BackgroundExperience with open disclosure and its study are restricted to certain western countries. In addition, there are concerns that open disclosure may be less suitable in non-western countries. The present study explored and compared the in-depth perceptions of the general public and physicians regarding open disclosure in Korea.MethodsWe applied the COREQ checklist to this qualitative study. We conducted 20 in-depth interviews and four focus group discussions with 16 physicians and 18 members of the general public. In-depth interviews and focus group (...) discussions were performed according to semi-structured guidelines developed according to a systematic review of open disclosure. We conducted a directed content analysis by analyzing the verbatim transcripts and field notes in accordance with the predetermined guidelines.ResultsOpen disclosure perceptions were summarized in terms of the “five Ws and one H”. All physician and general public participants acknowledged the normative justifiability of open disclosure. The participants mostly agreed on the known effects of open disclosure, but the physicians had negative opinions on its expected effects, such as decreased intention of the general public to file lawsuits and increased credibility of medical professionals. Generally, the participants thought that open disclosure is required for medical errors causing major harm. However, the physicians and general public had conflicting opinions on the need for open disclosure of near misses. Most physicians did not know how to conduct open disclosure and some physicians had bad experiences due to inappropriate or incomplete open disclosure.ConclusionPhysicians and the general public in Korea acknowledge the need for open disclosure. Guidelines according to the type of patient safety incident are required to encourage physicians to more readily conduct open disclosure. Furthermore, hospitals need to consider organizing a dedicated team and hiring experts for open disclosure. (shrink)

Che 1-kwŏn. Kodae-kŭndae sasang -- che 2-kwŏn. Hyŏndae sasang.

1. Yesul esŏŭi poiji annŭn kŏt -- 2. Mom ŭi chŏngch'i wa munhak ŭi mijongmal.

언론현상과 제문제를 철학적 관점에서 연구 분석한 논저. 도덕:저널리즘과 윤리 가치론:언론과 가치 등모두 9편을 실었다.

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

Dans Le Langage de la perception, Austin critique la conception habituelle de la perception qui pose que nous ne percevons pas directement les objets, mais des sense data, nos idées, ou des impressions sensibles. Il souligne, contre Descartes, que nos sens sont muets et il montre que le but de l’argument de l’illusion est de rendre réelles les entités intermédiaires. Dans cet article, j’examine les analyses du bâton qui paraît cassé dans l’eau dans les Sixièmes Réponses pour montrer en quoi (...) elles diffèrent de celles fournies par Austin et je montre que dans la philosophie cartésienne des idées, traiter la perception comme un acte mental n’implique pas de considérer les représentations comme des objets qui sont perçus. Grâce à la notion arnaldienne de « réflexion virtuelle », je présente une conception cartésienne de la réalité objective des idées qui ne pose pas d’« êtres représentatifs » dans la perception. Et c’est à la lumière de la mémoire de soi que j’interroge la radicalité de la conception austinienne de la perception. (shrink)

A lire attentivement Descartes, on se surprend à constater que l'inventeur de la philosophie du sujet pensant emploie rarement le mot de " sujet ", si ce n'est au sens traditionnel et scolastique de sujet des accidents ou des qualités, ou encore de substance. Le but de ce volume est donc d'aborder à nouveaux frais la question à partir de l'inventaire du vocabulaire cartésien de la " subjectivité ". Devons-nous dire ainsi que l'ego du cogito est sujet? Ou bien la (...) res cogitans? Ou encore la mens? Y a-t-il un sujet corporel chez Descartes, ou alors l'union est-elle le sujet? Y a-t-il, de la même manière, un sujet des passions? Un ipse, une ipséité serait-elle enfin le sujet chez Descartes? Multiples formes de la question de savoir s'il y a bien une philosophie du sujet chez Descartes. (shrink)