BACKGROUND: All medical conduct should be practiced under the permission of patients or guardians. Because anesthetic procedures have high risk, every anesthesia practice is done under verbal and/or written consent. However, collecting anesthetic permission is not common in Korean medical anesthesiologists. The purpose of this article is to survey current anesthetic status and to provide some suggestions. METHODS: We had given questionnaire sheet to anesthesiologists participating in an annual meeting of the Korean Society of anesthesiologists. It included the percentage of receiving the anesthetic consent, the reasons why they received the informed consent or not, and the conditions to improve to receive it. RESULTS: The total number of responded anesthesiologists was 187. More than half of the responders had received the informed consents from less than 25% of their patients. And only thirty percent of them had taken the consents from more than 75% of their patients. To increase this rate, they replied, it is needed to strengthen the legal validity of the consent and to improve working conditions. CONCLUSIONS: The rate of receiving the informed consent is very low for the anesthesia practice in Korea. There are some procedures that are needed to improve the current situation so that anesthesiologists can provide better quality to the patients.
Anesthesia* ; Humans ; Informed Consent* ; Jurisprudence ; Korea* ; Patient Rights

In the traditional medical field, the patient was a person to receive protection from the doctor because there are vertical relationship between the patient and the doctor. But in modern medical field, patients change their role to health-care consumer to be guaranteed their rights more actively. This study compare patient's rights in doctor's vocational ethics and patient's rights in law, consumer rights. This study analyzes what is type of law-relationship between patients and doctor and how can they act health-care as health-care consumer.
Ethics ; Humans ; Jurisprudence ; Patient Rights*

This year on May 21st, the full panel of the Supreme Court in Korea had first made a judgment on 'withdrawal of life-sustaining management'. In this case, where a 76 -year-old patient was represented by her children, while being in a persistent vegetative status, the Supreme Court ruled that if a patient is in an irreversible condition with imminent death and the discontinuation of treatment can be approved as the patient's self -determination, while such action will not be allowed in any other special circumstances. This judgement presented the general criteria and process of withdrawal of life -sustaining management in Korea for the first time. The Supreme Court also brought about the specific requirements of advance directives and decided that in case where legal proceedings are not taken, the hospital ethic committee constiting of medical specialists should decide whether the patient is in an irreversible condition. However, the judgment vaguely defined the concept of 'irreversible death-imminent condition' and did not clearly examine the relations between the patient's right on self-determination and the duty of the national government to protect the life of the people, and the discretionary power of the doctor.
Advance Directives ; Child ; Ethics Committees, Clinical ; Ethics, Institutional ; Euthanasia ; Federal Government ; Humans ; Judgment ; Korea ; Patient Rights ; Right to Die ; Specialization

Introduction: Open disclosure is poorly understood in Malaysia but is an ethical and professional responsibility. The objectives of this study were to determine: (1) the perception of parents regarding the severity of medical error in relation to medication use or diagnosis; (2) the preference of parents for information following the medical error and its relation to severity; and (3) the preference of parents with regards to disciplinary action, reporting, and legal action. Methods: We translated and contextualised a questionnaire developed from a previous study. The questionnaire consisted of four case vignettes that described the following: medication error with a lifelong complication; diagnostic error with a lifelong complication; diagnostic error without lifelong effect; and medication error without lifelong effect. Each case vignette was followed by a series of questions examining the subject’s perception on the above areas. We also determined the content validity of the questionnaire. We invited parents of Malaysian children admitted to the paediatric wards of Tuanku Jaafar Hospital to participate in the study. Results: One hundred and twenty-three parents participated in the study. The majority of parents wanted to be told regarding the event. As the severity of the case vignettes increased, the desire for information, remedial action, acknowledgement of responsibility, compensation, punishment, legal action, and reporting to a higher agency also increased. The findings did not have strong evidence of a relationship with subject’s demographics. Conclusion: This study gives insights into previously unexplored perspectives and preferences of parents in Malaysia regarding open disclosure. It also highlights the opportunity for more research in this area with potentially broad applications.
Disclosure ; Professional-Patient Relations ; Patient Rights

Involuntary and compulsive admission can damage a patient's autonomy from a medicoethical aspect, but the patient who cannot understand information and explanations from a psychiatrist due to impaired judgment and lacks insight can have impaired judgment in certain circumstances. The decision making of a patient without substantial autonomy in a psychotic or intoxicated state can be justly neglected by the psychiatrist for the patient's sake. Compulsory admission is generally permitted only in case that a patient presents a danger to himself or others, which is not of a benefit to the patient not in danger because of the loss of the opportunity to take appropriate treatment. This enables psychiatrists not to abuse medical paternalism and to protect from the damage to patient's autonomy and civil right. Compulsive admission can be ethically justified to keep the principle of the least restrictive treatment and the patient's right to appropriate treatment. Psychiatrists should help enhance the patient's underestimated autonomy on the basis of the limited paternalism.
Civil Rights ; Decision Making ; Humans ; Judgment ; Paternalism ; Patient Rights ; Psychiatry

PURPOSE: There is increasing concern about ethical conduct of human research in the field of medicine. The purpose of this study was to assess the ethical review process by institutional review boards for human research articles published in the journal of Korean Society of Emergency Medicine. METHODS: We reviewed human research papers published in the journal of Korean Society of Emergency Medicine from the 1st edition, 1990 to the 6th edition, 2006. A checklist was used to review the articles. RESULTS: The total number of prospective clinical research paper was 250. Among them, there were 63 papers (25.2%) in which the obtaining of informed consent was described in the article. Only two studies (0.8%) published in the journal were noted to have IRB approval. Invasive techniques were employed in 134 studies (53.6%). Among the 134, only 22 (16.4%) mentioned that informed consent taken was given during the study. Studies which may have involved discrimination totaled 21 (8.4%), and the number of studies that may have violated the patients' right to privacy was 20 (8%). The number of studies that may have a conflict of interest but was not declared was 12 (4.8%). CONCLUSION: There should be greater concern about the ethical conduct of research in studies with human research subjects in the journal of the Korean Society of Emergency Medicine.
Bioethics ; Checklist ; Conflict of Interest ; Discrimination (Psychology) ; Emergencies ; Emergency Medicine ; Ethical Review ; Ethics Committees, Research ; Helsinki Declaration ; Humans ; Informed Consent ; Patient Rights ; Privacy ; Research Subjects

PURPOSE: We have assessed the clinical usefulness of solid maker transit technique and Barr-score in 31 patients with idiopathic constipation (male:female; 17:14, mean age; 6.7 years, range 1.4-12 years). METHODS: All patients underwent full history taking and physical examination including rectal examination. On first visit to gastroenterology clinic a plain abdominal film was taken for Barr-score which evaluated by two observers without the information of the patients. Kappa score was calculated for inter or intra observer variability. Sitz marker were given orally at 9 am on days 1, 2 and 3, and another plain abdominal film was taken on day 5. Total remained solid marker were counted for the degree of retention. We calulated the residual sitz marker. Each film was divided into right colon, left colon and rectosigmoid areas, using bony landmarks, and the marker content of each area counted. RESULTS: 2 patients were excluded because they resisted to take sitz maker. Transit times were normal, mild, moderate and severe delay in 12 patients, 2 patients, 3 patients and 12 patients respectively on day 5 film. The correlation coefficiency between the degree of transit delay and clinical severity was 0.89. Among 14 patients with transit delay, 12 patients has outlet obstruction, 1 patient right colonic delay and 1 patients left colonic delay. The Kappa for inter and intra-personal variability were 4.13 and 4.18 respectively (moderate consistency each). The correlation coefficiency between Barr-score and solid marker colonic transit time was 0.603 (P=0.0008). CONCLUSIONS: This results showed that the solid marker colonic transit time and Barr score were useful in evaluation of patients with constipation.
Colon ; Constipation* ; Gastroenterology ; Humans ; Observer Variation ; Patient Rights ; Physical Examination

Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular proliferative process characterized by proliferation of endothelial cells with papillary formation located within a vascular lumen. It could manifest as a primary or pure form that develops in a distended vessel or it could be associated with hemangiomas, pyogenic granulomas, and/or lymphangiomas. We report a case showing development of intravascular papillary endothelial hyperplasia on a patient's right fifth finger.
Endothelial Cells ; Fingers* ; Granuloma, Pyogenic ; Hemangioma ; Hyperplasia* ; Lymphangioma ; Patient Rights

Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular proliferative process characterized by proliferation of endothelial cells with papillary formation located within a vascular lumen. It could manifest as a primary or pure form that develops in a distended vessel or it could be associated with hemangiomas, pyogenic granulomas, and/or lymphangiomas. We report a case showing development of intravascular papillary endothelial hyperplasia on a patient's right fifth finger.
Endothelial Cells ; Fingers* ; Granuloma, Pyogenic ; Hemangioma ; Hyperplasia* ; Lymphangioma ; Patient Rights

Development of new drugs using the incrementally modified drug (IMD) technique is becoming increasingly popular in the pharmaceutical industry. The technique addresses the critical need of pharmaceutical companies to reduce the astronomical budget required to develop a new drug. Incremental drug modification can encompass modification of the structure, formulation, or indication of existing drugs. Typical examples of the technique include modification of chemical structure, changes to formulation, and development of compound drugs. While some large pharmaceutical companies use the technique as a strategic tactic to prolong patent rights and maintain a profitable brand, it can also offer many health benefits, such as the discovery of new uses for the same compound, improved safety, and raised patient compliance. Several incrementally modified drugs have already been marketed for psychiatric use, and many more are waiting for approval. This new trend may expand the options available to clinicians; the usefulness of chiral and long-acting drugs has already been proven in clinical practice. This review presents an overview of the incrementally modified drug technique and its current status in psychopharmacology. It also discusses the economic and clinical implications of the current popularity of this technique.
Budgets ; Drug Industry ; Human Rights ; Insurance Benefits ; Patient Compliance ; Psychopharmacology*