Heo, Dae Seog;Yoo, Shin Hye;Keam, Bhumsuk;Yoo, Sang Ho;Koh, Younsuck
Journal of Hospice and Palliative Care
/
v.25
no.1
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pp.1-11
/
2022
The Act on Decisions on Life-Sustaining Treatment has been in effect since 2018 for end-of-life patients. However, only 20~25% of deaths of terminally ill patients comply with the law, while the remaining 75~80% do not. There is significant confusion in how the law distinguishes between those in the terminal stage and those in the dying process. These 2 stages can be hard to distinguish, and they should be understood as a single unified "terminal stage." The number of medical institutions eligible for life-sustaining treatment decisions should be legally expanded to properly reflect patients' wishes. To prevent unnecessary suffering resulting from futile life-sustaining treatment, life-sustaining treatment decisions for terminal patients without the needed familial relationships should be permitted and made by hospital ethics committees. Adult patients should be permitted to assign a legal representative appointed in advance to represent them. Medical records can be substituted for a patient's judgment letter (No. 9) and an implementation letter (No. 13) for the decision to suspend life-sustaining treatment. Forms 1, 10, 11, and 12 should be combined into a single form. The purpose of the Life-sustaining Medical Decisions Act is to respect patients' right to self-determination and protect their best interests. Issues related to the act that have emerged in the 3 years since its implementation must be analyzed, and a plan should be devised to improve upon its shortcomings.
Purpose: This study aimed to investigate the involvement of patients who died from hematologic neoplasms in the decision-making process surrounding the withdrawal of life-sustaining treatment (LST). Methods: A total of 255 patients diagnosed with hematologic neoplasms who ultimately died following decisions related to LST during their end-of-life period at a university hospital were included in the study. Data were retrospectively obtained from electronic medical records and analyzed utilizing the chi-square test, independent t-test, and logistic regression. Results: In total, 42.0% of patients participated in the decision-making process regarding LST for their hematologic neoplasms, while 58.0% of decisions were made with family involvement. Among these patients, 65.1% died in general wards and 34.9% in intensive care units (ICUs) as a result of decisions such as the suspension of LST. The period from the LST decision to death was longer when the decision was made by the patient (average, 27.15 days) than when it was made by the family (average, 7.48 days). Most decisions were made by doctors and family members in the ICU, where only 20.6% of patients exercised their right to make decisions regarding LST, a rate considerably lower than 79.4% observed in general wards. Decisions to withhold or withdraw LST were more commonly made by patients themselves than by their families. Conclusion: The key to discussing the decision to suspend hospice care and LST is respecting the patient's self-determination. If a patient is lucid prior to admission to the ICU, considerations about suspending LST should involve the patient input.
Purpose: The purpose of our study was to introduce an oath and ethics code for emergency medical technicians (EMTs). Methods: The proposed oath and ethics code for the EMTs was evaluated using a modified Delphi technique. This oath and ethics code was presented at Korean association of emergency medical technician conference and was revised by experts in emergency medical services. Results: We examined the ethics codes for other allied healthcare professionals regarding the topics of human rights, health promotion, acting as an advocate, ethics, cooperation, observance, human rights, right to know, self-determination, confidentiality, and professionalism. These elements are reflected in our proposed oath and ethics code for EMTs. Conclusion: The proposed oath and ethics code would raise the professional status of EMTs.
Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others'. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one's choice by free will.
Under the Korean case law, physicians are obliged to disclose or inform the risk associated with a specific treatment to their patients before they perform the treatment. If they fail to do this, they are liable to compensate pain and sufferings. If the patient can establish that he or she would not have consented at all to the treatment had he or she been informed, the physicians are liable to compensate all the loss incurred by the treatment. In this article, the author examines the legitimacy of this case law from the perspective of legal doctrine as well as its practical affect on the medical practice and the furtherance of self-determination of the patient. The fundamental findings are as follows: The case law that has physicians who failed to inform treatment risk compensate pain and sufferings for the infringement of the right of self-determination seems to be a disguised and reduced compensation of all the loss based on the possible malpractice, which cannot be justified in view of the general principles of tort liability. It is necessary to adhere to the requirements of causation and imputation between the failure to inform treatment risk and the specific patient's consent to the treatment. If this causation and imputation is established, all the loss should be compensated. Otherwise, there shall be no liability. The so-called hypothetical consent defence shall be regarded as a part of causation between the failure to inform and the consent. The suggested approach can preserve the essence of physician-patient relationship and fit for the very logic of informed consent better.
With the advent of the Internet and the development of mobile digital devices such as smartphones and tablet PCs, the communication service paradigm began to shift from existing voice services to data services. Recently, as social network services (SNS) are activated and 4th industrial revolution technologies centered on ICT (Information and Communication Technologies) such as Big Data, Blockchain, Cloud, and 5G/6G are rapidly developed, the amount of shared data type and the amount of data are increasing rapidly. As the transition to a digital society begins actively, the importance of using data information, as well as the economic and social values of personal information are becoming increasingly important. As a result, they are actively discussing policies to revitalize the data information industry around the world and ways to efficiently obtain, analyze, and utilize increasingly diverse and vast data, as well as to protect/guarantee the rights of information subjects (providers) in various fields such as society, culture, economy, and politics.. In this paper, in order to improve the self-determination right of personal information on data produced by information subjects, and further expand the use of safe data and the data economy, a differentiated data trusts system was considered and suggested. In addition, the components and data trusts procedures necessary to efficiently operate the data trusts system in Korea were considered, and the non-profit data trusts system and the for-profit data trusts system were considered as a way to flexibly operate the data trusts system. Furthermore, the legal items necessary for the implementation of the data trusts system were investigated and considered. In this paper, in order to propose a domestic data trusts system, cases related to existing data trusts systems such as the United States, Japan, and Korea were reviewed and analyzed. In addition, in order to prepare legislation necessary for the data trusts system, data-related laws in major countries and domestic legal and policy trends were reviewed to study the rights that conflict or overlap with existing laws, and differences were investigated and considered. The Data trusts system proposed in this paper is a reasonable system that is expected to recognize the asset value of data in the capitalist market economy system, to provide legitimate compensation for data produced by data subjects, and further to contribute greatly to the use of safe data and creation of a new service market.
Man pursues health as his basic right. Therefore, the government should try to preserve the right of the people's health and carry out the policy of medical treatment for that. But the system of our medical care is advantageous to the medical institutions, which produce medical goods each people buys and sells freely, more than to the maintenance and improvement of their health. That is to say, the first aim of the institution is not the healthy preservation of the people but their accumulation of riches. The medical conflicts are the social situation which is happening between those who produce medical treatment and the patients who consume it. Its behinning comes from the lack of belief by the inhuman relationship between patients and doctors. According to thelatest investigation, the patients of oriental clinics look more content than those who go to common hospitals. The reasons are as follows; fitness to one's physical constitution, the kind altitude of doctors and the view of oriental medicine toward human body. Though the content degreee is higher than western medicine, such conclusions result from the present condition the number of the patients is less. In short, the first, since the right of patients is higher and the fields make more variors and popular, the conflicts and mistakes go on increasing. The second, in their activity of treatment, the legal importance of atlention and explanatory obligation should be considered seriously so as not to break out medical mistakes. The third, in the center of technical books which are accepted by the academic world, the clinical exertion doing treatment is needful. The fourth, as the direct order of medical justification the self-determination of patients should be respected. The fifth, because the process and record of treatment become important in the time of emergency legally, the conversations and movements as well as the details of treatment must be recorded. The sixth, the academic effort about the settlement institution or the legal system is necessary.
This study aims to critically discuss the problems that need to be solved from a humanities perspective in order to utilize big data. It identifies and discusses three research problems that may arise from collecting, processing, and using big data. First, it looks at the fake information circulating with regard to problems with the data itself, specifically looking at article-type advertisements and fake news related to politics. Second, discrimination by the algorithm was cited as a problem with big data processing and its results. This discrimination was seen while searching for engineers on the portal site. Finally, problems related to the invasion of personal related information were seen in three categories: the right to privacy, the right to self-determination of information, and the right to be forgotten. This study is meaningful in that it points out the problems facing in the aspect of big data utilization from the humanities perspective in the era of big data and discusses possible problems in the collection, processing, and use of big data, respectively.
Most Consumers don't pay attention the process of giving consent for the provision of personal information. The terms of giving consent of personal information provision including 3rd party provision related contents. Although personal information leakage were related 3rd party sharing, consumers can't recognize the details. Therefore, this study focused on the perception of 3rd party provision of personal information. Consumers recognized 3rd party as who are related the service offer or not. Consumers want to know the cases of personal information sharing to the 3rd party, and if the business operators got benefit to share personal information with 3rd party, consumers want to know the facts. To understand the terms easily, the format have to be revised and to be standardized. Standardization of consent forms is very important for consumers to understand the difficult documents and the development of the business system to collect and use consumer's personal information to guarantee the right to self-determination of personal information.
Companies using internet as a kind of marketing means are increasing rapidly according to the expansion trend of e-commerce through internet and consumers also use internet as the common means of purchasing necessary articles. E-commerce using internet has advantages without limitation to temporal and spatial accessibility and general consumers and unspecified individuals also use internet to purchase their goods as well as general transactions such as advertisement, contract, payment and claim settlement. 'In the age of information, invasion of personal information resulted from the development of information and communication technology is one of the greatest problems all the countries in the world face. Therefore, Personal information protection Act is one of basic laws to protect personal information and rights and it is also an essential law in the age of information. In that sense, new Personal information protection Act is the advanced act containing various items to minimize the national damages from the leaking of private information and protect right to informational self-determination in the information society. It is expected that this legislation contributes to reduce the leaking of private information, enhance the level of privacy protection and develop privacy related industries. However, active participation of all members of our society and improvement of their recognition should be preceded for the rational and legal use of private information and the settlement of its protection culture. While the purpose of Personal information protection Act can protect privacy from collection, leaking, misuse and abuse of private information and enhance national interests and protect personal dignity and value, it also must perform the roles of balancing privacy protection with liberal information flow.
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