• Title/Summary/Keyword: Medical Ethics

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A study on Establishment and Management of the CCTV in Operating Room (수술실 CCTV 설치 및 운영에 대한 고찰)

  • Kim, Minji
    • The Korean Society of Law and Medicine
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    • v.20 no.1
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    • pp.109-132
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    • 2019
  • Recently, medical accidents related to surgical procedures have increased. In addition, the media reported that some of these accidents were involved in health crimes. Patient-advocate groups have called for mandatory establishment and management of CCTV in operating rooms. There is a lot of discussion among the interested parties, so it is necessary to review the relevant laws and regulations. The purpose of this study is to identify the characteristics of CCTV in operating rooms and to review legislations related to establishment and management of the CCTV in operating rooms. Medical institutions use CCTV for management of facilities and patient safety and install it in operating rooms optionally. The Constitution guarantees the privacy and the privacy of correspondence of every citizen, but it can be limited by the law for public welfare. Currently, however, there is no existing law about establishment and management of the CCTV in operating rooms and it can be defect of legal system. Under the current legislations, it is likely that the Self-determination can be violated due to the characteristic of healthcare provider when CCTV is mandatorily installed in operating room. In addition, the regulations on access and leakage of confidential information known by operator are insufficient. So that, the safety of the visual data might be threatened. Furthermore, unless the period and the place of storage of the visual data are clearly defined, it is highly unlikely to meet the original purpose of patient safety and prevention of medical accidents. This study is meaningful as there is few previous study on this topic although the need for legal review about this is growing and several bills are being proposed. It is expected that the results of this study can be utilized as basic data for enactment or amendment of the laws and regulations about establishment and management of CCTV in operating rooms.

A Study on the Clinical Nurse's Ethical Value (인간생명에 대한 간호사의 윤리의식)

  • Moon, Young-Im;Tak, Young-Ran;Kim, Myoung-Ae;Kim, Seon-Ae;Park, Kyung-Sook;Im, Dong-Sik;Park, Ho-Ran
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.4
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    • pp.541-557
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    • 2003
  • Purpose: This descriptive study was designed to explore the clinical nurse's ethical value regarding human life. Method: Data were collected from September to October, 2002. Study subjects were 527 clinical nurses working in General Hospital as tertiary located in Seoul. Ethical value was measured with questionnaire developed by researchers and consisted on items regarding ethical value on human life. Result: Among the items, most nurses highly agree with the item, "When a patient requests his/her health care provider to keep his/her personal secret, the health care provider is obliged to do so." and "When a patient asks for information on his/her medicinal and dietary contents, his/her wish must be granted." Most clinical nurses mainly agree with the item. "Health care providers must always be honest to the patient and/or his/her family". However, most nurses disagree with the item, "When a patient is on the verge of death after an accident, it is justifiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them". Most clinical nurses mainly disagree with the items, "When a patient is on the verge of death after an accident, it is justiable to soothe his/her family by saying 'he/she is OK' instead of telling them the truth, in order to avoid a sudden shock befalling on them" and "It is justiable that various new ways of treatment should be applied to patient at his/her terminal stage to prolong his/her life, even for the purpose of research". There were significant differences in some items of ethical value according by clinical nurse's age and professional experience, current position, religion, education, marital status, continued education on ethics, and the experience of holing on life saving treatment. Conclusion: It is intensifying the notion of ethical underpinning for human rights, truthfulness is essential to a trust relationship under what circumstances. Also most clinical nurses agree with that It is essential to trust in the nurse-patient relationship, patients have the right to know and it is the ethical thing to do as health care provider.

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A Study on the Rank of Stressful Events Related to the Experience of Hospitalization (입원환자가 경험한 입원스트레스 순위에 관한 연구)

  • 이소우;하양숙;박은숙
    • Journal of Korean Academy of Nursing
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    • v.15 no.1
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    • pp.17-29
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    • 1985
  • This study was to explore on the rank of stressful events related to the experience of hospitalization. 180 hospitalized patients on surgical and medical wards were asked to rate 49 stress-producing events associated with the experience of hospitalization. Two university hospitals was used as the setting for this study. Because the nature of the events in the stress scale pertain mainly to general short term hospitalizations, patients in the rehabilitation and psychiatric units of the hospital were not included. Prior to the beginning of the study, three times meeting were held with 12 head nurses and 3 investigators for discussing with the ethics subject related to the study. The pretest was done to determine whether items to use were pertinent or not. According to the result of the pretest, Volicer's Hospital Stress Rating Scale was selected as a study tool for this study. Data collection was used an interview and a card-sorting method. The interviewing was done by two authors and three graduate nursing students. A total 125 completed the card-sorting procedure. The stressful items were ordered from most to least stressful within the categories. Additional information such as: age, sex, marital status, and diagnosis was obtained from the kardex file. The ordered list of items, with mean values, as scored by the total of 125 respondents was significantly accepted at 1% level by Friedman test. (X²=1448.339) The event,“knowing you have a serious illness.”was rated highest stressful and (M=41.54) “Being awakened in the night by the nurse”least stressful. (M=14.73) Highly rated items were orderly “Thinking you might have cancer”“Thinking you might lose a kidney or some other organ”“Not being told what your diagnosis is. “Not knowing for sure what illness you have,”five lowerly rated items were orderly “Having to eat at different times than you usually do”“net being able to call family or friends on the phone”“Not having friends visit you,”“Having strangers sleep in the same room with you.”Futher analysis of the data was done to ascertain tao degree of similarity of judgment between different groups in the sample as to how events should be rated. The sample was divided into two groups according to the demographic characteristics and the degree of seriousness of illness. The rank order correlation was calculated for the two sets of ranks as a measure of consensus between the two groups. The correlations ranged from .85∼.99 all indicating a high degree of consensus.

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Defining the Core Competencies of the Nurses in A Tertiary Hospital and Comparing Different Units based on Their Respective Characteristics (일 종합전문요양기관 간호사의 핵심역량 도출 및 근무지 특성별 중요도 인식 비교)

  • Sung, Young-Hee;Jeong, Jeong-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.1
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    • pp.76-93
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    • 2006
  • Purpose: The purpose of this study was to define the core components required of nurses to provide quality nursing care to patients and analyze the significance of these components in the hospital's various units to maintain a high level of competence among nurses. Method: The study evaluated 3 categories included 35 subcategories with 148 core components that were derived from literature review and interviews of nursing professionals. The nursing professional category included 18 subcategories with 98 components, the organizational culture category included 4 subcategories with 16 components, and the temperament-attitude category included 13 subcategories with 34 components. The study included 335 nurses with more than one year of hospital experience and measured disparities among different hospital units. The data was analyzed with SPSS-Win 10.0, differing perceptions of the importance of general traits among the participants were measured using standard deviation, and differing perceptions of the importance of professional traits among the participants were assessed using ANOVA and subsequently with the Bonferroni Test. The reliability of the aforementioned research tools were evaluated using the Cronbach's ${\alpha}$. Result: The results of the study were as follows: 1. Among the three categories, temperament-attitude category was perceived to be the most important, followed by nursing professional category and organizational culture category. Among the ten most important subcategories within the three categories, safety and infection prevention as well as responsibility were perceived to be the most important, followed by promotion of physiologic adaptation, document management and presentation, self-control, ethics, observance law, coping with emergency, humanity, and medication. 2. The relative importance of category associated with the core competencies within the hospital unit were as follows : 1) The units that rated nursing professional category as being the most significant were: internal medicine, surgical unit, mother-child unit, emergency room, intensive care unit, and operating room, in that order. 2) The units that rated the organizational culture competencies as being the most significant were: mother-child unit, internal medicine, surgical unit, emergency room, operating room, and intensive care unit, in that order. 3) The units that rated temperament-attitude category as being the most significant were: internal medicine, surgical unit, emergency room, mother-child unit, operating room, and intensive care unit, in that order.

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Legal issues of obtaining informed consent in pharmaceutical clinical trial as human material research : Focusing on the use of statutory form (인체유래물연구에 해당되는 의약품임상시험에서 동의 획득 기준의 법적 문제: <인체유래물연구동의서> 법정 서식의 사용을 중심으로)

  • Yoo, Sujung;Kim, Eunae
    • The Journal of KAIRB
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    • v.1 no.2
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    • pp.30-42
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    • 2019
  • In pharmaceutical clinical trials as human material research, the collection, use, storage and provision of human materials must be in accordance with the criteria stipulated in 「Bioethics and Safety Act」, except in the case that some criteria about it is in the law related to clinical trials such as 「Pharmaceutical Affairs Act」 and 「Enforcement Rule on Safety of Drugs, etc.」 so these take precedence over. Under 「Bioethics and Safety Act」, the core aspect of the legal standard for obtaining informed consent is the use of statutory form . The use of statutory form ensure that both those who obtain informed consent and those who give it can know the contents contained this form as well as recognize its importance. Thus, the person who has the right to informed consent can sign the statutory form after correct understanding of the contents. In reality, however, some researchers and IRB members determine that only the main informed consent form is to be used because most of contents on statutory from are included in the main informed consent form. Some other researchers and IRB members judge that the use of statutory form is not needed if human materials may only be used for laboratory testing and the rest will not be stored and provided for future use. Most of these determination and judgement is based on the interpretation of the Korea National Institute for Bioethics Policy(hereafter, KoNIBP) on IRB Information Portal Site. But, it is questionable whether the KoNIBP's interpretation is legally valid and the KoNIBP is the legal entity having authority to interpret existing statute. In some cased not only using the main informed consent form including enough information about the collection, use, storage and provision of human materials but also collecting necessary minimum human materials, and discarding the rest, unusing the statutory form may not cause the problem to respect and protect the research participant's rights. Therefore, the provision stipulating the criteria about the use of statutory form as the legal standard of obtaining informed consent that applies all human material research without exception should review to revise. At least, straighten out the confusion surrounding whether or not the statutory form is to be used, before the revision of related provision, considering the logical opinions of some researchers and IRB Members, the Ministry of Health and Welfare as the legal entity having authority to interpret existing statute should represent its opinion about permission of the acceptable exceptions.

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Development of Bachelor Nursing Programme (일 대학 간호학과 교육 과정 개발 연구)

  • Chung, Bok-Yae;Kim, Mi-Ye;Suh, Soon-Rim;Hong, Hae-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.9 no.2
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    • pp.298-309
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    • 2003
  • The educational preparation of nurses has been the focus of considerable debate globally. It is needed the change of the basic nursing education for professional nurse to prepare the trends of the health care needs of clients for coming new generation. And also it is believed that educational preparation for being nurses is to be responsible to clients' needs. The purpose of the study was to develop a baccalaureate program in nursing. This study were implemented through three stages from April 2001, to April 2002.: preparation stage which were consisted of reviewing of the literatures, interviewing the fellow nurses in a variety workplace, and consulting professors who were concerned with the nursing education to identify the present educational problems, and analyzing the contents of seven major courses in nursing education, evaluation stage about a new developed curriculum with the directors of the five nursing schools, and confirmation stage of new developed education programme. The developed education programme was designed as a four year program with 126 credit hours including 39 credit hours of liberal arts, 34 credit hours of supplementary courses, and 53 credit hours of nursing major based on the four basic nursing dimensions of human, health, environment and nursing. Nursing majors were consisted of Nursing Ⅰ(oxygenation), Nursing Ⅱ(nutrition elimination), Nursing Ⅲ(activity rest), Nursing Ⅳ(neurologic- endocrine protection), Nursing Ⅴ(fluids electrolytes/sex reproductive), Nursing Ⅵ(psycho-social), Community Health Nursing, Fundamental Nursing, School Health, and Emergency care. This new nursing programme was focused on the nursing education for prevention and rehabilitation nursing care as well as the acute and chronic nursing care at hospital, on the integrated nursing programme to become effective, and the nursing process to encourage the critical thinking. The new education programme focused on the professional nurses who are responsible the nursing ethics, communication skills, and professional beliefs to suit the future trends in health. And also it will be needed for faculties to manage the integrated curriculum, to analyze the contents of each subject, and to communicate with each other before a new education programme apply to their education programme in future. This research was supported by the Han Kok Medical Science Foundation

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How is it possible to use the human body material for research without the written consent of the donor? (바이오뱅크 내 동의서 없는 폐기용 인체유래물 자원의 재활용을 위한 정당성 모색)

  • JEONG, Chang Rok;HEO, Eusun
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.199-235
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    • 2017
  • A topic of particular interest for biotech researchers are handling of human tissue specimens that may be used for present, or stored for future, research purposes. This article examines the ethical and legal legitimacy of using human materials for research purposes with special attention to the issues of informed consent and confidentiality. The purpose of this paper is moral and for law legitimacy exploring of the utilization of the human material without donator's consent. It is a known fact that future medical care should be exchanged a paradigm by preventive health care through a human meterial research. The developed country have established a biobank for a human meterial research and supported a researcher. Korea is the same, too. When it is done a defect, as for the thing researcher derived from the Korean human meterial research. The written consent of the donator can keep a human meterial research origin thing, but cannot use it now. I will justify morally and for law that researcher can use the human material without written consent. We can change the concept of recycling of human material. It is not mean only burning that recycling of human materials for research.

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Investigation of Espoused Theories in Nursing Practice (간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구)

  • Suh, Moon Ja;Kim, Hae Sook;Lee, Eun Hee;Park, Young Sook;Cho, Kyung Sook;Kang, Hyun Sook;Im, Nan Young;Kim, Joo Hyun;Lee, So Woo;Cho, Bok Hee;Lee, Myung Hwa;Chi, Sung Ai;Hah, Yang Sook;Son, Young Hee;Kwon, Sung Bok;Kim, Hee Jin;Choo, Jin A
    • Korean Journal of Adult Nursing
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    • v.13 no.1
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    • pp.53-69
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    • 2001
  • As a nursing practice involves nurses'actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives. Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal); excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, accountability and commitment(4 theories of nursing ethics); human respect, partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences, positive perspectives(4 theories of nurse), role of intervention, rewarding, peer relationship(3 theories of situations). The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore, it is recommended to review the theories-in-use in order to find any discrepancies between the espoused theories and the reality of nursing actions.

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Recruitment and Selection of Police Officials in the United States -the System and it's Implications- (미국 경찰관 모집·선발제도의 특징 및 함의)

  • Park, Dong-Kyun
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.384-392
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    • 2011
  • Recruitment and selection are separate but mutually reinforcing processes. The goal of recruitment is to attract the largest number of applicants possible to apply to the agency, and selection is the process of weeding out unqualified candidates and identifying qualified candidates. In this context, the recruitment and selection system of police officials is an important issue because it affects their future performance as police officers on the job, especially their policing skills, perception of society, occupational ethics. This study suggested the characteristics of U. S. recruitment and selection system of police officials. In the U. S, each police agency sets up its own recruitment and selection standards and procedures. However, recruitment and selection process follows a certain sequence : receiving application, psychological examination, background check, polygraph test, drug screening, interview, physical agility, and medical test. Special characteristic of American police system regarding recruitment and selection is that many law enforcement agencies use a polygraph test to ensure the integrity of the candidates. Another interesting screening process is a drug test because many Americans abuse illegal drugs. A candidate officer must submit urine or a hair sample for screening test. Police human resources specialists should continually identify the most innovative tests and approaches recruit and select police officers. Recruitment and selection strategies should increasingly attract and retain those officers who have the attributes to work in a community-oriented policing environment.

Pectus Excavatum and Pectus Carinatum: Associated Conditions, Family History, and Postoperative Patient Satisfaction

  • Kuru, Pinar;Cakiroglu, Aylin;Er, Aynur;Ozbakir, Hincal;Cinel, Ali Emin;Cangut, Busra;Iris, Merve;Canbaz, Berkay;Picak, Ebru;Yuksel, Mustafa
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.29-34
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    • 2016
  • Background: Pectus excavatum (PE) and pectus carinatum (PC) are the most common chest wall deformities. In this study, we aimed to characterize how patients obtained information about these deformities, as well as patients' family history, associated medical problems, and postoperative satisfaction after the Nuss and Abramson procedures. Methods: This cross-sectional retrospective study included patients who were operated by a single surgeon between 2006 and 2013. Follow-up calls were made after approval of our institution's ethics committee. We reached 207 of the 336 PE patients (61.6%) and 73 of the 96 PC patients (76%). Results: The majority of the patients were male (85% of the PE patients and 91.8% of the PC patients). The age of diagnosis of PE was $14.52{\pm}0.51years$ and the age at the time of operation was $17.89{\pm}0.42years$; for PC patients, the corresponding ages were $15.23{\pm}0.55years$ and $16.77{\pm}0.55years$, respectively. A total of 70% of the PE patients and 63.8% of the PC patients obtained information about pectus deformities through the Internet. In 27.1% of the PE patients with an associated anomaly, 57.1% (n=13) had scoliosis, while 41.1% of the PC patients with an associated anomaly had kyphosis (n=5). Postoperative satisfaction, as evaluated on a scale from 0 to 10, was $8.17{\pm}0.15$ for PE patients and $8.37{\pm}0.26$ for PC patients. The postoperative pain duration was $51.93{\pm}5.18days$ for PE patients and $38.5{\pm}6.88days$ for PC patients. Conclusion: In this study, we found that most patients with pectus deformities were male. The Internet was an important resource for patients to learn about their deformities. Family history and associated anomalies were identified as important aspects for consideration in the clinical setting. The patients reported high levels of postoperative satisfaction, and pain management was found to be one of the most important elements of postoperative care.