• 제목/요약/키워드: meaningless

검색결과 295건 처리시간 0.027초

무의미한 연명치료 중단 등의 기준에 관한 재고 - 대법원 2009.5.21 선고 2009다17417사건 판결을 중심으로 - (Review on the Justifiable Grounds for Withdrawal of Meaningless Life-sustaining Treatment -Based on a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009)-)

  • 문성제
    • 의료법학
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    • 제10권2호
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    • pp.309-341
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    • 2009
  • According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

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마황부자세신탕(麻黃附子細辛湯)이 MIA로 유도된 골관절염 유발 Rat에 미치는 영향 (Effects of Mahwangbujaseshin-tang (Mahuangfuzixixintang) (麻黃附子細辛湯) on MIA-Induced Osteoarthritis Rats)

  • 이형은;오민석
    • 한방재활의학과학회지
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    • 제24권2호
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    • pp.65-81
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    • 2014
  • Objectives This study was carried out to find out the anti-osteoarthritic effects of Mahwangbujaseshin- tang (Mahuangfuzixixintang ) on the monosodium iodoacetate (MIA)-induced osteoarthritis rats. Methods Osteoarthritis was induced by injecting MIA ($50{\mu}l$) into the knee joint of rats. Rats were divided into a 3 groups (n=7). The injection did not fit the normal group. A week later, after the injection of MIA, while control group took normal saline 2 ml, the extract of Mahwangbujaseshin-tang (Mahuangfuzixixintang ) (MBST) (200 mg/kg) was injected to treated group. After that, we examined hind paw weight bearing ability, functions of liver and kidney, serum TNF-$\alpha$, IL-$1{\beta}$, IL-6, $PGE_2$, $LTB_4$, TIMP-1, MMP-9 and hematology. Volume of cartilage was measured by micro CT arthrography. Injury of synovial tissue was measured by H & E, Safranin-O immunofluorescence. Results 1) DPPH and ABTS free radical scavenging activity of MBST was increased according to concentration of MBST and total phenolic contents were in high level. 2) In RAW 264.7 cells, ROS production was significantly decreased in MBST (at 10, $100{\mu}g/ml$) and NO was also decreased but meaningless in MBST (at $100{\mu}g/ml$). 3) In RAW 264.7 cells, IL-6 production was significantly decreased in MBST (at $100{\mu}g/ml$) and TNF-$\alpha$ and IL-$1{\beta}$ production were also decreased but meaningless in MBST (at $100{\mu}g/ml$). 4) In hind legs weight-bearing measurement, level of weight-bearing was increased. 5) Functions of liver and kidney were not affected. 6) TNF-$\alpha$, IL-$1{\beta}$, IL-6, $PGE_2$, $LTB_4$, MMP-9 and TIMP-1 production were significantly decreased. 7) In hematology, the levels of neutrophils, monocytes were significantly decreased and the levels of white blood cells, lymphocytes were also decreased but meaningless. 8) In micro CT-arthrography, cartilage volume was significantly increased. 9) Histopathologically, injury on cartilage and synovial membrane of MBST group was decreased. Conclusions Based on all results mentioned above, Mahwangbujaseshin-tang (Mahuangfuzixixintang) is believed to be meaningful for suppressing the progress of osteoarthritis. And it is related to inhibiting the activity of inflammatory cytokine and injury of volume in cartilage.

사전의료지시서(Advance Directives) 모형 개발을 위한 실증 연구 (An Empirical Study for Model Development Concerning Advance Directive)

  • 홍성애
    • 한국노년학
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    • 제30권4호
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    • pp.1197-1211
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    • 2010
  • 본 연구는 미래의 불확실한 상황이 발생했을 때를 대비하여 의식이 있을 때 임종기의 치료에 대한 선호도를 밝혀두는 사전의료지시서(Advance Directives) 모형 개발에 필요한 실증적 자료를 제공하기 위해 시도되었다. 6개 시·도에 거주하는 의료인(의사/간호사)과 일반성인 383명을 대상으로 AD 관련 실태와 무의미한 연명 치료에 대한 태도, AD 모형에 대한 인식과 선호도를 조사하였으며, 연구도구는 구조화된 설문지를 사용하였다. 수집한 자료는 SPSS 14.0을 이용하여 빈도분석과 백분율, χ2 test, 평균과 표준편차를 구하였다. 연구결과 대부분의 의료인들은 심폐소생거부권(DNR order)과 AD에 대해서 알고 있었으며, 소수이기는 하지만 병원 내규나 서식을 통해 활용하고 있었다. 무의미한 연명치료에 대해서는 전체적으로 부정적인 인식을 가지고 있었으며, 대다수의 응답자들이 우리나라에 AD를 도입하는 것과 AD를 작성하는 것에 동의하였고, AD가 법적 효력을 갖는 것에 찬성하였다. AD를 작성하는 방법으로는 생전유언과 대리인 지정을 혼합하는 유형을 희망했고, 문서로 작성하는 것을 희망했다. 또한 AD를 작성하는 시기로는 말기질환으로 진단받았을 때를 가장 선호하는 것으로 나타났다. 본 연구결과를 토대로 우리나라 문화와 실정에 맞는 AD 모형을 제시하였다. 향후 연구에서는 AD 도입을 위해 사회적 합의를 이끌어 내기 위한 구체적인 방안이 논의 되어야 할 것이다.

융통성있는 퍼지 초월분해 원리 (Adaptable Fuzzy Hyper-Resolution Principle)

  • 김창석;박순철;김대수;이상조
    • 전자공학회논문지B
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    • 제31B권8호
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    • pp.201-210
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    • 1994
  • We proposed so-called AFHR (adaptable fuzzy hyper-resolution principle) that can manipulate uncertain knowledge and tune the range of resolution. The AFHR can make a rangable resolution to execute an efficient resolution and can represent linguistic truth values. In this paper, we introduce new concepts of law of contrary, meaningless range level for truth values and strict degree of adaptable resolution. We show that the differences of AFHR and existing fuzzy resolution. Finally we prove completeness of AFHR.

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건설공사 유해,위험방지계획서의 효과적 작성방안에 관한 연구 (A Study on the Effectual Making Schemes of the Safety Assessment for the Construction Works)

  • 최진우
    • 한국안전학회지
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    • 제17권4호
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    • pp.168-172
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    • 2002
  • The Safety Assessment for Construction works is used in order to make the safety plans to protect calamities in construction sites. However in Korea it is problem that the Safety Assessment has strict and meaningless contents. So it is not used well. This study suggests the effectual making methods of the Safety Assessment to solve the problems which are found through investing serious calamities and interviewing experts.

MTBF 평가를 위한 고장정의 소고 (A Study on the Failure Definition for the MTBF Evaluation)

  • 김철
    • 산업공학
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    • 제1권2호
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    • pp.67-74
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    • 1988
  • MTBF (Mean Time Between Failures) is one of the measures to express the reliability for a repairable system, especially for a military weapon system. But MTBF is meaningless without a clear definition of the system failures. In this paper we discuss two failure definitions, one is defined by US Army Training and Doctrine Command jointly with US Army Materiel Command and the other one is used to M1 Tank.

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KTX기장의 개인-환경적합성이 직무만족, 조직몰입 및 이직의도에 미치는 영향에 관한 연구 (A Study on the Effects of KTX Driver's Person-Environment Fit on Job Satisfaction, Organizational Commitment, and Turnover Intention)

  • 김태성;허찬영
    • 한국철도학회논문집
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    • 제15권6호
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    • pp.645-653
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    • 2012
  • 본 연구는 KTX기장의 개인-환경(직무,조직,동료)적합성이 직무만족, 조직몰입 및 이직의도에 미치는 영향과 개인-환경적합성과 이직의도간의 관계에서 직무만족과 조직몰입의 매개효과를 실증분석 하였다. 분석결과, 개인-환경적합성은 직무만족, 조직몰입 및 이직의도에 대부분 유의미한 영향을 미치는 것으로 나타났으나, 개인-직무적합성은 직무만족에, 개인-동료적합성은 직무만족과 이직의도에 각각 유의미한 영향을 미치지 못하는 것으로 나타났다. 직무만족 및 조직몰입의 매개효과 또한 대부분 매개효과가 있는 것으로 나타났으나, 개인-조직적합성과 이직의도간의 관계에서 직무만족의 매개효과가 없는 것으로 나타났다. 결론적으로 본 연구는 KTX기장의 이직의도를 파악하고 이를 예방하기 위해서는 전반적인 개인-환경적합성을 높임은 물론, 직무만족과 조직몰입 향상방안 마련이 중요하다는 사실을 시사하고 있다.

이머시브 공간에서 나타나는 경계성 연구 (A Study on the Boundary Identified in the Immersive Space)

  • 손서연;안성모
    • 한국실내디자인학회논문집
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    • 제27권2호
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    • pp.45-54
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    • 2018
  • Immersive space is a new type of space, which is converged with other domains and expressed in various ways and here, a mutual exchange between space and participants is realized with active intervention of participants. The purpose of this study is to examine boundary changes and characteristics in virtual space and reality or inside and outside, focusing on immersive space. For this study, a case analysis was conducted, based on the key words regarding flow experience and boundary characteristics in immersive space. The boundary characteristics extracted are as follow. First, while immersive space is overlapped in many different ways, the boundary in space gradually changes and one unique and convergent space is formed. Also, a combination of overlap is made with internal and external physical force and a convergent boundary is created. Second, forms are mixed in diverse ways and an unrealistic boundary space is revealed. For new experience, it has familiar, but new experiential characteristics and also shows an expanded boundary by the medium of different domains. Third, a simultaneous space, based on variability of time and space, has an ambiguous boundary due to a meaningless physical boundary of space and changing into a space region constantly, it becomes an unlimited variable space. Fourth, a linear expansion-based emergent space has nonlinearity, which creates a meaningless boundary, recognized as an irregular, dynamic and transformative space and expands to a creative space. In conclusion, it is anticipated that based on diverse characteristics found in immersive space, this study would give unlimited inspiration to many design fields and art creation activities and contribute to a further development through continued research on immersive space.

정상성인의 뇌기능적 자기공명영상에서 명사, 동사, 형용사 그리고 부사 만들기 과제들에 대한 언어영역편재화의 재현성에 관한 연구 (Reproducibility of Hemispheric Language Dominance by Noun, Verb, Adjective and Adverb Generation Paradigms in Functional Magnetic Resonance Imaging of Normal Volunteers)

  • In Chan Song;Kee Hyun Chang;Chun Kee Chung;Sang Hyun Lee;Moon Hee Han
    • Investigative Magnetic Resonance Imaging
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    • 제5권1호
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    • pp.24-32
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    • 2001
  • Purpose : We investigated the reproducibility of language lateralization by 4 different word generation paradigms or the rest contents in each paradigm using functional magnetic resonance imaging in normal volunteers Materials and Methods Nine normal volunteers with left-handedness (mean age: 25 yrs) were examined on a 1.57 MR unit using a single-shot gradient echo epibold sequence. Four different word generation paradigms of noun, verb, adjective and adverb were used in each normal volunteer for investigating language system. In each paradigm, two different rest contents consisted of only seeing the " +" symbol or reading the meaningless letters. Each task consisted of 96 phases including 3 activations and 6 rests of 2 different contents. Two activation maps in one task were obtained under two different rest contents using the correlation method. We evaluated the detection rates of Broca and Wernicke areas and the differences of language lateralization among four different word generation paradigms, or between the rest contents. Results : The detection rates of Broca and Wernicke areas were over 67 % in 4 different language paradigms and there was no significant difference of them among language paradigms, or between two different rest contents. Language dominances, in all 4 different language paradigms, were shown to be consistent in 66 %, but were contrary with language paradigms in some subjects. The rest contents made no significant effect on dominant language dominance determination, but the success rates of the dominant language dominances determined from 4 language paradigms were higher in reading the meaningless letter (100%, n=9) than in only seeing "+" on screen at the rest task (78%, n=7).

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전신체열촬영(全身體熱撮影)에 의한 화병환자(火病患者)의 임상적(臨床的) 연구(硏究) (The clinical study of Digital Infrared Thermographic Imaging on Hwa-byung(火病) patients)

  • 김태헌;류영수
    • 동의신경정신과학회지
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    • 제10권1호
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    • pp.133-146
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    • 1999
  • First I chose a patient group and a comparative group composed of 23 members each. Then the body temperature differences in these groups was taken with D.I.T.I. The results are as follows. 1. Average body temperature of the Hwa-Byung patient group is $36.6^{\circ}C$ and that of the comparative group is $36.4^{\circ}C$. So there is no meaningful body temperature difference. 2. The hwa-Byung patient group has higher temperature than the comparative group by ${\triangle}T>1.0^{\circ}C$ at the following acupunture points in these body parts upper and lower, left and right, anterior and posterior, trunk and limb. Especially, the body temperature difference was clear in the CV-17 (jun-Joong) and the GV-4(Myung-moon). 3. When the body temperature was compared in the upper and lower part of the back, it had meaningful differences at the upper and lower acupunture points of the back in the Hwa-Byung patient group but not in the comparative group. 4. When the body temperature was compared in the left and right part of the body, its average difference was ${\triangle}T>1.0^{\circ}C$ in the two groups and the result were meaningless. 5. When body temperature was compared in the anterior and posterior part of the body, its average difference was ${\triangle}T>1.0^{\circ}C$ in the two groups and the result were meaningless. 6. When body temperature was compared in the trunk and limb part of the body, its difference in the patient group was meaningful compared with the non-patient group. From the above results, I think that D.I.T.I. could be used to objectively visualize heat sensation of the Hwa-Byung patients and make an objective concept of Han Yul in oriental medicine.

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