건강데이터 소유권에 관한 윤리적 접근

차현재,김준혁 한국의료윤리학회 2021 한국의료윤리학회지 Vol.24 No.4

In recent years, with the rise of the data economy, the amount of personal health data that is collected and stored has increased significantly and raised ethical and legal concerns over the question of who owns this data. This article reviews the relevant legislation in Korea, the EU, the US, and Japan and shows that in the current legal context there are practical problems with the concept of health data ownership. However, rather than abolishing that concept, this article attempts to situate it in a new ethical framework. Using Fraser’s critical theory of justice, which distinguishes between issues of redistribution versus recognition, this article argues that health data ownership should be understood in terms of a just relationship between data parties and data. 개인의 건강과 관련된 모든 정보를 의미하는 건강데이터(health data)는 데이터 경제의 빠른 확산과 함께 현재 보건의료 영역에서 빼놓을 수 없는 중요한 논의 주제가 되었다. 특히, 건강데이터의 보호와 활용을 위해 건강데이터 소유권 개념이 대두되었고, 이는 관련 법적 문제를 해결하기 위한 대책으로 주목받았다. 그러나, 데이터 소유권이 다루는 문제의 폭이 넓어 서로 충돌하며, 현행법이 데이터 소유권을 포괄하는 법제를 제시하는 데 한계를 지니고 있다는 문제가 확인되었다. 본 논문은 국내법, 유럽연합, 미국, 일본에서 데이터 소유권 및 건강데이터 소유권 관련 법적 상황을 검토하여, 데이터 소유권, 특히 건강데이터 소유권 개념은 현재 법적·실무적으로 유용하지 않을 수 있다는 주장을 확인하였다. 그러나, 본 논문은 건강데이터 소유권 개념을 폐기하는 대신, 지금까지 이루어진 건강데이터 소유권에 관한 논의를 종합, 건강데이터 소유권의 윤리라는 틀을 새로 제시하고자 하였다. 이를 위하여 최근까지의 건강데이터 소유권 논의가 데이터 경제와 문화의 참여와 배제라는 차원을 다루고 있음을 확인하였다. 경제 차원과 문화 차원에서 분배와 인정 문제가 관점적으로 구분되어야 한다는 주장을 첨예하게 제기한 프레이저의 비판적 정의론에 기대어, 본 논문은 건강데이터 소유권의 윤리가 데이터 당사자와 데이터가 맺는 정의로운 관계를 규명하고자 하는 논의임을 주장하고자 한다.

사회적 고립가구를 지원하는 사회복지사의 지원 경험에 대한 질적 연구

차현재,김준혁,오혜인 대한의료커뮤니케이션학회 2023 의료커뮤니케이션 Vol.18 No.2

Background : This research focuses on the experiences of social workers who assist socially isolated households to prevent solitary deaths. The study aims to understand their support-related experiences, examining both the perceptions and practices of these workers. It highlights the importance of tailored support for isolated households, especially considering the unique challenges faced by middle-aged individuals in this demographic. Methods : The study employed purposive sampling to recruit social workers in Seoul who are actively engaged in supporting socially isolated households. Semi-structured interviews were conducted to gather in-depth insights into their experiences. The research methodology was rooted in qualitative analysis, specifically using Giorgi’s method. Results : Analysis of the interview data led to the identification of 12 sub-components and 5 upper components: “implementation of support for socially isolated households different from previous experience,” “feeling helpless in the face of inevitability,” “sympathy and communication with the heart,” “discovering challenges and opportunities in the field,” and “slowly, waiting for change.” These findings underscored the complexities and emotional challenges faced by social workers. Conclusion : The study highlights a significant gap in resources and manpower for supporting isolated households. It suggests the need for long-term, specially designed support systems, emphasizing improvements to better aid socially isolated individuals and the social workers who support them.

건강데이터 기증 및 공유의 윤리적 접근: 인체유래물 기증 절차를 참조하여

차현재,김준혁 (재) 국가생명윤리정책원 2022 생명, 윤리와 정책 Vol.6 No.2

Although there is a strong demand to utilize health data in the context of the data economy, there is also a strong push to protect health data for privacy reasons, which has a long history. In order to both utilize and protect health data, it is important to place it within a specific management framework. However, the current discussion about health data usage has primarily centered on the legal basis of its availability. Based on the sim- ilarity between human tissue and health data, this paper examines whether the human tissue donation procedure can be used in the health data donation and sharing procedure. First, we outline the institutional development and current procedures for human tissue donation and review the recent discussion on posthumous health data donation to exam- ine whether it can be used to share health data when the data subject is still alive. Here, it is necessary to revise or modify the human tissue donation procedure in order to make it appropriate for health data donation and sharing. To this end, the paper reviews the cell-line case to examine the points to be considered in health data donation and sharing. Based on these considerations, the paper calls for the implementation of governance for health data donation and sharing based on social recognition and the right to control health data by parties involved in data creation and management.

인간 향상에서 자연 개념의 문제와 새로운 존재론의 요청

차현재 한국생명윤리학회 2023 생명윤리 Vol.24 No.1

유전공학, 나노기술 등의 지속적이고 빠른 발전으로, 향상 기술은 미래 의료의 다양한 가능성을 열고 있다. 본 논문은 향상 기술에 대한 논의에서 ‘자연’ 및 ‘인간 본성’에 대한 다양한 주장이 기술에 대한 도덕적 판단과 지지에 어떻게 영향을 미치는지를 탐구하고자 한다. 이를 위해 ‘자연’ 개념을 중심으로 기존의 생명보수주의자, 생명자유주의자, 트랜스휴머니스트의 향상 찬반론을 구체적으로 살펴볼 것이다. 향상 찬반론은 대립되는 입장 차이에도 불구하고 인간중심주의적 틀, 그리고 이원론적인 존재론 안에서 향상을 사유하고 특정한 가치를 추구한다는 점에서 공통적 한계를 지닌다. 이에 향상에 대한 논의가 1)환경적이고 맥락적인 사고, 2)‘어떤’ 인간의 ‘무엇’이 향상되는지에 대한 질문, 3)인간의 생물학적 신체와 정신을 넘어서는 사유를 포함하는 새로운 존재론적 틀에서 전개되어야 함을 강조할 것이다. 마지막으로, 포스트휴머니즘 존재론의 채택을 통해 향상 기술을 인간, 자연, 기술을 한 축으로 환원하여 이해하지 않고 경계를 가로지르는 확장된 시스템으로 이해하는 방식을 제안할 것이다.

인문사회 분야 연구자들의 기관생명윤리위원회(IRB) 갈등 경험 및 인식 연구

김선기,권수빈,정성조,차현재,이상길 연세대학교 사회과학연구소 2023 社會科學論集 Vol.54 No.2

국내에서 인문사회과학 분야의 인간대상연구가 기관생명윤리위원회(IRB)의 심의 및 관리 대상이 된 지도 10여 년이 지났다. 이러한 상황에서 인문사회 분야 연구자들의 IRB와 관련한 비판적 의견이나 부정적경험이 쌓여가고 있음에도 불구하고, 제대로 담론화되지는 못하고 있는 실정이다. 이 연구는 인문사회 연구현장에서 나타나고 있는 IRB 제도화의 문제점과 개선 방안 도출을 시도하였다. 이를 위해 영미권 문헌을중심으로 IRB와 인문사회 연구 사이의 갈등 요인을 파악하고, 온라인 설문조사(152명)와 초점집단면접(27 명)을 통해 연구자들이 겪는 IRB와의 갈등 경험 및 인식을 조사하였다. 연구 결과, 인문사회 연구자들은 심의 사전 단계에서부터 연구 과정 전반에 걸쳐 IRB 심의와 갈등을 경험하고 있었다. 인문사회 분야의 특수성을 고려하지 않는 IRB의 과도한 원칙주의와 형식주의가 갈등의 주요인으로 나타났다. 그에 따라, 인문사회연구자들은 IRB 심의에 불가피하게 순응하면서도 그것이 불투명하고 타당성이 부족하며, 창의적인 연구를위축시키고, 연구윤리 증진에는 효과가 미미하다고 인식하고 있었다. 인문사회 연구자들은 IRB와의 다양한갈등 상황에서 비롯한 비판적 문제의식을 공유하는 한편, 전반적으로 IRB의 필요성 자체에는 공감하는 방향에서 제도적 개선책들을 제안하였다. 이 연구는 IRB가 연구윤리의 제고에 기여하면서도 인문사회 연구의 자율성과 창의성을 제약하지 않을 수 있도록 IRB 심의의 기준과 절차 등에서 실질적 개선 방안을 마련하고, 학계 내에서 자율적인 연구윤리에 대한 공론의 장을 활성화해야 한다고 주장한다. About 10 years have passed since human subjects research in the humanities and social sciences became the object of systematic management by the Institutional Review Board(IRB). The negative experiences and dissatisfaction of the HSS(humanities and social studies) researchers with the IRB also continue to pile up over the past decade. This study aims to examine in detail the aspects of the conflict between the HSS researchers and the IRB. To this end, we conducted an extensive literature review, and attempted to identify conflict factors between the IRB and HSS researchers through an online survey(152 persons) and focus group interviews(27 persons). As a result of the study, it was confirmed that a lot of HSS researchers experienced conflicts with the IRB throughout the overall research process. IRB's excessive principledness and formalism appeared to be the main cause of conflict. Although HSS researchers inevitably complied with IRB deliberation, they recognized that it was opaque, lacked validity, discouraged creative research, and had little effect in promoting research ethics. HSS researchers generally agreed on the necessity of IRB, but suggested improvement opinions based on critical awareness arising from various conflict situations with IRB. This study argues that the IRB review system should be improved so that IRBs can contribute to the improvement of research ethics without restricting the autonomy and creativity of HSS research, and public debate on autonomous research ethics should be activated within academia.

패혈성 쇼크의 치료를 위한 승압제 사용 후 발생한 양측 사지 괴사: 증례 보고

허윤무,송재황,오병학,차현재 대한족부족관절학회 2019 대한족부족관절학회지 Vol.23 No.4

Symmetrical Digital Gangrene (SDG) is characterized by the sudden onset of peripheral, symmetrical gangrene in the absence of any major vascular occlusive disease. Catecholamine inotropes are frequently used for the treatment of septic shock combined with an unstable hemodynamic state, and their usage can rarely induce SDG. There is no standard treatment for the SDG. Early recognition and prompt management of sepsis and expeditious process of weaning off of the inotropes are necessary to prevent progression of SDG. To the best of our knowledge, this is the first report in Korea regarding the treatment of SDG induced by catecholamine inotropes.

‘취약성’의 제도화?: 인문사회 분야 IRB의 ‘취약한 대상’ 연구 심의에서 나타나는 갈등과 쟁점

김선기,권수빈,정성조,차현재,이상길 충남대학교 사회과학연구소 2023 사회과학연구 Vol.34 No.4

This study identifies issues from IRB reviews of research on vulnerable subjects in the humanities and social sciences. To this end, the IRB review experiences of 27 researchers who studied vulnerable subjects were investigated through focus group interviews. Results showed that researchers were experiencing conflicts with IRBs from two main aspects. First, excessive deliberation standards are applied when dealing with vulnerable subjects. Second, an IRB's request for formalized informed consent was recognized as a problem. A gap in the awareness of research ethics and vulnerability between the IRB and the researchers was identified as the cause of recurring conflict. Researchers generally evaluated the risks of humanities and social studies research as low, compared to the IRBs, and recognized the definition of a vulnerable subject in a context-dependent manner, which was different from the subject-specific definition held by IRBs. Such a conflict is problematic because it leads to institutional reproduction of the vulnerability of vulnerable subjects, restricting research on vulnerable groups and intervening with social prejudice against vulnerable groups in the review process.

Importance of Magnetic Resonance Imaging Examination in Unossified Avulsion Fracture of Child Elbow

오병학,김태균,허윤무,차현재 대한수부외과학회 2019 대한수부외과학회지 Vol.24 No.3

Unossified elbow avulsion fractures of children should be treated with care. Simple avulsion fractures seen on an x-ray may actually be severe injuries such as elbow joint subluxation or radial head dislocation. So, definite diagnosis is impor-tant in determining appropriate treatment of avulsion fractures around the unossified elbow, and magnetic resonance im-aging (MRI) examination plays a key role in the diagnosis. We experienced avulsion fracture of the capitulum with com-mon extensor tendon and lateral collateral ligament injuries and ulnar coronoid process fracture in an 11-year-old boy and radial head dislocation with common flexor tendon and partial ulnar collateral ligament injuries in an 8-year-old boy. We would like to talk about the importance of MRI in unossified avulsion fracture of child elbow by reviewing 2 case reports.

코킹 초기단계에서 팔의 과외전 자세가 야구 투수에게 정말 위험한가?

이제형,오병학,박진영,이병국,유태현,차현재 대한스포츠의학회 2019 대한스포츠의학회지 Vol.37 No.4

Purpose: Certain pitching mechanics is thought to lead pitchers in danger of surgical risk and decrease performance. The objective of this study is to analyze the effect of shoulder hyperabduction position during early cocking phase in association with surgical risk and performance in professional baseball players. Methods: From 2009 to 2013, total of 93 candidates reached minimum inning qualification. After exclusion criteria (overlapped players, foreign players, age over 31 years, proceed to other league and retirement), 19 players were analyzed with slow-motion pitching video for hyperabduction of the shoulder and hyperpronation of forearm in cocking-phase. Also players were analyzed with innings pitched, earned run average (ERA), walks and hits divided by innings pitched (WHIP) and surgical history with database offered by official Korean Baseball Organization website. Results: Out of total 19 players, nine players had hyperabduction arm movement and 10 players did not. Group with hyperabduction had average age of 24.3 years old, average inning/ERA/WHIP for 5 years were 55 innings/yr, 6.52 ERA/yr and 1.33 WHIP/yr, respectively, and seven players (77%) had surgeries eventually. Group without hyperabduction arm movement had average age of 25.4 years old; average inning, ERA/WHIP for 5 years were 127 1/3 innings/yr, 4.84 ERA/yr, and 1.32 WHIP/yr, respectively and five players (50%) went for surgeries. Player performance (ERA, p=0.66; WHIP, p=0.14) was not statistically influenced by the certain arm position at cocking phase but average inning pitched was statistically affected (p<0.01). Conclusion: Hyperabduction of shoulder in early cocking phase of throwing motion does not lead to decrease in performance (ERA, WHIP) but will result in tremendous decline of average IP. Also, risk of surgery is not associated to hyperabduction motion of the shoulder.

Effective Insertion Angle Measurement of Fibular Allografts for Treatment of Proximal Humerus Fracture using Finite Element Analysis

J. U. Kim(김종운),J. W. Yi(이진웅),H. J. Cha(차현재),K. S. Tae(태기식) Korean Society for Precision Engineering 2020 한국정밀공학회 학술발표대회 논문집 Vol.2020 No.9월