• Title/Summary/Keyword: Medical ethics

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

  • Youn, Gahyun
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.49-66
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    • 2019
  • Along with the advances in medical technology and the economic development, more terminally ill patients are receiving hospice and palliative care services. Moreover, hospice and palliative care clinicians have been showing considerable interest in studies that aim to improve the quality of said care for patients and their families. Meanwhile, after the government has strengthened its policy to protect research participants, the institutional review boards (IRBs) are more closely examining various ethical issues related to patients' vulnerability when reviewing protocols for hospice and palliative care research. However, terminally ill patients should be provided with guaranteed qualities of hospice and palliative care to improve and maintain their quality of life. To that end, support should be provided for efforts to conduct ethical and safe studies with hospice and palliative care patients. Thus, this review paper proposes ethical guidelines for hospice and palliative care research. The guidelines could be appropriately used as a reference for researchers who should prepare for ethically safe and scientifically valued research protocols and the IRBs that will review the protocols.

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

  • Young-Sun, Kim;Young-ran, Jung;Jung-Hwa, Lee
    • Journal of Korean Dental Hygiene Science
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    • v.5 no.2
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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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    • v.26 no.4
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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.

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

  • YUN, Hye-Young;KIM, Sun-Ki;JANG, Hyo-Eun;HWANG, Sin-Woo;KIM, Sang-Hee
    • Korean Journal of Medical Ethics
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    • v.21 no.4
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    • pp.360-376
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    • 2018
  • Nursing students experience ethical conflicts that lead to moral distress and moral sensitivity in clinical practice. Most nursing students have some difficulty in speaking up when faced with morally challenging situations. Hence, increasing moral courage of these students is important to improve the quality of practice, and carry out nursing responsibilities. However, research on the moral distress, moral sensitivity, and moral courage of nursing students has not been reported in South Korea. The purposes of this study were to (a) identify the levels of moral distress, moral sensitivity, and moral courage of nursing students and (b) examine the influence of moral distress and moral sensitivity on moral courage. Data were collected through a survey using self-reported questionnaires sent to senior nursing students at two nursing colleges in Seoul and Gyeonggido. A total of 138 senior nursing students participated in the survey. The data were analyzed using the IBM SPSS Statistics 23 program by Pearson's correlation coefficients and multiple regression analysis. The mean scores of the moral distress thermometer, moral distress, moral sensitivity, and moral courage were $3.53{\pm}2.18$, $57.33{\pm}43.35$, $134.98{\pm}13.98$, and $56.33{\pm}12.75$, respectively. The significant factors influencing moral courage were the moral distress thermometer and patient-centered nursing, which was a subcomponent of moral sensitivity. The explanatory power of the model was 5%. This study confirms that nursing students, like nurses, experience moral distress. It is therefore important to create organizational environments that support the moral courage of nursing students.

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

  • Lee Haw-Ja
    • The Journal of Korean Academic Society of Nursing Education
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    • v.1 no.1
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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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Development of a Curriculum for Rehabilitation Nurse Specialist Program (재활 전문간호사 교육과정안 개발연구)

  • Kang, Hyun-Sook;Suh, Yeon-Ok;Lee, Myung-Hwa;Kim, Jeong-Hwa;Lim, Nan-Young;Suh, Moon-Ja;Lee, Jeong-Ja;Park, In-Joo;Cho, Bok-Hee;Kim, In-Ja;So, Hee-Young;Song, Chung-Sook;Lee, Sung-Sook;Hwang, Ok-Nam;Park, Sang-Yeun;Yoo, Yang-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.2
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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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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 - (유전체맞춤의료를 둘러싼 인체유래물 및 인간유전체 정보의 도덕성 논쟁 - 잊혀질 권리와 공유할 의무를 중심으로 -)

  • JEONG, Chang Rok
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.45-105
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    • 2016
  • The purposes of this study is to debate the duty to share and right to be forgotten of human materials and human genome information in modern personalized medicine. This study debates the use of human materials and human genome information in modern personalized medicine from the perspectives of the duty to share and right to be forgotten. The arguments are based on personal and community aspects. In general, human genome information is considered the personal property of an individual. Nevertheless, on thinking carefully, we can understand that human materials and human genome information have both personal and community aspects. In this study, cases are examined including a HeLa cell, Guaymi woman cell strain, and Hagahai man cell, to support various debates an genetic information for database construction in personalized medicine. Finally, using moral theories, this study attempts to synthesize the dialectics of the duty to share and right to forget regarding the use of human materials and human genome information in medicine.

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Effects of Acupuncture Stimulation on the Radial artery's Pressure Pulse Wave in Healthy Young Participants: Protocol for a prospective, single-Arm, Exploratory, Clinical Study

  • Shin, Jae-Young;Ku, Boncho;Kim, Tae-Hun;Bae, Jang Han;Jun, Min-Ho;Lee, Jun-Hwan;Kim, Jaeuk U.
    • Journal of Pharmacopuncture
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    • v.19 no.3
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    • pp.197-206
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    • 2016
  • Introduction: This study aims to investigate the effects of acupuncture stimulation on the radial artery's pressure pulse wave, along with various hemodynamic parameters, and to explore the possible underlying mechanism of pulse diagnosis in healthy participants in their twenties. Methods and analysis: This study is a prospective, single-arm, exploratory clinical study. A total of 25 healthy participants, without regard to gender, in their twenties will be recruited by physicians. Written informed consent will be obtained from all participants. The participants will receive acupuncture once at ST36 on both sides. The radial arterial pulse waves will be measured on the left arm of the subjects by using an applicable pulse tonometric device (KIOM-PAS). On the right arm (appearing twice), electrocardiogram (ECG), photoplethysmogram (PPG), respiration and cardiac output (CO) signals, will be measured using a physiological data acquisition system (Biopac module), while the velocity of blood flow, and the diameter and the depth of the blood vessel will be measured using an ultrasonogram machine on the right arm (appearing twice). All measurements will be conducted before, during, and after acupuncture. The primary outcome will be the spectral energy at high frequencies above 10 Hz ($SE_{10-30Hz}$) calculated from the KIOM-PAS device signal. Secondary outcomes will be various variables obtained from the KIOM-PAS device, ECG, PPG, impedance cardiography modules, and an ultrasonogram machine. Discussion: The results of this trial will provide information regarding the physiological and the hemodynamic mechanisms underlying acupuncture stimulation and clinical evidence for the influence of acupuncture on the pressure pulse wave in the radial artery. Ethics and dissemination: This study was approved by the Institutional Review Board (IRB) of Kyung Hee University's Oriental Medical Center, Seoul, Korea (KOMCIRB-150818-HR-030). The study findings will be published in peer-reviewed journals and presented at national and international conferences. Trial registration number: This trial was registered with the Clinical Research Information Service (CRIS) at the Korea National Institute of Health (NIH), Republic of Korea (KCT0001663), which is a registry in the World Health Organization's (WHO's) Registry Network.

A Study on Legal Regulation of Neural Data and Neuro-rights (뇌신경 데이터의 법적 규율과 뇌신경권에 관한 소고)

  • Yang, Ji Hyun
    • The Korean Society of Law and Medicine
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    • v.21 no.3
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    • pp.145-178
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    • 2020
  • This paper examines discussions surrounding cognitive liberty, neuro-privacy, and mental integrity from the perspective of Neuro-rights. The right to control one's neurological data entails self-determination of collection and usage of one's data, and the right to object to any way such data may be employed to negatively impact oneself. As innovations in neurotechnologies bear benefits and downsides, a novel concept of the neuro-rights has been suggested to protect individual liberty and rights. In Oct. 2020, the Chilean Senate presented the 'Proyecto de ley sobre neuroderechos' to promote the recognition and protection of neuro-rights. This new bill defines all data obtained from the brain as neuronal data and outlaws the commerce of this data. Neurotechnology, especially when paired with big data and artificial intelligence, has the potential to turn one's neurological state into data. The possibility of inferring one's intent, preferences, personality, memory, emotions, and so on, poses harm to individual liberty and rights. However, the collection and use of neural data may outpace legislative innovation in the near future. Legal protection of neural data and the rights of its subject must be established in a comprehensive way, to adapt to the evolving data economy and technical environment.

An Ethical Consideration on the Standard Operating Procedure Operation Status and the Ethical Review of the Vulnerable Research Subjects of Institutional Review Board, a Medical Institution in Korea (우리나라 의료기관 Institutional Review Board의 취약한 연구 대상자 관련 표준운영지침서 운영 현황과 윤리적 고찰)

  • Eun Hwa Byun;Byung In Choe
    • The Journal of KAIRB
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    • v.5 no.1
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    • pp.21-32
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    • 2023
  • Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

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