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논문 기본 정보

자료유형
학술저널
저자정보
Yoo Shin Hye (Center for Palliative Care and Clinical Ethics Seoul National University Hospital Seoul Korea.) Kim Yejin (Center for Palliative Care and Clinical Ethics Seoul National University Hospital Seoul Korea.) Choi Wonho (Center for Palliative Care and Clinical Ethics Seoul National University Hospital Seoul Korea.) Shin Jeongmi (Center for Palliative Care and Clinical Ethics Seoul National University Hospital Seoul Korea.Public Healthcare Center Seoul National University Hospital Seoul Korea.) Kim Min Sun (Center for Palliative Care and Clinical Ethics Seoul National University Hospital Seoul Korea.Public Healthcare Center Seoul National University Hospital Seoul Korea.Department of Pediatrics Seoul Nat) Park Hye Yoon (Center for Palliative Care and Clinical Ethics Seoul National University Hospital Seoul Korea.Department of Psychiatry Seoul National University College of Medicine Seoul Korea.) Keam Bhumsuk (Center for Palliative Care and Clinical Ethics Seoul National University Hospital Seoul Korea.Division of Hematology and Medical Oncology Department of Internal Medicine Seoul National University Coll) Yim Jae-Joon (Division of Pulmonary and Critical Care Medicine Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.38 No.24
발행연도
2023.6
수록면
1 - 15 (15page)
DOI
10.3346/jkms.2023.38.e182

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Background: Clinical ethics support is a form of preventive ethics aimed at mediating ethicsrelated conflicts and managing ethical issues arising in the healthcare setting. However, limited evidence exists regarding the specific ethical issues in clinical practice. This study aimed to explore the diverse ethical issues of cases referred to clinical ethics support after the new legislation on hospice palliative care and end-of-life decision-making was implemented in Korea in 2018. Methods: A retrospective study of cases referred to clinical ethics support at a university hospital in Korea from February 2018 to February 2021 was conducted. The ethical issues at the time of referral were analyzed via qualitative content analysis of the ethics consultationrelated documents. Results: A total of 60 cases of 57 patients were included in the study, of whom 52.6% were men and 56.1% were older than 60 years of age. The majority of cases (80%) comprised patients from the intensive care unit. One-third of the patients were judged as being at the end-of-life stage. The most frequent ethical categories were identified as goals of care/ treatment (78.3%), decision-making (75%), relationship (41.7%), and end-of-life issues (31.7%). More specifically, best interests (71.7%), benefits and burdens/harms (61.7%), refusal (53.3%), and surrogate decision-making (33.3%), followed by withholding or withdrawal (28.3%) were the most frequent ethical issues reported, which became diversified by year. In addition, the ethical issues appeared to differ by age group and judgment of the end-of-life stage. Conclusion: The findings of this study expand the current understanding of the diverse ethical issues including decision-making and goals of care/treatment that have been referred to clinical ethics support since the enforcement of the new legislation in Korea. This study suggests a need for further research on the longitudinal exploration of ethical issues and implementation of clinical ethics support in multiple healthcare centers.
#Clinical Ethics #Ethics Committees #Ethics Consultation #Clinical Ethics Support #Retrospective Review

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