bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety Issues in Neuroenhancement*
Authors: LEE Sang Mok , CHOI Jong Hyun
Published: May 2019

Neuroenhancement refers to medical interventions through which healthy people improve their cognitive, emotional, and motivational function. Psychopharmaceutical substances—especially central nervous system stimulants including methylphenidate, amphetamine, modafinil—have recently become popular among students and night shift workers for enhancing cognitive function. Although health authorities in some countries have regarded pharmaceutical enhancement as a drug abuse issue and have issued restrictions or prohibitions, the use of stimulants remains prevalent. One reason why people use stimulants for neuroenhancement is that there is little information about the actual cognitive effects of stimulants; people using stimulants tend to rely on rumors which have not been proven scientifically. The purpose of this article is to provide objective information on the neuroenhancing effects and risks of stimulants. Although the possibility of addiction to methyphenidate has been exaggerated, meta-analysis shows this substance has only mild effects on cognition. Amphetamine has stronger effects on cognition than methyphenidate, but its use is ethically problematic since it can cause addiction and psychosis. Modafinil has strong cognitive enhancing effects and is safer than other psychoactive drugs, but recent studies show that it too can lead to addiction. Most studies point out that the effects of stimulants for neuroenhancement are benign and the risks of addiction should not be ignored. This article shows that the safety issue remains the main obstacle for legalizing the use of neuroenhancing drugs by healthy individuals.
Ethical Values and Human Rights Sensitivity in Nursing Students
Authors: KIM Seong Eun
Published: May 2019

This cross-sectional study examined the differences in nursing students’ human rights sensitivity relative to their ethical values. The data for this study were collected using a self-report questionnaire answered by 168 nursing students from two South Korean universities. A t-test and ANOVA were performed on the collected data using the IBM SPSS Statistics version 21.0 for Windows program. The distribution of ethical values was as follows: situationism (36.3%), exceptionism (25.0%), subjectivism (20.8%), and absolutism (17.9%). The mean score of the subjects’ human rights sensitivity was 68.3 points. There were no significant differences in the human rights sensitivity scores among the different groups based on ethical values. The results of this study suggest that human rights sensitivity should be considered in developing ethics curricula for nursing students.
Study on the Recognition, Understanding, and Satisfaction about Surgical Informed Consent Terms among Surgical Patients in a Hospital
Authors: KIM Young-Kyung , JEONG Ihn Sook
Published: May 2019

This cross-sectional study is designed to evaluate the recognition, subjective understanding (SU), and objective understanding (OU) of the terms used in obtaining informed consent for surgery and also the levels satisfaction with the explanations (ES) provided in the informed consent process. Data are collected using a structured self-report questionnaire answered by 243 patients who had orthopedic operations in South Korea in July to August, 2014. The mean number of terms recognized is 6.24, and lower in age over 50 years (F=11.46, p<0.001) and education level of elementary and middle school compared with college and higher (F=12.06, p<0.001). The mean SU was 73.90 out of 100 points and was lower in patients without a high school education than in those with a college education (F=12.39, p<0.001). The mean OU is 68.04 out of 100 points and lower in age over 50 years (F=5.91, p<0.001) and education level of elementary and middle school compared with college and higher (F=8.06, p=0.001). ES is positively correlated with both term recognition (r=0.168, p=0.009) and SU (r=0.135, p=0.035). The results of this study suggest that medical personnel should monitor patients’ recognition, understanding, and explanation satisfaction of the terms used in the consent process and give feedback to patients to enhance their understanding and explanation satisfaction.
The Roles of Patient Managers and Their Implications for Medical Ethics: An Ethnographic Study of a Plastic Surgery Clinic*,**
Authors: LEEM So Yeon
Published: May 2019

Based on long-term ethnographic fieldwork at a plastic surgery clinic, this article shows that non-medical professionals called “patient managers” have played mediating roles between patients and doctors and possibly challenged medical ethics and authorities. Unlike previous social studies of plastic surgery, rather than simply criticizing the unethical aspects of the private medical market, this study starts from their realities and considers them as resources for medical ethics. By taking the roles of non-medical professionals into both ethical and educational consideration, this study supplements current medical ethics, which is mainly concerned with medical professionals, and extends medical ethics education to include more common problems faced by patients. This study is a preliminary attempt to draw ethical implications from social studies of medicine. It demonstrates that medical ethics is a concern, not only for physicians, but for multiple agents including non-medical professionals. This kind of interdisciplinary approach can thus contribute to improving both the effectiveness of medical ethics and the social perception of doctors and medicine.
A Survey of Korean Adults’ Understanding of Medical Decision-Making*
Authors: KWON Ivo
Published: May 2019

A web survey was conducted to examine the experiences with, and understanding of medical decision-making among adults in South Korea. The subjects for the study were 500 residents, 19 years of age or older living in Seoul, Gyeonggi-do, and Incheon. The average satisfaction with the current health-care system was found to be 3.08 on a 5-point Likert scale. The degree of trust in health institutes was 3.15 and the degree of trust in medical doctors was 3.24. More than 90% of the respondents want to receive an accurate diagnosis when they experience a serious disease, and 73.2% want to be informed from the doctor directly. With respect to medical decision-making, 41.2% of subjects prefer a decision-making model that involves the doctor, the patient, and a guardian (usually a family member); 36.2% of subjects prefer that the relevant decisions be made by the patient in consultation with the doctor. More than 60.0% of subjects answered that they would respect the preference of their parents in medical decision-making, while 21.0% responded that it would depend on the condition. The gender, age, occupation, and education level all had very little influence on subjects’ responses; gender did exhibit some influence on certain items. The results of this study indicate that while Korean adults accept the importance of their own judgements in medical decision-making, many of them want to engage their guardians in the actual decision-making process.
A Study of the Effects of a Bioethics Education Program on Caregivers
Authors: JUNG Eun-Young , PARK Ji-Kyeong
Published: May 2019

The purpose of this study was to examine the effects of a bioethics education program on caregivers’ understanding of biomedical ethics and their attitudes toward the elderly. A nonequivalent control group pretest-posttest quasi-experimental design was adopted. The subjects in this study were 58 caregivers who work in long-term care facilities in South Korea. An experimental group and a control group were organized with 29 caregivers in each group, and the effects of the bioethics education program developed for this study were tested. The data were analyzed with the SPSS 19.0K statistical package. The findings of the study were as follows. First, after subjects in the experimental group received the bioethics education program, positive changes were detected in their understanding of biomedical ethics and their attitudes to the elderly. Second, the experimental group underwent more positive changes than the control group in terms of their understanding of the right to life of fetuses, artificial abortion, artificial insemination, prenatal diagnosis of fetuses, brain death and human biotechnology as well as in their attitudes toward the elderly. Accordingly, the bioethics education program that was provided to caregivers in this study had a positive effect on caregivers’ understanding of biomedical ethics and their attitudes toward the elderly.
A Study of the Role, Constitution, and Management of Hospital Ethics Committees*
Authors: KIM Sang Deuk
Published: May 2019

The purpose of this essay is to inquire into the role, constitution, and practical management of hospital ethics committees (HECs). HECs have been established to provide guidance on the ethical dilemmas physicians confront in clinical practice. While HECs carry out collective decision-making based on procedural fairness, how is procedural fairness guaranteed? Three questions can and should be raised concerning HECs: a) What exactly is the role of HECs? B) How should HECs be constituted? c) How should HECs be managed? This article addresses these questions from a philosophical point of view and argues that HEC must involve ethical experts. Furthermore, this article offers a reasonable and ethical model for HECs, the so-called “Ethics Consultation Team,” and identifies the main role of HECs as providing ethical consultation in concrete cases.
The Relation between Doctors and Patients from the Viewpoint of Medical Anthropology and Ethics
Authors: JEONG Daesung
Published: May 2019

This article illuminates the relation between doctors and patients from the viewpoint of medical anthropology and ethics. The article also identifies the social structures that can prevent doctors from acting ethically. The proper relation between doctors and patients is not the relation between “I and it,” but rather the relation between “I and you.” The virtues of trust and concern are required to bring about this proper relation between doctors and patients. Medical science should regard human beings as subjects that continually produce their own meanings and have souls. Therefore, it is argued in this article that doctors must attend not only to the physical needs of patients but also to their mental and emotional needs.
A Response to the Critics of the Prudential Lifespan Approach
Authors: LEE Kyung Do
Published: May 2019

Norman Daniels proposed the prudential lifespan approach (PLA) to resolve debates about ageism.
In this approach, he redefined the allocation of healthcare resources, especially regarding life-sustaining treatment, between age groups and tried to change the focus of the ageism debates from competition between the young and the old to personal allocative decisions within one’s lifespan. Using this approach, Daniels justified rationing healthcare resources by age in some limited settings. However, several critical problems remain with the justification of age-based rationing made by PLA. Brauer and Schefczyk have pointed to philosophical as well as practical problems with the PLA. This article examines both the PLA and the critiques of it offered by these two authors. While maintaining the basic idea of the PLA, several modifications to the justification of age-based rationing using PLA are made in order to solve these both the practical and philosophical problems. Furthermore, recommendations for the application of this modified justification of age-based rationing in a real-world setting are given.
Biomedical Ethics Awareness, Moral Self-Concepts, and Self-Esteem among College Students Majoring in Healthcare*
Authors: KIM Miok , KIM Kyung Sook
Published: May 2019

The purpose of this study was to evaluate the level of biomedical ethics awareness, moral self-concepts, and self-esteem among college students majoring in healthcare. This study employed a crosssectional survey design. The participants were 268 third- or fourth-year university students majoring in healthcare in South Korea. The statistical analyses include descriptive statistics of the respondents’ general characteristics, and the data were analyzed with a t-test and ANOVA using the SPSS WIN 18.0 program. The average score for biomedical ethics awareness was 2.01±0.20 (using a 4-point Likert scale); the scores for self-esteem and moral self-concepts were 2.04±0.45, and 2.17±0.31 respectively. Biomedical ethics awareness showed a positive correlation with moral self-concepts (r=.157, p=.011); and selfesteem showed a positive correlation with moral self-concepts (r=.596, p<.001). Reproductive ethics (r=.124, p=.043) and the right to life (r=.147, p=.016), sub-domains of biomedical ethics awareness, also showed positive correlations with moral self-concepts. The results of this study suggest that biomedical ethics education should focus primarily on reproductive ethics, the right to life, and the ethics of death.
Parents’ Understanding of, and Satisfaction with, the Explanations Provided in Pediatric Clinical Trials
Authors: AHN Ju Hee , YOON Young Ran , NA Yeon Kyung , HONG Hae Sook
Published: May 2019

The purpose of this study was to assess parents’ understanding of, and satisfaction with, the explanations provided by researchers conducting pediatric clinical trials. Self-report questionnaires were collected from forty one parents of children treated at a national university hospital in South Korea. A Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation test were performed on the collected data using SPSS Statistics 20.0. The mean for understanding was 71.1 points out of 100. The item that was best understood was collective benefit (84.3 points); the item that was least understood was compensation for risk (40.9 points). The predictors of understanding were the explanation time of the researcher (p=.045) and the feelings of difficulty with the researcher’s explanation (p=.033). The mean for explanation satisfaction was 73.6 points and was related to understanding (p<.001). The results of this study suggest that researchers in pediatric clinical trials should identify items that parents are likely to find difficult to understand, spend sufficient time explaining procedures to parents, and match the level of the explanations they offered to individual parents’ general level of understanding.
The Ethics of For-profit Healthcare and Medical Tourism in South Korea
Authors: McGuire John Michael
Published: May 2019

On December 18, 2015, South Korea’s Ministry of Health and Welfare formally approved the establishment of Korea’s first corporate-owned for-profit hospital. The establishment of this hospital, which will be named Greenland International Hospital (GIH), raises two distinct but overlapping sets of ethical concerns. One set of concerns relates to the fact that GIH will be engaged in for-profit medicine, which some believe is incompatible with the ethical principles that are thought to govern medical practice. The second set of ethical concerns relates to the fact that GIH is being established in an effort to further develop Korea’s burgeoning industry in medical tourism, an industry that has recently attracted academic interest in light of the ethical concerns that it raises. In this paper I draw on some of the existing literature concerning the ethics of for-profit medicine and medical tourism in an attempt to shed light on the ethical issues involved in the recent decision by the South Korean government to approve the establishment of GIH.
An Examination of the Principles of Biomedical Ethics, Confucian Bioethics and Personalist Bioethics
Authors: SON Bo Mee
Published: May 2019

This article examines the central principles and implications of medical ethics from three perspectives: biomedical ethics, Confucian bioethics, and personalist bioethics. The most basic principle of these three ethical frameworks is that all the three share respect for human dignity and human rights. However, in order to fully respect human rights it is necessary to protect human life. Therefore, this article argues that the principle of autonomy should not be regarded as the paramount ethical principle of medical decision-making.
Development of Integrated Palliative Care Model for Clinical Nurses Caring for Cancer Patients*
Authors: JO Kae-Hwa , LEE Jin Ju , PARK Ae-Ran , CHOI Su-Jung
Published: May 2019

This study was conducted to examine the factors influencing and to test structural equation modeling on the integrated palliative care. The subjects were randomly selected 570 nurses working hospitals over 500 beds in Daegu Metropolitan City. The data were collected from March 1st to April 30th in 2016 with self-reported survey form. Data were analyzed using by IBM SPSS Program 19.0 and AMOS Program 19.0. Upon the results of this study, comfort and ethical climate of the nurses were confirmed to influence directly to integrated palliative care, and their empathy ability and ethical climate were confirmed to influence indirectly to integrated palliative care with the intermediary of comfort. Based on the study results, the interventions are required to improve positive ethical climate and comfort of the nurses. In addition, the clinical training programs are required including the contents of comfort and empathy ability of the nurses.
Moral Distress Experienced by Nurses in South Korea: An Integrated Review
Authors: PARK Bohyun , OH Younjae
Published: May 2019

Nurses are frequently faced with ethical dilemmas in their nursing practice. Nurse can experience moral distress when they know the morally correct response to a situation but cannot act accordingly because of institutional or hierarchical constraints. The aim of this integrated review was to synthesize the available quantitative and qualitative evidence in the literature on moral distress experienced by nurses. We appraised seven articles published between January 1984 and December 2015. This review revealed that many nurses in South Korea experience moral distress associated with difficult care situations and feel negative psychological symptoms, which can have an impact on their job performance. Further research is required to examine workplace strategies to support nurses in these situations and to develop coping strategies for dealing with moral distress.
Consent Withdrawal in Assisted Reproductive Technology and the Reconstitution of Reproductive Autonomy
Authors: YOO Sujung
Published: May 2019

The provisions of South Korea’s ‘Bioethics and Safety Act’ related to the creation of embryos using assisted reproductive technology allow for consent to be withdrawal at any stage in the process. However, in cases in which the creation of an embryo involves two individuals, the consent withdrawal of one participant may damage or infringe upon the other participant’s reproductive autonomy. In this article I argue that the provisions of the ‘Bioethics and Safety Act’ that allow for consent withdrawal at any time result from a tendency to identify informed consent with a flawed notion of autonomy, one that is found in the work of Beauchamp and Childress. The article criticizes this notion of autonomy and proposes relational concept of autonomy as a better alternative. Relational autonomy includes social, political, and even economic considerations in addition to individual relationships. Finally, this article suggests several methods to prevent conflicts from arising in the consent process for embryo creation.
A Comparative Study on the Perceptions of Elderly Patients and Their Caregivers toward Life-Sustaining Treatment*
Authors: HWANG Hyeyoung , YANG Sook Ja
Published: May 2019

The purpose of this study was to compare the perceptions of elderly patients and their caregivers toward life-sustaining treatment (LST). This study was a descriptive investigation using a structured questionnaire administered to ninety elderly patients and their main caregivers. The data were collected from three general hospitals in Seoul and analyzed using IBM SPSS Statistics version 23. The significant differences between the perceptions of the elderly patients and those of their caregivers are as follows: the experience of having heard of LST (χ2=3.90, p=.048), the time required to determine the need for an LST (χ2=13.49, p=.010), the main reason for the need for LST (χ2=12.18, p=.014), opinions on hospice palliative care (χ2=9.45, p=.002), the appropriate person to act as a patient’s surrogate (χ2=6.77, p=.034), and the requirements for acting as a surrogate (χ2=21.61, p<.001). Study findings indicate that both groups have a high level of interest in self-determination and Korean society is following the standard of substituted judgement, which presumes the opinion of the patient from a surrogate’s point of view. Therefore, developing guidelines for LST decision-making that takes into account the cultural features of South Korea could contribute to LST decision-making that respects the patients’ self-determination.
Communicative Feminist Bioethics and Shared Decision-Making*
Authors: LEE Eun-Young
Published: May 2019

Shared decision-making is a collaborative medical decision-making process between patients and their health care providers. This process aims to assist patients in taking an active role in making decisions related to their own health. Patient-centered care can be seen as the ultimate goal. In order to exhibit its effectiveness as a process that actualizes patient-centered care, shared decision-making must resolve problems caused by an imbalance in both power and knowledge between doctors and patients. This article propose communicative feminist bioethics as theoretical foundation to resolve imbalance in shared decision-making. Communicative feminist bioethics regards empathy and relationships as the foundation of shared decision-making and seeks to strengthen the ability of patients and doctors to make decisions together. Shared decision-making based on empathy and relationships, doctors refrain from expressing or imposing their own values on patients and instead encourage patients to develop the skills necessary to look after themselves. This article argues from a feminist discourse and perspective that doctors should strive develop relationships of equality that respect patients as competent decision-makers.
Two Conceptions of Autonomy in Surrogate Decision-Making for Life-Sustaining Treatment: An Examination of Article 18 of the Hospice, Palliative Care, and Life-Sustaining Treatment Decision-Making Act*
Authors: KIM Claire Junga
Published: May 2019

It is necessary to have a conception of autonomy that can plausibly explain the interaction between patients and family members or patients and significant others in order to craft effective principles for surrogate decision-making concerning life-sustaining treatment. In this article the author contrasts two possible conceptions of autonomy―family autonomy and relational autonomy―that are thought to explain the relationships between patients and family members or patients and significant others. In doing so, the author aims to determine the best conception of autonomy for surrogate decision-making. In article 18 of the newly enacted Hospice, Palliative Care, and Life-Sustaining Treatment Decision-Making Act, family members are authorized to make surrogate decisions. However, the law does not provide any criteria for surrogate decision-making or limit the surrogates’ authority. The author applies the aforementioned conceptions of autonomy to article 18 and examines the possible outcomes. It is concluded that that relational autonomy is the best conception of autonomy in the context of surrogate decision-making concerning end-of-life decisions. This conception allows due regard to be given to the role of family members and significant others. Moreover, additional support is provided for the relational concept of autonomy by the significant level of equal liberty that this concept ensures.
Toward Effective Human Research Protection: The Current Status and Limitations of the Human Research Protection Program in Korea*,**
Authors: JUNG Junho , KIM Jeong Hyun , JUNG Se Hee , KIM Ock-Joo
Published: May 2019

Korea has witnessed rapid growth in the clinical trial industry in past 10 years. Public concern regarding the rights and safety of human research participants has been a major issue in the field. As the need for a more effective system of protection for human subjects grows, one which surpasses the scope of the Institutional Review Board (IRB), the Korean Ministry of Food and Drug Safety (MFDS) has issued its “Operation Guidelines for Human Research Protection Program (HRPP)” in 2014. It is the first government-initiated adoption of a HRPP in the world. This study shows that there is great deal of variation in clinical trial institutes in terms of their size and systems of operation and that many small- to medium-sized clinical trial institutes are not willing to adopt HRPP. The current MFDS HRPP policy does not reflect the differences in the various clinical trial institutes, which leads to a low adoption rate in HRPP in Korea. Furthermore, the government-initiated HRPP policy may puts more burdens on smaller organizations. Despite the limitations of the current HRPP policy, it is argued in this article that strong leadership to promote HRPP by the Korean government can improve clinical trial participant protection and the quality of clinical trials in Korea. Future policy for establishing and promoting HRPP in Korea should encompass considerations of the variability in the characteristics of clinical trial institutes as well as measures for enhancing the understanding of HRPP in the research community.
Ethical Issues in the Distinction between Discarded and Created Embryos: The Nothing Is Lost Principle
Authors: LEE Hyang Yeon
Published: May 2019

Stem cell research raises many ethical issues, including the possible harms that are done to early embryos in the process of deriving stem cells. There are two basic stances concerning human embryonic stem cell research: one supports the research and regards the destruction of embryos as an acceptable cost; the other rejects the research and foregoes the potential benefits that the research might offer. In this article, I examine each of these stances and consider a flexible middle-ground position. Additionally, I introduce the Nothing-is-Lost Principle as one element of this middle-ground position and examine whether or not it justifies the discarded-created distinction. I suggest that there is a need for improved guidelines and regulations concerning stem cell research.
The Ethical Issues in Genome Editing and a Review of Korea’s Bioethics and Biosafety Act*
Authors: KIM Hyunseop
Published: May 2019

This article, which is written in response to the recent development of genome editing technologies, examines the ethical issues of gene therapy and genetic enhancement as well as the justifiability of the relevant clauses of Korea’s Bioethics and Biosafety Act. I argue that somatic genome-editing therapies should be regulated in the same way as other gene therapies, that the regulations should be individualized in light of the advantages and disadvantages of each technology, and that these regulations should be multiphased such that the risk-benefit analysis at each stage should be taken into account in deciding whether to proceed to the next stage of research. Furthermore, I argue that the current regulation of research on redundant human embryos from in vitro fertilization (IVF) should be revised, that new regulations on the gene editing of human eggs and sperms should be set up, that gene-editing research on relevant somatic cells and animal models should precede preclinical studies on heritable human gene editing, and that the results of preclinical studies should be taken into account in considering whether to allow clinical trials of human germline editing. I conclude by calling for regulations on human genome editing for enhancement and describing the role of Korea’s National Bioethics Committee in reforming existing regulations.
The Relationships between Moral Self-Concept, Ethical Sensitivity, and Empathy in College Students*
Authors: KIM Jimee , HONG Sung-Kyung
Published: May 2019

The purpose of this study was to determine the relationships between moral self-concept (MSC), ethical sensitivity (ES), and empathy in college students in South Korea. This study was a descriptive investigation using a structured questionnaire administered to 625 college students in one city in Gyeonggi-do, South Korea. The data were analyzed by means of a canonical correlation analysis using PASW Statistics 18.0. The mean score for MSC was 3.11±0.34; ES and empathy were 3.92±0.53, 3.59±0.38, respectively. The complicated correlations between MSC, ES, and empathy were identified. The canonical variate indicated that the subjects had lower “moral self-identification,” “moral self-acceptance,” “moral self-action” ; and “ES” showed lower “perspective taking,” “do imagine,” and “empathic concern.” The results of this study indicate that there is a need for educational strategies to nurture MSC, ES, and empathy in Korean college students.
The Roles of Hospital Ethics Committee and Clinical Ethics Consultation Teams*
Authors: HEO Dae Seog , PARK Hye Yoon , HONG Jinui , LEE Jinwoo , KEAM Bhumsuk
Published: May 2019

New legislation on hospice-palliative care and end-of-life decision-making in Korea comes into effect in February 2018. Hospital Ethics Committees (HECs) will play a key role in deciding controversial cases. HECs have existed in Korea for decades, but most of their work has been directed toward dispute mediation. With the new legislation coming into effect, HECs will now concentrate on end-of-life issues. However, since there are many other ethical issues that arise in clinical practice, the roles of HECs need to be reconsidered and perhaps reconfigured. Since HECs tend to convene on a monthly basis, they are illequipped to deal with end-of-life decisions, which often must be made within hours or a few days. Clinical ethics consultation teams can bridge the gap between the urgent demands of clinical practice and the slower and more formal activities of HECs. This article argues that it is necessary for HECs to delegate some of their roles or responsibilities to clinical ethics consultation teams.
Clinical Ethics Consultation and Hospital Ethics Committees*
Authors: CHOI Kyungsuk
Published: May 2019

This article addresses the question of what is an appropriate Korean translation of “clinical ethics consultation” and also interprets clinical ethics as a branch of medical ethics. Three models of clinical ethics consultation are introduced: an authoritarian approach, a pure facilitation approach, and an ethics facilitation approach. The author argues that an ethics facilitation approach is the most desirable one in a pluralistic society. Contemporary Korean society is moving in the direction of a pluralistic society, with both eastern and western influences as well as progressive and traditional forces. Where there is no single, dominant value system, it is desirable that consultants try to help relevant parties reach reasonable conclusions within moral boundaries rather than recommend one conclusion. In a pluralistic society, an ethics facilitation approach does not imply moral relativism. Hospital ethics committees established according to the current law should be organized to provide clinical ethics consultation. While the current law limits the role of hospital ethics committees to the withholding or withdrawal of life-sustaining treatment that their role should be broadened into fully-fledged hospital ethics committees that cooperates with a team taking multi-disciplinary approaches to the resolution of ethical issues.
The Globalization of Healthcare and Ethical Problems in Korea
Authors: LIM Juwon , JUNG Junho , SHIN Yeunsun , KIM Ock-joo
Published: May 2019

The globalization of healthcare is a multi-layered phenomenon in Korea. Medical tourism, which has emerged as a major trading resource and engine of economic growth, is receiving strong support from the government. At the same time, the number of multicultural patients with inadequate access to basic medical services is rapidly increasing. This article examines the ethical issues related to the globalization of healthcare in Korea as well as some of the ethical problems caused by insufficient clinical and cultural competence within the medical profession. Failure to understand the health-related differences between regions and cultures can compromise the quality of healthcare. Furthermore, language and cultural barriers can cause inequity by hindering access to health care. This article argues that in order to resolve the problems of polarization and inequality in a globalized healthcare system, efforts must be made to ensure the clinical and cultural competency of medical professionals in Korea.
The Sexual Harassment of Residents by Professors in University Hospitals
Authors: PARK Chang-Bum
Published: May 2019

The sexual harassment of residents by professors in university hospitals has recently received significant public attention. Causal factors contributing to this form of sexual harassment include the hierarchical and authoritarian working culture in university hospitals, the tradition of semi-coercive social gatherings, the sense of tribalism among professors, and the structure of resident training programs. This article makes several policy proposals for eliminating or reducing instances of sexual harassment of residents by university professors, including the implementation of practical education programs for professors and strong punishment for offenders, such as salary reductions, short-term suspensions, and even dismissal. The culture of drinking in semi-coercive social gatherings must also be eradicated, and residents must be able to move easily to other training hospitals to protect themselves from sexual harassment. However, in order for such changes to take place, government action in the form of new legislation is required.
The Search for a Moral Metaphysics in Artificial Intelligence Robot Medicine: The Responsibility of an Electronic Human in Medicine*
Authors: JEONG Chang Rok
Published: May 2019

The European Parliament is currently considering a proposal to grant artificial intelligence (AI) robots the legal status of “electronic persons”. This article examines the metaphysical status of AI robots and considers the some of the ethical questions that arise from the use of AI robots in the practice of medicine. In particular, would electronic human doctors have rights? And to what extent could they be held responsible for their behavior? In answering these questions this article considers the concept of a “kill switch” and how it relates to the notion of freedom that is presupposed by a Kantian understanding of responsibility. The article also outlines some of the new horizons opened up by the arrival of Watson in medicine, including the emergence of “self-care medicine” and the possibility of “universal self-care.” This article argues that in light of the advent of electronic human doctors, the new role for human health care personnel is that of a “kill switcher.”
Using a Health Care Proxy to Overcome Limitations of the Act on Decisions on Life-sustaining Treatment*
Authors: KIM Bobae , KIM Myunghee
Published: May 2019

The Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for patients at the End of Life was finally signed into law in South Korea following a long process of consensus-building. However, the appointment of proxy decision-makers was excluded from the recommendations made by the National Bioethics Committee and was not included in the provisions concerning life-sustaining treatment. Considering the increasing number of single-person families as well as the limited information that is typically available in making decisions concerning life-sustaining treatment, a system for designating surrogate decision-makers should be introduced into the provisions on life-sustaining treatment. The most appropriate system, which is currently used in the United States, is one that allows patients to designate healthcare proxies to make decisions on their behalf. A designated agent can make the best decisions for a patient based on both a substituted judgment standard as well as a best interest tandard. However, when the two standards conflict or in other cases in which it is difficult to administer the decision of the designated agent, we recommend that the system allow physicians to receive help from either an institutional ethics committee or a clinical ethics service.
Criminal Issues of Artificial Abortion
Authors: LEE Keun-Woo
Published: May 2019

Korean criminal law punishes abortion in principle and treats it as illegal unless it falls within the scope of specific exceptions. However, the provisions of the criminal law and the Mother and Child Health Act are not entirely consistent with each other. In addition, societal views on the status of women in abortion have changed in recent years. Views now range from the total abolition of the ban on abortion to the strengthening of punishment for the crime of abortion. This article critically examines some of the theoretical issues that are overlooked in typical discussions concerning abortion. More specifically, the article examines abortion from the perspective of the criminal law in an effort to provide some suggestions on how to resolve the moral conflict at the heart of the abortion debate.
Ethical Principles for Consent in Human Subject Research: A Focus on Research Involving Vulnerable People and the Disabled*
Authors: CHOI Kyungsuk
Published: May 2019

Research involving human subjects is necessary in the biomedical sciences. One of the main ethical issues involved in this area is how research involving human subjects can be carried out without infringing upon human dignity. In this article I argue that respect for autonomy is not the only ethical principle for research on human subjects. I identify and explain the other ethical principles that are required for obtaining informed consent. For competent human subjects, respect for autonomy demands that informed consent be obtained, but in the case of substituted consent I argue that the principle of autonomy is insufficient and that a best-interest standard is required. However, this standard should be applied with some qualification. I claim that the only principle that can justify the waiver of informed consent is utilitarian in nature, but in this case the research should not involve more than minimal risk to the human subjects. In addition to describing the ordering and qualifications concerning the three core principles of autonomy, best-interest, and utilitarianism this article examines international codes for the protection of vulnerable people, substituted consent, and the waiver of informed consent.
Should We Be Physicians as Good Samaritans?*
Authors: BAE Hyuna
Published: May 2019

Good Samaritan laws are designed to encourage individuals, including physicians, to provide medical care in emergency situations. Such laws purport to protect physicians and others who volunteer to provide assistance during emergencies. However, whether Good Samaritan laws, such as the Korean Emergency Service Act article 5-2, really do protect physicians is uncertain and varies from case to case. When attempts at providing emergency medical care do not go as expected, and legal disputes arise, such disputes will inevitably affect how other physicians respond to future medical emergencies. In this article I argue that the current legislation needs to be revised and expanded to fully protect physicians who provide emergency medical care in good faith. In particular, the relevant laws must also protect physicians who render emergency aid hospital settings when they have no pre-existing duty to provide assistance.
Una variante pedagógica de la investigación-acción educativa
Authors: Restrepo Gómez Bernardo
Published: May 2019

Este artículo presenta una variante de la investigación-acción educativa impulsada por Stephen Corey en la década del 50, por Lawrence Stenhouse y John Elliot desde la década del 70 y por otros proponentes australianos, ingleses y americanos en los últimos 30 años. La variante es el resultado de aplicar la metodología a la «transformación de la práctica pedagógica personal» de los docentes, más que a otras prácticas escolares. Esta variante o modelo particular es el resultado de cinco años de trabajo con grupos o cohortes de maestros investigadores y más concretamente de los dos últimos años en los cuales se contó con la cofinanciación de COLCIENCI-AS, Instituto Colombiano Estatal para el fomento de la Ciencia y la Tecnología.
5 principios de la neuroeducación que la familia debería saber y poner en práctica
Authors: Bueno Torrens David , Forés Miravalles Anna
Published: May 2019

Durante estas dos últimas décadas, los estudios en neurociencia y neurociencia cognitiva han estado aportando datos muy interesantes sobre cómo se construye y aprende el cerebro. Aplicados a la educación, en lo que se viene en llamar neuroeducación, deben dejar de ser una disciplina estudiada solo en contextos neurocientíficos y pedagógicos para llegar a toda la sociedad, a todas aquellas personas interesadas en los aprendizajes de sus hijos e hijas y en los suyos propios. Este artículo pretende aproximar al lector los 5 principios básicos de la neuroeducación que deben conocer los padres y madres para llevarlos a la práctica y fomentar el aprendizaje y una vida más digna.

El trabajo se basa en estudios y escritos previos realizados por ambos autores desde la perspectiva más biológica y la perspectiva más educativa. Esta mirada transdisciplinar favorece romper ciertas fronteras de saberes cerrados para dar una visión más alineada con el funcionamiento integrado e integrador del cerebro.

Es importante que las familias y la sociedad en general, incluidos los organismos de toma de decisiones educativas, conozcan cómo podemos favorecer la educación de las nuevas generaciones a partir del conocimiento de cómo aprende el cerebro. Este artículo se enmarca en este objetivo de divulgación social.
Intimate Partner Violence: Promoting the Need for Adequate Screening, Assessment and Interventions for Physical and Mental Conditions Resulting from Intimate Partner Violence
Authors: Kennedy Bernice ,   BRK Global Healthcare Consulting Firm, LLC
Published: May 2019

Intimate partner violence is a public health problem having a tremendous impact on women’s health. Also, intimidate partner violence, also known as domestic violence is the primary cause of injury to women in the United States. Physical and psychiatric problems are the result of domestic violence with victims having increase use of health services compared to those not abused. Often, domestic violence is not identified in the health services organizations when victims access health care. This analytical review of the literature addressed existing research and literature on the current status of intimate partner violence. The Holistic Model Based on Adequate Screening, Assessment and Interventions for Improving the Health Outcomes in Victims of Intimate Partner Violence is a useful model for guiding health professionals in recognizing the relevance of violence when women present certain illnesses in diverse health services organizations. Strategies for improving the health outcomes for this group include: (a) adequate screening, assessment, and interventions; (b) more education for health professionals on assessing victims of violence; (c) domestic violence included in the curriculum of universities and colleges for health professionals; (d) continuing education on domestic violence in the workplace; and (e) assess for signs and symptoms of domestic violence and conduct valid screening and assessment tools on patients in certain health services organizations when women access to care. More policy development is needed for victims of intimate partner violence to improve health outcomes.
Design of a double-decker coordination cage revisited to make new cages and exemplify ligand isomerism
Authors: Samantray Sagarika , Bandi Sreenivasulu , Chand Dillip K
Published: May 2019

The complexation study of cis-protected and bare palladium(II) components with a new tridentate ligand, i.e., pyridine-3,5-diylbis(methylene) dinicotinate (L1) is the focus of this work. Complexation of cis-Pd(tmeda)(NO3)2 with L1 at a 1:1 or 3:2 ratio produced [Pd(tmeda)(L1)](NO3)2 (1a). The reaction mixture obtained at 3:2 ratio upon prolonged heating, produced a small amount of [Pd3(tmeda)3(L1)2](NO3)6 (2a). Complexation of Pd(NO3)2 with L1 at a 1:2 or 3:4 ratios afforded [Pd(L1)2](NO3)2 (3a) and [(NO3)2@Pd3(L1)4](NO3)4 (4a), respectively. The encapsulated NO3– ions of 4a undergo anion exchange with halides (F–, Cl– and Br– but not with I–) to form [(X)2@Pd3(L1)4](NO3)4 5a–7a. The coordination behaviour of ligand L1 and some dynamic properties of these complexes are compared with a set of known complexes prepared using the regioisomeric ligand bis(pyridin-3-ylmethyl)pyridine-3,5-dicarboxylate (L2). Importantly, a ligand isomerism phenomenon is claimed by considering complexes prepared from L1 and L2.
Observations of the Kepler Field with TESS: Predictions for Planet Yield and Observable Features
Authors: Christ Callista N. , Montet Benjamin T. , Fabrycky Daniel C.
Published: May 2019

We examine the ability of the Transiting Exoplanet Survey Satellite (TESS) to detect and improve our understanding of planetary systems in the Kepler field. By modeling the expected transits of all confirmed and candidate planets detected by Kepler as expected to be observed by TESS, we provide a probabilistic forecast of the detection of each Kepler planet in TESS data. We find that TESS has a greater than 50% chance of detecting 260 of these planets at the 3σ level in one sector of observations and an additional 120 planets in two sectors. Most of these are large planets in short orbits around their host stars, although a small number of rocky planets are expected to be recovered. Most of these systems have only one known transiting planet; in only ∼5% of known multiply transiting systems do we anticipate more than one planet to be recovered. When these planets are recovered, we expect TESS to be a powerful tool to characterize transit timing variations. Using Kepler-88 (KOI-142) as an example, we show that TESS will improve measurements of planet–star mass ratios and orbital parameters, and significantly reduce the transit timing uncertainty in future years. Because TESS will be most sensitive to hot Jupiters, we research whether TESS will be able to detect tidal orbital decay in these systems. We find two confirmed planetary systems (Kepler-2 b and Kepler-13 b) and five candidate systems that will be good candidates to detect tidal decay.