위약반응으로 바라본 우리 삶의 의학

임영채 한국의철학회 2013 의철학연구 Vol.16 No.-

The placebo is in itself an inactive false drug or an ineffective inert medical procedure. However, giving such drugs or doing such procedures can produce the beneficial and positive effects in patients, placebo responses. The placebo response has been to date considered to be a nuisance as a background noise, which has to be removed in order to test the true effect of new drug or new treatment in the double-blind placebo-controlled randomized clinical trials. Especially in biomedical, mechanistic, and reductive explanatory systems of modern medicine, the placebo response is recognized to be an uncertain, ambiguous, and unexplainable exceptional phenomenon. The modern medicine, which lays emphasis on the certain prediction based upon objective sciences and accelerates its ramification or specialization, is alienated gradually from our life. It is therefore required to observe the possibility to communicate modern medicine with our life again by contemplating the placebo response. It was first manifested in this study that the factors related with the placebo response represent multidimensional complexity and variability like our whole life. The logical reasons why the explanatory systems of modern medicine can not explain well placebo responses and the themes on the placebo response overlooked were discussed. In order to explain better the placebo response, this study presented the necessity of the new explanatory system which accepts the subjective, nonreductive, and nondeterministic aspects around our whole life instead of the reductive and deterministic model of modern medicine around medical personnel and medical institutions. The meaning of placebo responses suggests that it is requested for modern medicine to unfold the new medicine encompassing our whole life by broadening and deepening the range of modern medicine. To achieve this purpose, medical personnel first need to pay more attention not only to diseases but also to the multidimensional and multilayered aspects of our whole life to include medical personnel as well as patients. In addition, it is required to collaborate with other various academic fields such as the humanities to embrace various facets of our whole life. It is also requested to rediscover and utilize the curative capability of our life. By reviving the meaning of placebo responses further now and forever, it might become practicable to communicate medicine with life without separation from each other, not to divide between person to treat and person to be treated, and to flow through each other between the humanities and sciences in medicine. Our whole life, root and home of modern medicine, could proceed together harmoniously.

근대기 의료 윤리로서의 '인술'의 재탄생

이효진 대한의사학회 2023 醫史學 Vol.32 No.1

“Medicine is an art of benevolence [Kr. 인술 Insul, Ch. 仁術 Renshu].” This slogan is widely accepted in East Asia, and at least in South Korea, it is generally regarded as an innate medical ethic. However, the original meaning of ‘In’ (仁, Ch. Ren), which means ‘benevolence,’ ‘humanity,’ or simply ‘love for one another,’ is a Confucian virtue emphasized by Mencius. It is unclear when this Confucian term became the representative medical ethic in South Korea. The term “medical ethic” was not coined until the 19th century in the West (Robert Baker and Laurence B. McCullough, eds. 2009). We often use the terms ‘Insul,’ ‘affection,’ ‘Hippocratic Oath,’ and other related concepts interchangeably, but these words come from different times and have different ideological implications (Shin 2000). This paper examines how ‘Insul’ has been recreated under the tensions between Western and Eastern Medicine in modern Korea. The arrival of Western medicine caused an existential crisis in traditional Korean medicine. The status of TKM doctors was demoted by the ‘Uisaeng Regulation’ in 1913 by the JGGK, which aimed to establish a unicameral medical system based on Western medicine. In response, the scientification of Eastern medicine became an inevitable task, and Eastern medicine had to maintain its identity while also modernizing itself to avoid being absorbed into Western medicine. Until the late Joseon period, ‘Insul’ was rarely used in medicine but rather for political practices. Medical practice was a peripheral way of conducting Ren (仁), the Confucian benevolence. However, TKM rediscovered the concept during the modern era. With the Convention of Korean Uisaeng in October 1915, the TKM community actively used ‘Insul’ as their identity. At this convention, Governor General Terauchi Mastake used the term to mean traditional medicine and implied that without scientification, ‘Insul’ would be disused. This address was immediately and widely quoted in TKM journals. TKM doctors and adherents interpreted his address to mean that if they could achieve scientification of TKM, their medical ideal (Insul) would be used in the future. Soon, a number of articles on ‘Insul’ as a medical ethic were published in newspapers and journals. From the mid-1920s, regardless of whether the doctors practiced East or West medicine, people started to claim that only those who pursued ‘Insul’ were true medical personnel, and they used this as a criterion for evaluating medical doctors. The people’s demand for ‘Insul’ influenced medicine in general, and Western doctors also linked their medical practices to ‘Insul.’ This is an interesting example of the localization of Western medicine in Korea. Through the rivalry relationship or interaction between East and West medicine that took place in modern Korea, ‘Insul’ gradually became a representative term of Korean medical ethics since the mid-1920s. The process took place gradually over a decade, and it has now become firmly established throughout medicine in Korea.

Awareness and Perspective on Use and Integration of Traditional and Modern Medicine in a Rural Area of Sokoto State, Nigeria

Henry Chukwuemeka OKAFOR,Osita John IKPEAMA,Jane Nkechinyere OKAFOR,Rita Ifeyinwa OKAFOR4 한국식품보건융합학회 2021 식품보건융합연구 (KJFHC) Vol.7 No.6

There are two forms of medicine that have existed over time and are important in the delivery of expert health care. The forms of medicine are traditional and modern medicine. This study was aimed at assessing the awareness and perspective on the use and integration of traditional and modern medicine in a rural area of Sokoto State, Nigeria. Two hundred and seventy-one (271) respondents were recruited and a self-administered questionnaire on the awareness and perspective on use and integration of traditional and modern medicine was used to assess the participant’s view. Among the participants, 200(73.8%) were females. The mean±SD age of respondents was 30.55±9.73 years. 80.8% of the respondents were aware of traditional medicine while 100% were aware of modern medicine. All respondents prefer modern medicine but about 28.8% support integration of both healthcare services. The results were considered significant when p-value was less than 0.005. There is a statistically significant relationship between the integration of traditional and modern forms of medicine and age, gender, religion, education, ethnicity and occupation but not for marital status. Though all the respondents preferred modern medicine to traditional medicine, some people still feel it will be good to combine both for a better healthcare system.

위약효과로 바라본 의학의 새로운 모습

임영채 ( Lim Young Chai ) 전북대학교 인문학연구소 2020 건지인문학 Vol.0 No.27

Despite the remarkable achievements in treating diseases, modern medicine, based upon the scientific and predictable biomedical paradigm with biological model of disease as the center, has lots of problems including dehumanization of medical practice. Placebo effects, beneficial therapeutic effects happened even in the absence of effective therapeutic substances, could not be explained by the biomedical paradigm of modern medicine. However, many meanings of placebo effects suggest the useful possibilities for improving the problems not solved by existing biomedical model. This study first described many problems of modern medicine, and then discussed new facets of modern medicine contemplated through various meanings of placebo effects in order to improve the problems of modern medicine. What the meanings of placebo effects indicate might be not just to look at medicine in a confined way, which is the case of modern medicine, but to look at medicine more broadly. That is, placebo effects request the expansion to the medicine of our life beyond the science- centered medicine around diseases mainly by medical personnel and institutions, further requiring the comprehensive medicine to consider multi- dimensional factors such as society, environment, ecology, and etc. To this end, placebo effects suggest us to recognize our body not just as the existing biological passive ‘objectified body,’ but as independently connecting relational active ‘lived body.’ Also it requires us to consider the artistic or contextual aspects and connective or shared aspects, which were so far neglected in modern medicine, drawing the fine medicine which is humane and considerate of society and ecology to live with us together.

일제의 공식의료와 개신교 선교의료간 헤게모니 경쟁과 그 사회적 효과

조형근 ( Hyung Keun Cho ) 한국사회사학회 2009 사회와 역사 Vol.0 No.82

일제하 식민지 조선에서 근대의료의 확산은 일제 식민권력과 개신교 선교의료세력이라는 두 행위자 집단이 주도했다. 양자는 서로의 존재를 전제한 가운데 의료체계와 실천양식을 형성해갔다. 조선인의 자주적 근대화 노력은 제한적이었다. 따라서 일제 식민지기와 해방 이후 근대의료의 성격을 이해하기 위해서는 양자를 분절하지 않고, 관계론적으로 접근하는 것이 필요하다. 공식 의료체계를 독점한 일제 식민권력과 민간 의료부문에 영향력을 행사한 선교의료 측은 전통의료에 대한 비판, 조선인 대중의 전통적 신념과 태도에 대한 비판과 계몽이라는 측면에서 협력관계를 맺었다. 이런 협력관계의 양상은 근본적으로 세계자본주의 질서의 헤게모니 국가인 미국과 하위제국 일본 사이의 양자관계라는 구조적 역학관계에 의해 규정되었다. 하지만 양자간에는 병원체계 구축 과정에서의 양적 경쟁, 의료 재생산 기지인 의학교육에서의 제도적 차별과 경쟁, 공식의료로서의 사회통제적 성격과 인도주의적 성격이라는 의료실천 양식에서의 대조에 기반한 갈등도 지속되었다. 그 결과 양자간에는 협력적·비대칭적·제한적 경쟁이라는 독특한 상호작용이 제도화되었다. 일제의 공식의료와 선교의료의 상이한 특징들이 서로의 존재를 의식한 가운데 형성된 것처럼, 양자에 대한 조선인의 이중적 태도 또한 양자에 대한 비교 속에서 형성되었다. 식민지 조선인들의 근대의료 전반에 대한 태도는 서구의 식민지에서와는 달리 이들 사이의 헤게모니 경쟁이라는 매개를 통해 굴절된 효과로 나타났다. 일제 공식의료는 억압적인 것으로 비판된 반면, 선교의료는 인도주의적인 것으로 받아들여졌다. 선교의료에 대한 차별적 태도는 종교적 차원보다는 미국의 근대문명에 대한 동경과 더욱 긴밀히 결합되어 있었다. 이 이중적 태도는 해방 이후 의료체계의 전면적인 미국화 과정에서 중요한 역사적 연원이 된다. In colonial Korea, the rise of modern medicine was led by the Japanese colonial power and American protestant missionary. The both shaped their own medical system and practices, but in doing so, they were deeply aware existence of their counterparts. Hence, we need to approach the relationship between the two not in an articulated fashion, but in a relational one. The Japanese colonial power monopolized an official medical system while medical missionary influenced a Korean civil society. They cooperated in criticizing Korean traditional medicine and enlightening Korean people. This cooperation was depend upon the structural power relation between the hegemon U.S and sub-empire Japan. Meanwhile, the both continued to compete in building hospitals and medical schools. In addition, their medical practices were conspicuously contrasted. Japanese colonial medicine was accepted as repressive governmental medicine by Korean while missionary medicine humanistic civil medicine. As a result, A cooperative, asymmetrical and restricted competition was institutionalized between the two. The colonized Korean shaped their attitudes toward the two medicine through comparing them. In comparison with cases of European colonies, the attitudes of Korean toward modern medicine were considerably different, for their attitudes were refracted by this hegemonic competition. The missionary medicine was generally welcomed as humanistic medicine. This friendliness to missionary medicine was led by the respect to American modern civilization more than religious belief. This dual attitudes in assessing two modern medicine became a historical origin of the Americanization in Korean medical system after the liberation from Japanese colonialism.

현대의학의 전망과 법적 책임의 변화

김기영(Kim, Ki-Young) 원광대학교 법학연구소 2021 의생명과학과 법 Vol.25 No.-

기존의 전통적인 의료는 환자에 대한 개별적인 의료개념이며, 환자의 진료에 대한 의학문헌과 의사의 경험을 기준으로 시행되지만, 인구집단에서 특정 질병의 발생확률은 알 수 있으나, 그중 어느 특정 개인에게 해당 질병이 발생할지는 알 수 없다는 점에서 한계가 있다. 반면 빅데이터 분석에 따른 데이터 기반 의료의 요소는 집단적 구조적 의료의 개념이기 때문에 개개인의 고유한 정보의 특성분석을 통해 개인별, 질환별 발생확률 계산이 가능하며, 개인에게 해당 질병이 발생하기 이전에 적절한 선제적 조치를 설계하고 적용할 수 있으리라는 가정을 가져 고전적인 인구집단 기반의 예방의학의 패러다임보다 진일보한 개념으로 볼 수 있다. 본 연구에서는 현재의 “현대의학”과 미래의 “현대의학”을 나누어 우선 현재의 “현대의학”의 변화분야로서 맞춤의학에 따른 치료개념의 변화와 현대기술의 발전에 따른 로봇기반의 수술 및 의약품의 변화에 대해 살펴보고 있다. 뿐만 아니라 미래의 “현대의학”과 관련하여 소위 의료분야에서 알고리즘을 사용하는 위험과 기회에 대한 문제를 검토하고 이러한 여러 가지 개념적 이해와 인공지능과 빅데이터 사용에 따른 의료책임의 변화와 유형들을 검토하고 있다. 의료책임의 변화에 따른 법적인 문제들에 대해서는 특히 의료수준의 기준에 대한 변화와 설명의무의 기준의 유형들로 구분하고, 특히 진료과실에 대한 책임을 진단상의 과실책임과 시간적인 기준을 중심으로 분석하고 책임의 법적 한계를 도출하고 있다. 아울러 새로운 의료패러다임의 변화를 위해서는 건강보험시스템의 도입 등에 대한 개혁이 필요하고 바람직한 의료실무와 의학교육에 어떻게 반영할 것인가에 대해 결론을 맺고 있다. Existing traditional medical care is an individual medical concept for a patient, and it is implemented based on the medical literature on patient care and the experience of doctors. There is a limitation in that it is not known whether this will occur. On the other hand, since the element of data-based medical care according to big data analysis is a concept of collective structural medicine, it is possible to calculate the probability of occurrence for each individual and each disease through the characteristic analysis of individual information. With the assumption that preemptive measures can be designed and applied, it can be viewed as a more advanced concept than the classic population-based preventive medicine paradigm. In this study, the current “modern medicine” and the future “modern medicine” are examined, and first, as a field of change in the current “modern medicine,” the treatment concept according to customized medicine and the robot-based according to the development of modern technology changes in surgery and medicine. In addition, in relation to “modern medicine” in the future, we examine the risks and opportunities of using algorithms in the so-called medical field, and examine the changes and types of medical responsibilities due to these conceptual understandings and the use of artificial intelligence and big data. are doing Legal problems arising from the change in medical responsibility are classified into types of standards of obligation to explain and change in standards of medical care, in particular, and responsibility for medical errors is analyzed based on diagnostic negligence responsibility and temporal standards. and deriving legal limits of liability. In addition, in order to change the new medical paradigm, reforms such as the introduction of the health insurance system are necessary, and it is concluded on how to reflect it in desirable medical practice and medical education.

경성의학전문학교 부속 의원의 건축사적 의미를 통해 본 국립현대미술관 서울관의 장소성

김종헌 한국근현대미술사학회(구 한국근대미술사학회) 2019 한국근현대미술사학 Vol.38 No.-

It has been six years since the National Museum of Modern and Contemporary Art, Seoul(MMCA) opened in November 2013. The purpose of this study is to clarify the meaning of place and architectural history through the process of change of the Affiliated Hospital of Kyungsung College of Medicine, which was originally established on this site. The purpose of this study is to examine how the architectural value of the National Museum of Modern and Contemporary Art Seoul can be utilized by tracking the architectural image accumulated at the place of the Affiliated Hospital of Kyungsung College of Medicine. From the perspective of a researcher studying modern architecture, I think the 2013 National Museum of Modern and Contemporary Art, Seoul should have an exhibition with the theme of place and history. The contents of the research so far are as follows. In 1916, Kyungsung College of Medicine was established and training was carried out in Yeongeon-dong using a medical lecture center attached to the Hospital of the Japanese Governor-General of Korea. The Medical School of Kyungsung Imperial University was established in 1924 as students of Kyungsung College of Medicine led the 3.1 Movement. As a result, the Hospital of the Japanese Governor-General of Korea was incorporated into The Medical School of Kyungsung Imperial University. At the same time, faculty and medical facilities at Kyungsung College of Medicine were transferred to Kyungsung Imperial University. Due to protests by the students of Kyungsung College of Medicine, which required clinical education in the hospital, the Affiliated Hospital of Kyungsung College of Medicine began on November 29, 1928, at the site of the Office of the Royal Genealogy in Sogyeok-dong, next to Gyeongbokgung Palace. At this time, the building has a triangular-shaped plane with the classical gable surface and the vertical window highlighted with ⊥ shape plan. In 1929, the L-shaped plane was connected to the ⊥-shaped plan with the symmetrical front of the vertical window, completed in 1928.. The newly connected building is square in size and has brightened the room. It also has a feature that emphasizes functionality. Hanok, which was used as the Office of the Royal Genealogy's Haengnangchae (buildings on both sides of the main gate where servants live, servants’s quarters), was used as an outpatient ward, forming a unique view of Kyungsung College of Medicine. In 1931, a unique block with a semicircular staircase connected to a previously built hospital. The window shows the horizontal window structure of the curtain wall that stretches laterally from the previous vertical window. The building, with a modern image like the Bauhaus in Dessau, Germany, became the main image of this school. The construction of the ward changed the location of the main entrance of Kyungsung College of Medicine. In 1936, the training system of nurses was installed, and the Affiliated Hospital of Kyungsung College of Medicine was expanded to become a finger plan, showing the appearance of a completed hospital as a general hospital. Throughout the 8.15 Liberation and the Korean War, the space has been transformed into the National Armed Forces District Hospital and the Headquarters of the Republic of Korea(ROK) defense security command, which is located near the Blue House and has a close connection with Korean modern political history. Finally, in 2008, the ROK defense security command moved and the existing the Affiliated Hospital of Kyungsung College of Medicine was registered as Registered Cultural Property # 375. The Affiliated Hospital of Kyungsung College of Medicine, which was used as the Education and Management Bureau of the Japanese colonial period after the Office of the Royal Genealogy in Joseon Dynasty, has undergone a continuous change process and is now used as the Seoul National Museum of Modern and Contemporary Art, Seoul in 2019. It is said that the placeness and historical characteri...

전일의학을 위한 대체의학에로의 현상학적 접근

여종현(Jong-Hyun Yeo) 한국철학회 2011 哲學 Vol.0 No.108

본고가 정초하고자 하는 전일의학은 현대의학과 대체의학이 산술적으로 통합된 의학이 아니라 WHO에 의해 규정된 건강, 즉 “단순히 질병 없는 상태가 아니라 신체적, 정신적, 사회적으로 그리고 영적으로 정상인 상태”를 충족시키는 의학이다. 이러한 전일의학은 현대의학을 중심으로 정초될 수 없고, 대체의학을 중심으로 정초될 수 있다. 그 까닭은 현대의학은 그것이 기초해 있는 철학의 성격상 대체의학이 그 안에 통합될 수 있는 전일성을 가질 수 없고, 대체의학은 그것이 기초해 있는 철학의 성격상 현대의학이 그 안에 통합될 수 있는 전일성을 갖기 때문이다. 현대의학이 심신이원론적인 데카르트적 철학에 기초한다면, 대체의학은 그러한 이원론적 철학을 극복한 철학에 기초한다. 데카르트적인 이원론적 철학을 극복한 철학들 중의 하나가 후설의 초월 현상학이다. 본고는 후설의 초월 현상학이 현대의학이 그 안에 통합될 수 있는 대체의학의 전일성의 철학적 기초임을, 다시 말하면 대체의학의 전일성은 후설의 초월 현상학에서 의해서 정초됨을 보이고자 한다. ‘Holistic medicine’ in the sense for which I will here try to provide a foundation is not a mathematical combination of modern medicine and alternative medicine, but an approach to medicine that can meet the concept of health defined in 1998 by the WHO: “a state of complete physical, mental, social, and spiritual well-being and not merely the absence of disease or infirmity.” This holistic medicine should be founded with not modern medicine but alternative medicine as its central approach. (This is one reason that alternative medicine is getting a spotlight as a new medicinal approach for the 21st century.) The reason is that modern medicine is strongly influenced by a philosophy in which alternative medicine cannot be involved, a Cartesian philosophy of mind?body dualism, while alternative medicine is based on or amenable to philosophies in which modern medicine can be incorporated, philosophies that overcome this Cartesian, dualistic philosophy. One such philosophy is Husserl’s transcendental phenomenology. This study aims to elucidate how transcendental phenomenology may be an appropriate philosophical basis for an alternative medicine in which modern medicine can have a place.

양방과 한방에 대한 인식 조사

강병조,채병진,권도훈,김풍택,김재식 대한생물치료정신의학회 1999 생물치료정신의학 Vol.5 No.2

In order to find out whether or not the general public have understanding of modern and oriental medical practices and if they do what the extent of their understanding is, 640 subjects were chosen over a four-month period in 1998. They were given questionnaires to answer and the key results of the study are as the following:1. The public were found to prefer modern medicine to oriental medicine.2. About 1/3 were using both modern and oriental medicines.3. 4/5 of the cases believed certain diseases are to get better efficacy from oriental medicine and such diseases are known to be neuraligia, myalgia, stroke, lumbago and gastric disease.4. 3/4 believed that modern medicine is good for treatment while oriental medicine is good as restorative.In summary, this study show that major medical system is modern medicine and oriental medicine is only for restorative and complementary.

1934년 한의학 부흥 논쟁 한의학 정체성의 "근대적" 재구성

전혜리 ( Hae Lee Jeon ) 한국과학사학회 2011 한국과학사학회지 Vol.33 No.1

In 1934, there was a severe controversy between advocates of traditional medicine in Korea and a biomedicine-trained doctor. Through the debate, the advocates of Korean medicine attempted to "modernize" their field and to secure an independent status that would guarantee the institutionalization of Korean medicine. Pursuing their independent standing, however, required the advocates to find a rationale that Korean medicine should be separated from Western medicine. They emphasized that there existed fundamental differences in both theory and practice between the two kinds of medicine. Cho Hunyoung (趙憲泳, 1900-1988), for example, successfully showed that Korean medicine was not only distinct from Western medicine but also complementary to it. In so doing, he made a parallel comparison between the two so that Korean medicine could be seen as a part of the "modern" medicine rather than of the "traditional" one. After the debate, practitioners of Korean medicine broadly accepted the newly established identity of Korean medicine as a counterpart of Western medicine. The advocates founded a journal, Oriental medicine (東洋醫藥), and promoted it as an independent space for the research of Korean Medicine. However, there was a limitation in the project for the self-reliance of Korean Medicine, since the "modernization" of Korean Medicine was achieved by making it as "the other" of Western medicine. Korean medicine couldn`t be entirely independent from the standards of Western medicine.