Research for Safe Drug use in Pregnant Women)

  • 한정열;조금준;오정미
    • 한국모자보건학회지
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    • 제21권3호
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    • pp.159-165
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    • 2017
  • The thalidomide tragedy in the 1960s has resulted in a perpetuation of a certain perception amongst physicians and pregnant women that the use of medication during pregnancy is a potential teratogen. Consequently, physicians hesitate in prescribing medication to pregnant women. In addition, pregnant women often refuse medication despite therapeutic necessity because of this existing perception. Recently there have been frequent adverse pregnancy outcomes related to the recurrence of chronic diseases, such as hypertension and diabetes, following pregnancy in older women. And there are lots of unnecessary termination of pregnancy due to the of information of medication exposed to medication following over 50% of unintended pregnancy. In light of this, better dissemination of information regarding the safe usage of medication for pregnant women is required. This would not only be cost-effective in terms of medical expenditure, but also prove beneficial for the treatment of diseases. In addition, Korea needs to adapt to the increasing changes of the international information system regarding supporting the safe usage of medication during pregnancy. An example of this is shown by the recent changes to the labeling of medication by the United States Food and Drug Administration. The new labeling includes information on the risk of usage, rather than just an arbitrary alphabetic classification of B, C, D, or X. Furthermore, this information is limited in Korea because of the lack of research, which in turn is due to several limitations on ethics and methodology, as well as present regulations on the research of pregnant women. From this, we can learn that government support is critical for the establishment of research so that we can alter the perception that all medication is harmful to pregnant women.

가습기살균제 참사에 관한 학술연구의 비판적 검토와 다양한 관점의 이해 (Critical Reviews of Academic Research and Perspectives for Understanding the Humidifier Disinfectant Disaster)

  • 김지원;방예원;박문영;조경이;최예용
    • 한국환경보건학회지
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    • 제45권4호
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    • pp.340-357
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    • 2019
  • The purpose of this paper is to help develop a comprehensive understanding of the humidifier disinfectant disaster from diverse perspectives based on a critical review of the relevant academic research papers published so far in the fields of both natural and social science. The authors reviewed pertinent articles in the six academic areas of law, social science, humanities, medicine, toxicology, and environmental health. A proper understanding of the issue of humidifier disinfectant is a challenging task because diverse aspects of it have become related over the more than two decades since such products were first released to the market in 1994. Technical and esoteric issues such as the complex system for relief and compensation for health damages and the approval of chemical toxicity are known to be major impediments to viewing the bigger picture regarding this tragedy. The authors believe that experts need to consider a comprehensive perspective going beyond their individual research arena to gain a better understanding of this issue, especially since it was an alarm signal on ethics and the role of experts and scholars in Korean society. Besides the two professors arrested by the prosecutor's office, it should be remembered that medical doctors recommended patients use humidifiers and disinfectants, and the media was inactive in reporting on this issue. Furthermore, the current paucity of examination of the social and political implications of this tragedy calls for more active engagement by researchers in the humanities and social sciences. In this regard, this paper is a work of self-examination and self-criticism by the authors that could resonate with the overall academic community.

호스피스 완화의료 연구에서의 윤리적 고려사항 (Ethical Considerations in Hospice and Palliative Care Research)

  • 윤가현
    • Journal of Hospice and Palliative Care
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    • 제22권2호
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    • pp.49-66
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    • 2019
  • 의료기술 발달 및 경제개발 수준 상승 등으로 호스피스 완화의료(hospice & palliative care) 서비스를 받는 말기 환자들이 점점 늘어나고 있다. 이와 더불어 최근 호스피스 완화의료 분야 임상전문가들은 환자나 가족 대상 호스피스 완화의료 서비스의 질을 향상시킬 목적으로 하는 연구에도 많은 관심을 보이고 있다. 한편 정부의 연구대상자 보호 정책이 강화되면서 IRB(생명윤리심의위원회)에서도 호스피스 완화의료 연구의 연구계획서를 심의할 때 환자의 취약성과 관련된 다양한 윤리적 사안들을 더 엄밀하게 점검하고 있다. 그러나 말기 환자들의 삶의 질 향상 및 유지를 위해서는 질적으로 보장된 호스피스 완화의료 서비스가 제공되어야 한다. 이를 위해서 윤리적으로 안전한 호스피스 완화의료 연구의 시도가 지지되어야 한다. 이에 필자는 호스피스 완화의료 연구의 윤리지침을 종설 논문 형식으로 제안했다. 이는 윤리적으로 안전하고 과학적으로 가치가 있는 연구계획서를 준비해야 하는 연구자 및 그 연구계획서를 심의하는 IRB가 적절하게 참조할 수 있도록 해주기 위함이다.

치위생학과 학생의 직업인성역량에 관한 연구 (A Study on the Occupational Personality Competence of Dental Hygiene Students)

  • 김영선;정영란;이정화
    • 대한치위생과학회지
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    • 제5권2호
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    • pp.105-112
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    • 2022
  • Background: A study was conducted to check the occupational personality competency status of students enrolled in the three-year dental hygiene department and to understand the contents of vocational personality education to be prepared according to these results. Methods: For 240 students enrolled in the Department of Dental Hygiene in Area, Daegu, the College Student Occupational Personality Scale (OPSU) was administered. Results: The higher the major satisfaction (F=10.589, p<0.000) and the higher the major performance (F=3.704, p<0.01), the higher the vocational personality competency. The average occupational personality competency for job adaptation was 3.96±0.47 points (out of 5 points). As for the average for each sub-area, consideration was the highest at 4.51±0.42, and confidence was the lowest at 3.54±0.84. Among professional personality competencies, the average of each sub-area showed the highest positive correlation in the order of positivity (r=0.835, p<0.00), reliability (r=0.769, p<0.00), and community consciousness (r=0.767, p<0.00), and consideration (r=0.696, p<0.00) showed the lowest correlation. Conclusions: Personalized career and employment education should be provided in consideration of the individual occupational personality level of dental hygiene students considering the characteristics of the health and medical fields, and individual counseling should be provided in areas that are insufficient or supplemented. In addition, dental hygiene ethics education is necessary for the development of vocational personality competencies in the dental hygiene curriculum, and universities should spare no support for completing vocational personality education programs in preparation for the future society by using comparative programs.

Spiritual Care Guide in HospiceㆍPalliative Care

  • Kyung-Ah Kang;Do-Bong Kim;Su-Jin Koh;Myung-Hee Park;Hye Yoon Park;Deuk Hyoung Yoon;Soo-Jin Yoon;Su-Jeong Lee;JI-Eun Choi;Hyoung-Suk Han;Jiyoung Chun
    • Journal of Hospice and Palliative Care
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    • 제26권4호
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    • pp.149-159
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    • 2023
  • The Spiritual Care Guide in HospiceㆍPalliative Care is evidence-based and focuses on the universal and integral aspects of human spirituality-such as meaning and purpose, interconnectedness, and transcendence-which go beyond any specific religion. This guide was crafted to improve the spiritual well-being of adult patients aged 19 and older, as well as their families, who are receiving end-of-life care. The provision of spiritual care in hospice and palliative settings aims to assist patients and their families in finding life's meaning and purpose, restoring love and relationships, and helping them come to terms with death while maintaining hope. It is recommended that spiritual needs and the interventions provided are periodically reassessed and evaluated, with the findings recorded. Additionally, hospice and palliative care teams are encouraged to pursue ongoing education and training in spiritual care. Although challenges exist in universally applying this guide across all hospice and palliative care organizations in Korea-due to varying resources and the specific environments of medical institutions-it is significant that the Korean Society for Hospice and Palliative Care has introduced a spiritual care guide poised to enhance the spiritual well-being and quality of care for hospice and palliative care patients.

파킨슨병 변증 유형 및 지표 분포에 대한 전향적 다기관 관찰연구 프로토콜 (An Observational Multi-Center Study Protocol for Distribution of Pattern Identification and Clinical Index in Parkinson's Disease)

  • 조혜연;권오진;서복남;박성욱;유호룡;장정희
    • 대한한방내과학회지
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    • 제45권1호
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    • pp.1-10
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    • 2024
  • Objectives: This study investigated the pattern identification (PI) and clinical index of Parkinson's disease (PD) for personalized diagnosis and treatment. Methods: This prospective observational multi-center study recruited 100 patients diagnosed with PD from two Korean medicine hospitals. To cluster new subtypes of PD, items on a PI questionnaire (heat and cold, deficiency and excess, visceral PI) were evaluated along with pulse and tongue analysis. Gait analysis was performed and blood and feces molecular signature changes were assessed to explore biomarkers for new subtypes. In addition, unified PD rating scale II and III scores and the European quality of life 5-dimension questionnaire were assessed. Results: The clinical index obtained in this study analyzed the frequency statistics and hierarchical clustering analysis to classify new subtypes based on PI. Moreover, the biomarkers and current status of herbal medicine treatment were analyzed using the new subtypes. The results provide comprehensive data to investigate new subtypes and subtype-based biomarkers for the personalized diagnosis and treatment of PD patients. Ethical approval was obtained from the medical ethics committees of the two Korean medicine hospitals. All amendments to the research protocol were submitted and approved. Conclusions: An objective and standardized diagnostic tool is needed for the personalized treatment of PD by traditional Korean medicine. Therefore, we developed a clinical index as the basis for the PI clinical evaluation of PD. Trial Registration: This trial is registered with the Clinical Research Information Service (CRIS) (KCT0008677)

간호대학생의 도덕적 용기에 대한 도덕적 고뇌와 도덕적 민감성의 관계 (The Influence of Moral Distress and Moral Sensitivity on Moral Courage in Nursing Students)

  • 윤혜영;김선기;장효은;황신우;김상희
    • 한국의료윤리학회지
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    • 제21권4호
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    • pp.360-376
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    • 2018
  • 간호대학생은 임상실습을 통해 도덕적 고뇌와 도덕적 민감성을 경험하게 되는 윤리적 갈등상황에 직면한다. 대부분의 간호대학생은 윤리적 갈등상황에서 본인의 의견을 말하기가 어렵다. 따라서 간호대학생의 도덕적 용기를 증진시키는 것은 간호전문직의 책임을 다하고 임상 실무에서 간호의 질을 향상시키는 데 중요하다. 간호대학생을 대상으로 도덕적 고뇌, 도덕적 민감성, 도덕적 용기에 대한 연구는 국내에서 처음 시도되었다. 본 연구는 간호대학생의 도덕적 고뇌, 도덕적 민감성 및 도덕적 용기의 수준을 파악하고 도덕적 고뇌와 도덕적 민감성이 도덕적 용기에 미치는 영향을 확인하기 위한 서술적 조사연구이다. 연구대상은 서울, 경기의 2개 간호대학에 재학 중인 4학년 간호대학생 138명으로, 자가보고식 설문지를 사용하였고, 결과 분석은 IBM SPSS Statistics 23 프로그램의 상관분석과 다중회귀분석을 사용하였다. 본 연구결과 도덕적 고뇌 온도계, 도덕적 고뇌, 도덕적 민감성, 도덕적 용기의 각각의 총점 평균은 $3.53{\pm}2.18$, $57.33{\pm}43.35$, $134.98{\pm}13.98$, $56.33{\pm}12.75$으로 나타났다. 도덕적 용기에 영향을 미치는 요인은 도덕적 고뇌 온도계와 도덕적 민감성의 하부요인인 환자중심간호였다. 최종회귀모형은 통계적으로 유의하였으나(F=4.27, p=.016) 모형의 설명력은 5%였다. 본 연구의 결과를 통해 간호사처럼 간호대학생도 도덕적 고뇌를 경험함을 확인할 수 있었다. 따라서 도덕적 고뇌를 해결하고 도덕적 민감성을 높이고 도덕적 용기로 이어지게 하기 위해서는 다양한 사례를 바탕으로 하는 교육을 통해 윤리적 가치를 함께 공유하고, 간호대학생의 도덕적 용기를 지지 및 소통하는 조직 환경을 조성하려는 노력이 필요하다.

대학간호교육목표의 시안개발 (Development of the Tentative Educational Objectives for the Nursing College)

  • 이화자
    • 한국간호교육학회지
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    • 제1권1호
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    • pp.32-45
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    • 1995
  • This thesis is a study to develop the tentative objectives and present the professional and courses for the nursing college. The conclusions conducted by the purpose of this study are as follows. First, on the basis of the concepts of the nursing and the view-points of nursing education, the tentative goals for the nursing education are set up as follows. 1. To understand human being's life, dignity and their physical, mental, and social aspects. 2. To understand the basic concepts and the principles of human sciences, social sciences, natural sciences, and medical sciences. To apply their knowledges to nursing practices. 3. To diagnose and assess the problems of individual, family and community in terms of nursing practice. To develop the ability of planning, negotiation, management, and evaluation for the nursing education. 4. To develop appropriate knowlege, attitudes, and skills to promote the clients' health and treat their illness. 5. To accomplish all tasks effectively as a trained and qualified professional nurse through the endless studies. Second, the nursing areas and courses for the nursing college in terms of validity, Importance, continuity, relationship, utility and appropriateness are listed as follows. 1. Fundamental courses of the nursing. (1) General courses communication human development, behavior science, biochemistry, microbiology, pharmacology (2) Medical courses physiology, anatomy, pathology 2. Basic courses in nursing (1) General nursing fundamental nursing, introduction of nursing, nursing history, nursing process, health education, health assessment, philosophy of nursing, nursing psychology (2) Maternal-Child nursing child-health nursing, child-disease nursing, adolescent nursing, obstetric nursing, post-partum nursing, gyneco-pathy nursing (3) Adult nursing adult health nursing, adult disease nursing I(fluid & electrotonic, shock, anoxia disorder), adult disease nursing II(nutrition-excretion disorder, sexual dysfunction), adult disease nursing III(sense-, control-, activity-, sleep disorder), adult disease nursing IV(operation, rehabilitation, emergency), gerontological nursing (4) Psychiatric nursing child-adolescent psychiatric nursing, adult psychiatric nursing, gerontological psychiatric nursing, spiritual nursing (5) Community health nursing community nursing, school nursing, industrial nursing, family nursing, nursing epidemiology 3. Nursing management and research skills (1) Nursing management nursing administration, nursing ethics, laws related to nursing (2) Research skills nursing statistics, nursing research methodology Finally, the principles of the statement of the specific objectives are the followings : 1. To state the specific objectives on the basis of the syllabus of each courses. 2. To match a content with a verb or gerund as the basic form of objectives. 3. To control the level of the objectives according to the rule 'the higher the level of a content, the lower the level of a verb or a gerund'. This rule applies in the reverse, as well. 4. To decide the number of the objectives in each course on the basis of the numbers of the syllabus and the level of its comprehensiveness, 5. To correct, supplement or eliminate the stated objectives by a professional or professional groups in that area.

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재활 전문간호사 교육과정안 개발연구 (Development of a Curriculum for Rehabilitation Nurse Specialist Program)

  • 강현숙;서연옥;이명화;김정화;임난영;서문자;이정자;박인주;조복희;김인자;소희영;송충숙;이성숙;황옥남;박상연;유양숙
    • 재활간호학회지
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    • 제4권2호
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    • pp.179-186
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    • 2001
  • The purpose of this study is to develop a systematic and efficient curriculum for the rehabilitation nurse specialist program. This research was carried out as a group work of 15 experts in order to share various opinions about the curriculum, and also through literature review. Articles, curriculums of other Clinical Nurse Specialist Programs, medical laws guidelines, as well as Clinical Nurse Specialist Program from the Korean Nurses Association were reviewed, and the issue was discussed throughly via group meetings. The developed curriculum is as follows: 1. Educational philosophy lies in the fact that the rehabilitation nurses support the patients to maximize their potential and functional level, so that they could maintain healthy state and re-adapt to changed environment. Furthermore the rehabilitation nurses are disposed of arbitrary decision power under their own responsibility, thus they take charge of welfare and healthy environment of the local society through the patients(subjects) and local resources. 2. Educational goals are to train rehabilitation nurse specialist, who correspond to the social needs, so to say, those who have the knowledge and skills for nursing practice, education and research. 3. The curriculum consists of 37 credits, of which 24 credits are based on lectures and 13 credits based on clinical practice. General courses are 3 subjects (5 credits) ; nursing theory, nursing research, and laws/ethics. Mandatry courses are 8 subjects with 19 credits; advanced physical assessment, pharmacology, pathophysiology, issues in rehabilitation nursing, advanced rehabilitation nursing intervention I, advanced rehabilitation nursing intervention II, sports physiology, special rehabilitation nursing intervention. As for the clinical practice courses, assessment and evaluation for rehabilitation(64 hours), community and home based rehabilitation nursing(128 hours), hospital based rehabilitation nursing(128 hours), institution based rehabilitation nursing(96 hours) would be treated. 4. Contents of the curses were developed to correspond with the courses' objectives and specific items. 5. Evaluation would be carried out both in the lecture and in the clinical practice. The knowledge and skills of the students would be measured to ensure full validity and credibility. However this developed curriculum should be continuously modified and updated in more desirable direction.

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유전체맞춤의료를 둘러싼 인체유래물 및 인간유전체 정보의 도덕성 논쟁 - 잊혀질 권리와 공유할 의무를 중심으로 - (Moral Debate on the Use of Human Materials and Human Genome Information in Personalized Genomic Medicine: - A Study Focusing on the Right to be Forgotten and Duty to Share -)

  • 정창록
    • 의료법학
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    • 제17권1호
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    • pp.45-105
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    • 2016
  • 본 논문은 현대 유전체 맞춤 의료에서 인간유전체 정보를 둘러싼 잊혀질 권리와 공유할 의무를 중심으로 전개되는 논쟁들을 살펴보고 그 의의를 고찰하는 것을 목적으로 한다. 이 목적을 위해 필자는 먼저 인간유전체 맞춤 의료의 정의와 이슈를 정리해 볼 것이다. 이후 본 논문은 인체유래물 및 인간유전체 정보를 둘러싼 논란을 크게 두 방향에서 전개한다. 두 방향이란 인간유전체 정보의 소위 개인적인 측면과 공동체적 측면을 말한다. 인간유전체 정보는 과연 누구의 것일까? 한 개인의 것일까? 그 개인이 속한 가족이나 공동체의 것일까? 필자는 인간유전체 정보가 이 두 속성을 모두 갖는다고 본다. 그리고 이 두 속성은 정보가공과 관련하여 개인과 공동체의 입장차를 중심으로 정보가공자인 연구자와 정보소유를 둘러싼 몇몇 문제를 제기한다. 그리고 이렇게 제기된 문제는 또 다른 의문을 불러일으킨다. 인체유래물로부터 그 정보를 가공한 연구자는 그 정보에 대해 얼마만큼의 소유권을 주장할 수 있을 것인가? 본 논문에서 필자는 이러한 문제의식들을 가지고 헬라세포(HeLa cell), 트리스탄 다 쿠나(Tristan da Cunha)섬 사람들의 천식유전자 특허, 과이미(Guaymi)여성 세포주, 하가하이(Hagahai)남성 세포주 등의 사례를 통해 유전체 맞춤의료를 위한 연구와 유전정보데이터베이스 구축에서 벌어지는 다양한 논쟁점들을 고찰해 보려 노력한다. 마지막으로 필자는 인체유래물 및 인간유전체 정보의 잊혀질 권리와 공유할 의무의 변증법적 종합을 몇몇 도덕철학자들의 입장을 통해 시도해 본다.

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