임상윤리상담과 병원윤리위원회

최경석 한국의료윤리학회 2017 한국의료윤리학회지 Vol.20 No.4

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. 이 글은 임상윤리를 의료윤리의 하위 범주로서 개별사례에 집중하며 그 해결책을 모색하는 학문영역으로 규정하고, “clinical ethics consultation”을 어떻게 번역할 것인지 논의한 후, “자문”보다는 “상담”이적절한 번역어임을 주장한다. 나아가 임상윤리상담의 모델로서 권위주의적 접근, 순수 지원 접근, 윤리지원 접근을 소개하고, 다원주의 사회에서 바람직한 모델은 윤리 지원 접근 모델임을 주장한다. 한국사회 역시 동서와 고금이 혼재한 다원주의 사회라고 평가할 수 있으며, 하나의 가치 체계가 지배적이지않은 상황에서는 어느 하나의 결론을 권장하고 주입하기보다 갈등을 상담하는 주체들이 윤리적으로허용 가능한 범주 내에 있는 결론에 도달하도록 지원하고 도와주는 것이 상담가의 역할이라고 주장한다. 다원주의 사회의 윤리 지원 접근은 윤리적 상대주의를 함축하고 있는 것은 아니며 공통 도덕의 존재는 윤리적 상대주의가 올바른 이론이 아님을 보여준다. 한국의 의료기관윤리위원회는 임상윤리상담의 역할을 수행하는 위원회로서 운영될 필요가 있으며, 현행법이 의료기관윤리위원회의 역할로 연명의료의 유보 및 중단만 언급하고 있으나, 이번 설치를 계기로 보다 일반적인 병원윤리위원회를 활성화하고 학제적 임상윤리상담팀을 운영하는 계기를 마련할 필요가 있다고 주장한다.

환대의 밥상, 환대의 신학삶

정경호(Gyoung-Ho Jeong) 영남신학대학교 2010 신학과 목회 Vol.34 No.-

This study is a Christian ethical reflection of “Food of Hospitality." It is very important for me to build Life-giving and Peace-making theology and ethics reflected upon “Food and Faith." First of all, I deal with Jacques's hospitality such as “Conditional hospitality" and “Unconditional hospitality" and then compare with Elizabeth Newman's hospitality such as “Sentimental hospitality", “Privatized hospitality", “Hospitality as mode of marketing", “Mere hospitality as inclusively" and “Homeless hospitality". I call “Homeless hospitality" as “Divine hospitality" here after. Then I try to find out various cultures of hospitality in global context, food of hospitality focusing on Abraham and Sarah in Genesis 18 and hospitality for global world. As a result of this study, it becomes evident that food of divine hospitality of Abraham and Sarah for the strangers is costly source of life and blessing. I am convinced that divine hospitality is holy duty, responsibility and faith because God so loved all life community, especially the stranger such as the poor, hungry, isolated, alienated people and life community in global world. I, therefore, conclude that we have to learn and practice our costly divine hospitality as beautiful life-giving faith and theological · faithful life for global peace, justice and all life community in fullness toward Reign of God.

이방인의 권리와 환대의 윤리: 칸트와 데리다 사상의 지리학적 함의

최병두 韓國文化歷史地理學會 2012 문화 역사 지리 Vol.24 No.3

이 논문은 최근 급속히 증가하고 있는 외국인 이주자들이 가지는 권리와 이들에 대한 원주민들의 규범적 태도, 즉 환대의 윤리에 관한 지리학적 함의를 논의하고자 한다. 특히 이 논문은 환대에 관한 세계시민적 권리를 주장한 칸트와 이를 비판적으로 원용하여 무조건적 환대를 강조한 데리다에 초점을 둔다. 이들의 주장에 함의된 지리학적 요소들은 3가지 측면, 즉 환대의 권리가 근거하고 있는 사회공간적 기반, 보편적 윤리와 공동체적 권리 간 긴장, 그리고 실제 이러한 환대의 권리가 실현될 수 있는 현실의 공간 양식으로 확인될 것이다. 칸트의 주장에서 이러한 3가지 요소는 지표공간의 절대적 한정과 자원의 공유, 보편적 인권과 (공간적으로 한정된 공동체의) 성원적 권리, 그리고 공화국의 민주적 주권과 세계연방제에 관한 논의로 이루어진다. 데리다의 경우 이들은 무조건적 환대의 근거로서 자기-집의 구축/해체, 무조건적 환대와 조건적 환대 간 긴장, 무조건적 환대를 지향하는 새로운 유럽에 대한 묘사 등으로 다루어 질 수 있다. This paper discusses geographical implications for rights of recently increasing foreign immigrants and normative attitudes, that is, ethics of hospitality of natives to them. In particular, it brings focus into Kant who suggested cosmopolitan rights of hospitality, and Derrida who emphasized unconditional (or absolute) hospitality, criticizing positively Kant’s concept of hospitality. Geographical implications of these two great thinkers can be identified in terms of three elements, that is, socio-spatial grounds of (unconditional) hospitality, tensions between universal ethics and communal rights, and actual spatial modes of realizing hospitality. In the case of Kant’s suggestion of cosmopolitan right of hospitality, these three elements can be discussed in terms of the absolute limit of the Earth’s space and hence communal use of resources, universal human rights and rights of members in a spatially restricted community, and his idea of democratic sovereignty of the republics and world federation. In the case of Derrida’s concept of unconditional hospitality, they can be dealt with in terms of construction/deconstruction of self-housing as the ground of unconditional hospitality, strains between unconditional hospitality and conditional hospitality, and his description on new Europe orienting towards unconditional hospitality.

병원윤리경영 지표개발에 관한 연구

배성권,권수진 고신대학교 고신보건과학연구소 2010 보건과학연구소보 Vol.20 No.-

The purposes of this research is to understand index for business ethics Korean Hospitals and to review good strategical direction of its. Most hospital have faced financial crisis by environments change of competitive business. Because of change in business environments, most Korean hospital is experienced difficult situations to keep core value of management containing business ethics. This study reviewed on nowaday situation about environments change of competitive business, defined the concepts of business ethics, and proposed a business ethics index to maintain good identities of hospital. In spite of poor and competitive environments around health care industry, hospital try to keep core value of hospital and overcome ethical crisis of hospital management. This study is useful content to define business ethics for hospital and is a good basic attempt to decide the direction of ethical hospital management.

간호윤리 상황극을 통한 병원간호사의 긍정윤리관 변화

엄영란,강소영,노원자 병원간호사회 2012 임상간호연구 Vol.18 No.1

This study was done to examine changes towards positive ethics in registered nurses working in hospitals who took part in performing 'theatre of situations' in terms of issues of nursing ethics. Methods: This research was conducted with one-group pretest-posttest design. The sample, 232 registered nurses, voluntarily participated in a contest of ‘Theatre of Situations’ with themes of nursing ethics hosted by Hospital Nurses Association of Korea on September 8, 2011. For this contest, eight nursing situational scenario regarding ethical issues or dilemma were created. The theatre of situation was performed by volunteer nurses over a period of 160 minutes. Data were collected before and after the performance using 10 items to measure Positive Ethics. Item internal consistency had a Cronbach’s alpha in this study of .716. Results: Before the theatre of situations was performed, the mean (±standard deviation) level of positive ethics was 2.34 (±.37). For the nurses who participated, there was a significant increase in the degree of positive ethics after the theatre of situations (2.62 ±.36, p<.001). Conclusion: This result implies that indirect experiences such as ‘theatre of situations’ in terms of ethical issues, created as well as performed, is effective for registered nurses in changing their ethical perspective positively and in realizing ethical ideals.

칭의론에 나타난 환대의 윤리

정승우 ( Sung-woo Chung ) 한국대학선교학회 2019 대학과 선교 Vol.40 No.-

바울의 칭의론에는 유대교의 율법과 로마제국의 법과 같은 기존법의 기능과 구조로는 하나님의 정의를 수행할 수 없다는 생각이 내재 되어 있다. 바울이 생각한 하나님의 정의(dikaiosyne theou)는 기존의 법체계를 해체하는 지점에서 나타난다. 따라서 유대율법에 의해 수용될 수 없는 이방인과 로마법에 의해 보호받을 수 없는 노예와 여성들과 같은 사회적 약자들을 향한 하나님의 의(義)는, 무법적 정의(justice outside the law)의 성격을 지닌다고 할 수 있다. 하나님의 정의는 법을 준수한 댓가가 아니라, 법을 초월한 하나님의 선물(gift)을 의미한다. 이런 점에서 하나님의 정의는 자격 없는 인간들을 향한 무조건적 환대(unconditional hospitality)를 위한 윤리적 근간이다. 바울이 처음 칭의론을 언급하는 상황이, 바로 이러한 환대의 자리가 파괴된 안디옥 교회의 식탁교제라는 것을 유념할 필요가 있다 (갈 2:11-14). 이 때문에 이방인의 환대문제는 칭의론과 긴밀히 연관되어 있다. 이러한 점에서 환대의 윤리와 타자의 윤리를 강조한 데리다와 레비나스의 철학적 통찰은, 이방인에 대한 혐오와 배제를 부추기는 우리 사회에 새로운 윤리적 성찰을 제공할 수 있다. The purpose of this paper is to explore the ethical implication of the doctrine of Justification in the lights of Derrida’s ethics of hospitality and the ethical responsibility of Levinas as well. New Perspectives on Paul pointed out that Paul’s Justification could not be understood as a timeless answer to the plights and pains of the introspective conscience of the West. They agree that the justification was designed by Paul to defense the right of Gentile Christians who were a minority in Pauline ekklesia. However, the previous studies overlooked the anti-Roman propaganda implied in Paul’s justification. In recent years, some scholars such as Crossan, Horsely, and Wright have insisted that Paul’s gospel should be aimed against Roman imperial ideology. According to their argument, Paul proclaimed that the Roman Emperor is not lord and savior of all, because Jesus is. On basis of this insight, I try to examine the ethical meaning of the Justification in terms of Derrida’s ethic of hospitality. My argument is that both Derrida and Paul are indispensable guides to a new way of thinking about the doctrine of justification. The central concern of the justification is with the question of justice that must be thought outside of the law on the basis of the gift of God. I suggest that Paul’s thinking about the righteousness of God outside of Mosaic law is clarified by reading Derrida on such themes as justice and law, gift and hospitality. It is important to note that Paul’s justification emerges shortly after saying to the Antioch accident. It shows that the table fellowship is closely related to the purpose of why Paul says the Justification. Through the righteousness of God, Paul emphasizes unconditional hospitality to the Gentile Christians. According to Levinas, Messiah appears with a face of Others. Paul met the Christ in the form of the Other on the road to Damascus. In this respect, Paul’s ethical exhortation can be described as being driven by the responsibility for the others, who is emerged as the gentiles, slaves, and woman. I hope that the ethics of others of Levinas will give a new ethical insight to understand the doctrine of Justification in the ethical problems which Korean society faces today.

윤리적 분위기가 조직유효성에 미치는 영향:

이근환(KeunHwan Lee),유지영(Jiyoung Lyu),신영전(Youngjeon Shin),장영철(YoungChul Chang) 피터드러커 소사이어티 2016 창조와 혁신 Vol.9 No.4

대기업이 병원경영에 참여하여 기존 대학병원과 차별화된 전략적 경영기법을 보여준 지 20년이 넘었지만, 의료조직의 윤리경영은 아직 경영사(經營史) 차원의 학술 접근이 이루어지지 않았다. 이 연구는 의료조직의 윤리경영을 윤리적 리더십, 윤리경영시스템, 조직윤리가치, 윤리적 분위기와 긍정심리자본 등으로 검증하고실제 사례로 삼성그룹(삼성생명공익재단)이 1994년 설립한 삼성서울병원(삼성의료원)의 윤리경영을 분석하였다. 삼성서울병원은 병원업계에 진입하면서 기존 국립대병원과 사립대병원이 큰 관심을 두지 않았던 윤리적 리더십과 윤리경영시스템, 조직윤리가치 등 윤리경영을 내세웠다. 윤리적 분위기와 긍정심리자본을 인사관리 및 조직관리라는 차원에서 전략적으로 운영하였다. 첫째, 병원장을 비롯한 최고경영진(TMT)의 윤리적 리더십을 윤리경영 관련 경영전략으로 내세웠다. 한국 의료계를 주도하던 대학병원 등이 시도하지 못했던 의료조직 전체의 윤리적 리더십을 확보하여 새로운 윤리경영 시스템을 구축하였다. 둘째, 국내외에서 활동하던 최고 수준의 전문 인력을 활용하여 경영목표로서 삼성서울병원의 조직윤리가치를 구체화시켰다. 90년대 서울대병원 등이 누리고 있었던 독점적 우월성을 넘어 병원 간 경쟁체제에서 경쟁우위를 확 보하려는 경영전략이었다. 셋째, 경쟁이 심하지 않았던 병원경영에서 쉽게 볼 수없었던 윤리적 분위기와 긍정심리자본으로 삼성서울병원만의 새로운 조직문화를 완성하려 하였다. 이것은 대학병원 등 기존 병원경영에서 최고경영진의 윤리경영 을 바라보는 시각과 윤리 수준을 높이는 효과를 가져왔으며, 한국 병원업계의 윤리경영 제도화에도 영향을 주었다. 삼성서울병원은 이러한 윤리경영 성과가 있음에도 조직 내부의 윤리적 분위기등 윤리경영과 다른 차원에서 의료접근도의 격차, 영리･상업화, 일부 의료서비스 영역의 독점 등 조직 외부 관련 문제를 야기하였다. 따라서 병원 조직 내부의 윤리 경영에 더하여 사회적 책임이라는 보다 적극적인 윤리경영 문제에 대한 고려가 함께 이루어져야함을 보여주고 있다. Although big business has been involved in establishing and strategically managing hospitals for more than two decades, the academic and historical approach to the ethical management of hospitals has neither been researched nor debated. Thus, this research examines the levels of ethical management of hospitals by specifically analyzing the ethical leadership, ethical management system, organizational ethical value, ethical climate, positive psychological capital, and other factors of Samsung Seoul Hospital, a hospital established by Samsung Group in 1994. Samsung Seoul Hospital differentiated its approach from other public hospitals or private university hospitals by emphasizing the ethical leadership, ethical management system, organizational ethical values, and other criteria for ethical management. The hospital’s HR and OR strategically managed its ethical climate and positive psychological capital. First, the differentiated approach of ethical management highlighted ethical leadership of its CEO and other top management team. They established the ethical management system of a new hospital by organizing and recruiting ethical leadership which sets it apart from other University Hospitals, which were more of the dominant medical institutions of the time. Secondly, they actualized organizational ethical value, as its own management objective by recruiting the best of domestic and international workforce. It was a strategic approach in order to compete and obtain superiority over Seoul National University Hospital, which was the top-notched hospital in the early 90s. Third, there was an attempt to create a new climate and culture by introducing a new factor such as ethical climate, positive psychological capital. This innovative attempt has improved ethical climate of hospitals and influenced other hospitals’ management. Despite these performance, the ethical atmosphere such as the internal ethics of the organization remains different from that of the ethical management, which caused problems such as the gap of medical approach, pursuit of profit and commercialization, and monopolization of some medical services. Therefore, it shows that ethical management in hospital organization should be considered together with more active ethical management problem of social responsibility.

환대의 윤리 관점에서 본 이주노동자 정책과 한국 교회의 과제

강정희 21세기기독교사회문화아카데미 2018 신학과 사회 Vol.32 No.2

Korean society has gradually but acceleratedly entered into multi-cultural stage. In this situation, Korean society confronts the problem that how Korean society should deal with aliens from different ethnicities and cultures, especially the weak. The problem is also significant from the standpoint of Christian ethics, because God of Christian belief presents Himself as God of the poor, so-called the weak. In this view, this study aims at dealing with the ethical responsibility on migrant workers especially undocumented migrant workers as the new weak under the current situation. In solving the problem of this kind, this paper views migrant workers not as the object of discrimination and exclusion, or assimilation but as the subject that should be the object of hospitality. In this sense, this study presents Jacques Derida’s ethics of hospitality and the ethical responsibility of Emmanuel Levinas when one is to confront with the face of the other as the tool for evaluating the policies of Korean government on the migrant workers in terms of Korean law, policy, and practice. And then it discusses the direction of improving the policies. In conclusion, this study presents the role of church community as a community of hospitality and its role to reduce the existing difference between the religious and philosophical concept of hospitality and its policies of Korean government. 대한민국 사회는 급격하지는 않지만, 다문화 사회에 진입하는 현상이 가속화되고있다. 이러한 상황에서 한민족이라는 하나의 민족이 압도적인 구성비를 보이고 있는한국사회는 인종과 문화가 다른 이방인들, 그 가운데서도 특히 약자들을 어떻게 대할것인가에 대한 문제에 직면해 있다. 이것은 특별히 기독교 윤리적으로 중요한 문제이다. 왜냐하면 기독교가 믿는 하나님의 가난한 자, 소위 약자의 하나님으로 자신을규정하고 그들에게 특별한 관심을 요구하기 때문이다. 이런 관점에서 이 논문은 현재의 다문화 상황에서 새롭게 등장한 약자인 이주노동자 특히 미등록 이주노동자에 관한 윤리적 책임을 다루고자 한다. 특별히 이주노동자를 차별과 배제, 그리고 동화의 대상으로 보는 전반적인 정부 정책의 시각에서보다는그들이 한 주체로서 환대의 대상이라는 관점에서 살펴보고자 한다. 이런 의미에서 자크 데리다의 환대의 윤리와 에마뉘엘 레비나스의 타자의 얼굴에 대한 윤리적 책임이라는 관점에서 대한민국 정부의 이주노동자 정책을 법적, 정책적, 실천적 측면에서 평가해 보고, 철학 및 윤리적인 면과 정책적인 면에서 제기되는 차이를 줄여가도록 정책적인 방향과 내용을 개선하기 위해 환대의 공동체로서 한국 교회가 감당할 책임에 관한 논의를 하면서 마무리하고자 한다.

『허클베리 핀의 모험』에 나타난 환대의 문제

이복기 ( Lee Bok-ki ) 대한영어영문학회 2014 영어영문학연구 Vol.40 No.2

Mark Twain's novel, The Adventures of Huckleberry Finn, has been stood in a spotlight because of its usage of politically incorrect terms and the objectification of slave character Jim in recent years. Besides the debate on the usage of the racist term, the long debates have been going on about the ending of the novel. The critics defending and offending the ending have ignored the important theme of hospitality and ethics in their interpretation, which obviously is expressed all through the novel. The acts of hospitality depicted in the novel can be categorized into two types: conditional hospitality and hospitality intending to absoluteness. The acts of hospitality performed by Widow Douglas, Miss Watson, and other Southerners share a strong intention to capture and thematize the other, so are conditional hospitality. On the other hand, in their acts of hospitality Mary Jane and Huck welcome the others as they are and become friends of the others, so are categorized as hospitality intending to absoluteness. Huck, though, passes through some inner struggles in his decision of welcoming a run-away slave, Jim, and fails in the ending scene by objectifying Jim. This shows that his hospitality is not absolute one but one which orienting to absoluteness. The ending scene also ironically manifests that the freedom Jim is allowed to is a simulacre which reveals that the emancipated former slaves are still living in a large prison called white supreme society. (Chonbuk National University)

데리다의 무조건적 환대의 한 경우 - 지오노의 『나무를 심은 사람』을 중심으로

변광배(Byun, Kwang-Bai) 인천대학교 인문학연구소 2019 인문학연구 Vol.31 No.-

최근 정치철학, 윤리학 등의 분야에서 환대, 관용, 혐오 등에 대한 논의가 활발하다. 데리다는 ‘윤리적 전회’ 이후, 환대에 관심을 집중시킨다. 그는 ‘무조건적, 절대적 환대’를 내세운다. ‘주인’은 ‘이방인’을 맞아들이면서 그 어떤 조건도 부과해서는 안 된다. 하지만 인간들 사이에서 이런 환대는 이론적으로 가능할 뿐이다. 이 글에서는 지오노의 『나무를 심은 사람』에 나타난 ‘자연’과 ‘인간’의 환대에 주목하면서 데리다의 ‘무조건적, 절대적 환대’의 실현 가능성을 탐사한다. 이 작품에서 ‘자연’은 부인과 아들을 잃은 부피에를 환대한다. 그는 훼손된 ‘자연’을 환대한다. 또한 모국어를 잃어버릴 정도로 거의 ‘자연화되었다’고 할 수 있는 그는 이 작품의 화자 역시 환대한다. 이런 환대들이 인간들 사이에서 실현 불가능한 것으로 보이는 데리다의 ‘무조건적, 절대적 환대’가 실현된 한 예에 해당하는 것으로 보인다. This study investigates instances of realization of unconditional or absolute hospitality within Derrida focusing on Giono’s L’Homme qui plantait des arbres. Recently, many studies on hospitality or tolerance have been cited and accumulated in political philosophy or ethics. These studies, in most cases, focus on human-to-human relationships. And it remains the same with Derrida who pursues unconditional or absolute hospitality. Here lies the problem investigated in this study: would it be possible to actualize a realization of this hospitality? We try to examine this problem by focusing our attention on the relationships between nature and all living beings, including man, in L’Homme qui plantait des arbres. It is nature itself that provides hospitality to all living beings. Even someone as prominent as Bouffier suffered from the death of his family. And he offers hospitality to the narrator of this short story as well as to nature itself which is ruined by excessive deforestation. This double reciprocal hospitality can be defined as unconditional or a form of absolute hospitality of Derrida.