국내 인터넷 사용자들의 의료윤리 문제에 대한 의식 조사: "병원이 비윤리적이라고 느끼게 되었던 경우"에 대한 질적 분석

While ethical issues in medical practice are receiving a great deal of attention these days from professionals within the medical community, relatively little attention has so far been paid to patients perceptions of these ethical issues. For this reason, we performed an on-line survey of patients perspectives on ethical issues. Structured and unstructured questions were posted on a medical information home page (http://www.hospital.co.kr), and information was then collected from 158 respondents. The collected information included the respondents' demographics and data from self-administered questionnaires, which asked patients for their views on abortion, new drug trials, and organ transplantation. The respondents were also asked to describe any personal experiences they had of unethical behaviour in a hospital or a clinic. The collected data shows that the issue that patients regard over-treatment as the most common ethical problem in medical practice. Other frequently mentioned problems are treatment refusal, equality, bribery, sex pre-selection, and artificial abortion. Approximately 48% of the respondents replied that they regarded artificial abortion as murder, and 62% of the respondents answered that selling a person's living organs for transplantation should be allowed. About 77% of respondents were willing to participate in new drug trials if they had fatal diseases, but only 43% would do so if they were in good health.

We undertook a qualitative analysis for 58 unstructured answers out of the 158 respondents. We grouped the respondents into two major categories : i) those with perceptions of ethical problems arising from patient-doctor relationships, and ii) those with perceptions of ethical problems arising from health care systems. In the first category, negligent attitudes on the part of doctors was the most frequently reported item, while over-treatment and the abuse of laboratory tests was the second most prevalent item. In the second category, the policy of pay-before-treatment in emergency rooms was the most common complaint.

The results of (his study suggest that patients are more concerned with patient-doctor relationships and doctors' communication skills than with other ethical issues in medical practice. Therefore, we believe that these issues ought to occupy a greater portion of the ethical curriculum for medical students.