• 제목/요약/키워드: ethical variability

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초대받은 임상시험: 한국 임상시험 산업화 과정에서 생명자본(biocapital)과 윤리 가변성(ethical variability) (Invited Clinical Trials: Biocapital, Ethical Variability, and the Industrialization of Clinical Trial in Korea)

  • 송화선;박범순
    • 과학기술학연구
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    • 제18권3호
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    • pp.1-45
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    • 2018
  • 한국은 최근 세계 임상시험 중심지의 하나로 떠올랐다. 임상시험을 가장 많이 한 국가 순위에서 미국과 독일 등 전통적 제약 강국에 이어 6위를 차지했고, 도시별 순위에선 서울이 1위 자리에 올랐다. 이 논문은 한국에서 임상시험이 급격하게 증가한 배경으로 수요공급의 시장 메카니즘 외에 다른 요인, 즉 정부의 임상시험 산업화 정책이 중요했음을 보일 것이다. 1990년대 말 금융위기 이후 정부는 바이오테크놀로지(BT)를 차세대 국가 성장 동력으로 정하고 이를 위한 정책개발에 심혈을 기울였다. 바로 이러한 맥락에서 다국적 제약사의 임상시험을 국내에 유치하고 이 분야를 키울 계획을 세우게 된 것이다. 정부가 제도정비, 인프라 구축, 관련 인력 양성 및 국민의식 개선 등의 작업을 수행하는 가운데, 해외 CRO(Contract Research Organization: 임상시험수탁기관)가 들어와 사업을 시작했고, 국내 업체들도 생겨났다. 한국에서 임상시험은 정부에 의해 '초대?된 것이다. 이 논문은 한국의 임상시험 산업화 과정 속에 묻혀있는 생명윤리의 문제를 끄집어내 다루고자 한다. 이를 위해 최근 인류학과 과학기술학에서 논의되고 있는 ??생명자본?? (biocapital)과 ??윤리 가변성??(ethical variability)의 개념을 활용하여, 임상시험을 둘러싼 주요 행위자인 정부 담당자, CRO 직원, 병원 의료진, 환자 등이 실제로 어떤 동기와 목적을 가지고 여기에 참여했는지를 사회 구조적 관점에서 분석할 것이다. 임상시험 참여자의 동의서를 받고, IRB의 심의를 통과하고, 국제기준을 충분히 만족시킨다고 해도, 실제 상황에선 생명윤리의 원칙이 무시될 여지는 충분히 있고, 국가의 산업육성 프레임 안에서 생명윤리는 관련 서류를 갖추면 되는 절차상의 문제로 환원될 수 있음을 보일 것이다.

간호학생의 도덕판단과 윤리적 가치관 (A Study on Moral Judgement and Ethical Values of Nursing students)

  • 권영미
    • 한국간호교육학회지
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    • 제8권1호
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    • pp.17-28
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    • 2002
  • The purpose of this study was to provide the basic sources for educational program that identifies moral judgement and ethical values of nursing students. The subjects consisted of 114 nursing students in college. Data were collected by the Korean Form of Moral Development Inventory(Shin, 1997) and Nursing Ethical Values(Lee, 1990) from March 5 to 21. 2002. The findings were as follows: 1. The mean score of the stage 5B was higher than the score of other stages. The mean score of P(%) was 39.15. No significant difference were found between P(%) and general characteristics. 2. The mean score of the nursing ethical values was 3.38. The nursing students took the position of deontology slightly. In nurse-colleague relationship area(4.22), the subjects should to taking evidently deontological position. 3. According to general characteristics, no significant difference was found except nurse-patient relationship area among subcategory of ethical values. The mean score of this area by influence person of moral development were significantly different at the .05 level. 4. The trend of subjects in action choices on 4 dilemmas of the DIT showed between-subjects variability. Action choices on 'Heinz and the drug', 'Doctor's dilemma', and 'webster' were 'pro' in most of subjects, whereas 'escaped prisoner' was 'con'. 5. The ethical values in human-life area associated with action choices on 'Heinz and the drug' was significantly different . And the nursing ethical values, human-life area, and nurse-nursing task relationship area were significantly different according to action choices on 'Doctor's dilemma'. 6. There was found little correlation between action choices on 4 dilemmas of the DIT and moral judgement. Also little correlation was shown between action choices on 4 dilemmas of the DIT and ethical values. No significant correlation were found between moral judgement and nurse ethical values.

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뇌사자 장기이식에 대한 수술실 간호사의 태도와 삶의 의미가 간호윤리 가치에 미치는 영향 (Operation Room Nurses' Ethical Value regarding Their Attitude and Meaning of Life about Organ Transplantation in Brain Death)

  • 서형은;김미영
    • 성인간호학회지
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    • 제28권4호
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    • pp.355-366
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    • 2016
  • Purpose: The purpose of study was to describe operation room nurses' ethical values in relationship to the attitude and meaning of life toward organ transplantation in brain death. Methods: This study used a descriptive correlational survey design. Participants were 174 nurses who had attended to organ transplantation surgery in brain death more than once. Data were collected from September 1 to 11, 2015 and were analyzed using independent t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficients, and hierarchical multiple regression with SPSS 22.0. Results: Educational level, attitude on organ transplantation in brain death, and meaning of life were significant variables predicting the level of nursing ethical value, accounting for 82.6% of the variability. Conclusion: Continued education and self-development programs should be encouraged for operating room nurses to establish professional nursing ethics as well as positive meaning of life and attitude toward the organ transplantation in brain death.

위세척의 올바른 이해와 적용 (Proper Understanding and Application of Gastric Lavage)

  • 오범진;노형근
    • 대한임상독성학회지
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    • 제11권1호
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    • pp.1-8
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    • 2013
  • Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.

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