인문학 기반의 죽음학 강의를 위한 시론

방미경 한국문화융합학회 2022 문화와 융합 Vol.44 No.2

Death education includes understanding of death, preparation for death, and mourning for death. People recognize that the education specializing in each stage of life is needed, not just for the elderly people or terminal patients. This study examines the meaning of death education for university students in their early adulthood and is aiming at providing them an opportunity for reflection on death through some works of art. For the death education based on the humanities, we used two literary works and three films. First, focusing on Tolstoy’s The Death of Ivan Ilyich, the students could share their thoughts about what dying means to them and what they would wish for the most when assuming death. Second, through Camus’s The Myth of Sisyphus, we reflect on the meaning and value of life, and examine the freedom of human being and their rebellion overcoming the absurdity of meaningless life, and the solidarity arising out of the rebellion. <Me before you> comes next to think about whether we have the right to choose our own death, and we examine the problems of the assisted suicide measure. At the end, in <Coco> and <Wonderful Life>, we think about whether life exists after death and learn about the near-death experience and research on the life after death. Studying and discussing the meaning of life and death, and the problems of suicide on various levels could help the students in the early adulthood to establish their view of the world and image of the self. Therefore death education aims to learn to enrich in excelsis the life given to us.

사망진단서 및 시체검안서의 작성현황과 평가자 간 일치도에 대한 고찰: 단일기관 관찰연구

백대현,조한진,문성우,박종학,송주현,김주영,전승호,안유상 대한응급의학회 2017 대한응급의학회지 Vol.28 No.4

Purpose: This study aims to review the appropriateness of the issued death certificates and autopsy reports and to evaluate the improvement points of these documents in accordance with the guidelines of the Korean Medical Association and the National Statistical Office. Moreover, this study also examines why the guideline is necessary for the credibility of these documents. Methods: The death certificates and autopsy reports written by a training hospital were analyzed for a 12-month period, between December 2014 and November 2015. The reference to analysis was the “guidelines to medical certificate 2015” written by the Korean Medical Association, “World Health Organization (WHO) death certificate principle”, and “guideline leaflet,” as provided by the National Statistical Office. Two researchers analyzed the documents that were against the guidelines, and suggested improvement points. The analyzed variables were age, sex, issued date, direct cause of death, manner of death, location of death, and types of accident. The primary goal was to see the rate of issued documents written correctly according to the guidelines and to suggest possible improvement points. The secondary goal was to analyze the reason for accordance and discordance between researchers. Results: There were a total of 603 death certificates and autopsy reports issued during the research period; 562 (93.2%) and 41 (6.8%) cases, respectively. As for the manner of death, 521 cases were “death from disease,” 64 were “external causes,” and 18 were “others or unknown” (86.4%, 10.6%, and 3.0%, respectively). As for the issued department, internal medicine and emergency medicine issued 301 (49.9%) and 126 (20.9%) documents, respectively. Of these, 139 (23.1%) cases were regarded to be in accordance with the guidelines, while 304 (50.4%) were considered to be discordant cases. Among the discordant cases, there were 177 (29.4%) cases that were the mode of death directly written to cause of death. As for the records of “period of occurrence to death” were recorded only 70 (11.7%) cases (including “unknown” 65 cases) and the others were blank. The Kappa number of analysis regarding the evaluation correspondence of the two researchers was 0.44 (95% confidence interval, 0.38 to 0.51). Conclusion: The most frequent error was ‘the condition of death to direct cause of death’ with the ratio of 29.4%. This may have been because the rate of concordance between the researchers based on the guidelines was not high enough. There is a need to provide specific guidelines for each case, and also promote and educate regarding significant errors.

3차병원 권역응급의료센터에서 발부된 사망진단서의 오류 분석

윤성희,김란,이충식 대한법의학회 2017 대한법의학회지 Vol.41 No.3

This study aimed to analyze the errors and their causes in inappropriately completed death certificates, and to suggest improvement measures. The death certificate is an important medical document that proves the cause and manner of death. However, a death certificate is not as valuable as a medical document, since many death certificates are inappropriately completed and thus provide inaccurate information. We reviewed 307 death certificates issued by the Emergency Room of Chung Nam National University Hospital between January 1, 2015, and November 31, 2016, and compared their details with the cause and manner of death in the patients’ medical records. Among various errors, the most common was “omission of other significant information not related to the cause of death” (184 cases). On 29 death certificates, the mechanism of death was recorded instead of the cause of death. When comparing death certificates and medical records, discrepancies in the cause and manner of death were found in 13 (4.2%) and 17 (5.5%) cases respectively. Although the contents of a death certificate may vary according to a physician’s point of view, multiple errors on death certificates should be avoided, and we suggest necessary improvement measures.

‘좋은 죽음’과 유학의 죽음관

김명숙 동양사회사상학회 2009 사회사상과 문화 Vol.19 No.-

Death is one of the biggest event in life. But these days the process of death is transferred to doctors, thus dignity of finishing the finale of life or meaning for people who are left to live(Surviving) seems less important. Facing death not only provokes fear it also makes us aware of the meaning of life and makes our lives affluent so it is something we shouldn’t put behind. The point of this paper is to show what is the ‘good process of dying’(facing death) modern day Korean wants, and how ‘good death’(Death) consist of by doing a survey called ‘idea research of death for Korean’. And found out what influence is given or can be given by view of death in confucianism in ‘good death’ present age Koreans want. 죽음은 인생의 핵심 대사 중의 하나이다. 그러나 오늘날 대다수 사람들의 죽음의 과정은 병원이나 의사에게 일방적으로 떠넘겨지고 삶의 대단원을 마무리하는 존엄함이나 떠나보내는 사람들의 삶의 의미로 살아나지 못한다. 죽음에 직면하는 것은 불안감을 야기하기도 하지만 오히려 삶의 의미를 일깨워주는 경험이 되어 삶을 풍요롭게 할 가능성도 높기 때문에 뒷전으로 밀쳐 버릴 일이 아니다. 본고에서 논자는 현대 한국인들이 바라는 ‘좋은 죽어 가는 과정’(임종)이란 어떠한 것인지, ‘좋은 죽음’이란 어떻게 구성되는지를 ‘한국인의 죽음에 대한 표상 연구’라는 설문의 응답을 통해 알아보았다. 그리고 유학의 죽음관이 현대 한국인들이 바라는 ‘좋은 죽음’에 어떤 영향을 주고 있는지 혹은 줄 수 있을지를 살펴보았다.

하이데거의 존재론에 나타난 죽음의 현상학적 의미와 죽음교육

신교남(Shin, Kyo-Nam),이병승(Lee, Byung-Seung) 한국교육철학회 2013 교육철학 Vol.50 No.-

The purpose of this study is to investigate the phenomenological meanings of death in Heidegger's ontology and seek for its implications on death education. Death and life is one. At least, death is important part of life. So reflection on death is as important as the meaning of life and further more it broaden the dimension of our life. Heidegger said 'the human-beings are the beings toward to Death' in Sein und Zeit. He thought that death is the subject related with the recovery of the individual authenticity, and defined the death not as the biological concepts but as the existential concepts. In short, he understood the death as the unique existing way. Moreover he interpreted death as the important turning point which enriches our life. So Heidegger's understanding on death is existential, ontological and further phenomenological. This phenomenological view of death of Heidegger gives following implications on death education. First, it will broaden the dimension of death understanding. Second, death education as pioneering education of life can be a philosophical base of our positive life. Third, the perspective of phenomenological method can be studied as the reflection of the current studies of death education. In this context, it is necessary to study on Death in Heidegger's ontology continuously. As it is said that teaching about death is the teaching about life, the education about the life is more meaningful only with death education. We should think deeply about death and be ready to face death to seek for the answer about the existential questions by Dasein and to recover the authenticity of Dasein.

사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율 : 3개 대학병원에서 교부된 사망진단서를 중심으로

박우성,박석건,정철원,김우철,탁우택,김부연,서순원,김광환,서진숙,부유경 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

Background : To exatnine the problems intolved in writing practice of death certificates, we cotnpated the determination of underlying cause of death for wital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 rnortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record wpecialists. And causes of death determined at ministry of statistics for national vita statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificaties sere analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. Ane the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions tha caused death too. Conclusion : When we examined the correctness of death certificate writing practice using abpve methods, cortectness of writing could not be told as satisfactory. There was difference in correctness of writing between hospotals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

HIV병 사망자 중 결핵 사망 분율과 관련 요인

이혜권(Hye-Kwon Lee),나백주(Baeg-Ju Na),천성아(Sung-A Chun),박균익(Kyun-Ik Park) 한국농촌의학 지역보건학회 2015 농촌의학·지역보건 Vol.40 No.2

본 연구는 HIV병 사망자 중 HIV병과 결핵이 동반사망한 분율을 조사하고 그 관련 요인을 분석하였다. 2002년부터 2010년까지 사이에 HIV병 사망자는 모두 774명으로 결핵이 동반사망한 분율은 10.1%로 나타났다. 그런데 이러한 분율은 2005년부터 2007년 사이에 16.3%까지 치솟았지만 2008년부터 2010년 사이에는 4%까지 감소하는 경향을 보였다. 또한 HIV-결핵 동반사망 분율은 젊은 계층에서 더 높았고 배우자가 있는 그룹과 교육을 잘 받은 그룹에서는 유의하게 낮은 경향을 보였다. 이처럼 활동성이 높은 젊은층에서 HIV-결핵 동반사망 분율이 높고 사회경제적 안정계층에서 HIV-결핵 동반사망 분율이 낮은 것은 비슷한 해외 연구에서도 유사하게 나타나고 있어 HIV-결핵 동반사망의 예방 가능성을 시사한다. 한국은 다행히 점차 HIV-결핵 동반사망 분율이 낮아지고 있어 HIV감염자에 대한 결핵 예방사업의 효과가 나타나고 있음을 시사하고 이후 이러한 지표의 지속적인 모니터링이 필요함을 보여주고 있다. Objectives: To identify the importance of preventing tuberculosis for HIV (Human Immunodeficiency Virus) infectees and to monitor their management of health, we investigated the proportion of HIV-TB (Tuberculosis) deaths among the HIV deaths and its related factors. Methods: Data for HIV deaths from 2002 to 2010 was acquired from Statistics Korea, after which the HIV deaths were reclassified into HIV-TB deaths or other deaths according to the KCD (Korean Classification of Diseases). We analyzed the proportion of HIV-TB deaths among HIV disease deaths and the relationship between HIV-TB deaths and related variables such as sex, age, educational level, marital status, etc. Results: There were 774 HIV deaths in South Korea between 2002 and 2010. TB was the main cause of death in 10.1% of all HIV deaths. The total proportion of HIV-TB deaths was 10.1% but its proportion reached 16.3% between 2005-2007 and then decreased to 4% in 2010. Also, the proportion of HIV-TB deaths was significantly high in the young age groups, but its proportion was significantly low in married groups and well educated groups (p<0.05). Conclusions: The result implies that the policy that takes care of HIV infectee regarding TB prevention has been getting systemized on a national scale. Also, HIV-TB deaths have been affected by social factors such as education and marriage status.

서정인의 초기 소설에 나타난 죽음의 문제

김주언 ( Kim Joo-eon ) 한국문학이론과 비평학회 2009 한국문학이론과 비평 Vol.45 No.-

Death is one of the main themes of modem novels. In particular, the matter of death has earned a clearer expression now more than ever before in existentialism. Indeed, this matter of death is the most important issue in Sea Jung-in's early works, which has rich existentialism. However, this study has attempted to be free from the attitude that suggests that death is only influenced by existentialism. The deaths mentioned in "The evacuation" "Put on the costume" "The day when waves were high" and other works are designated as a trauma. As such, this analysis about death requires further psychoanalysis. Especially, "The evacuation" needs to be further explained in terms of a critical psychoanalysis. These deaths, constantly emerging as trauma in the series of works, imply that the most urgent priority of the writer is to resolve this issue. Because death would be that others forcibly draw upon this experience as passivity. The writer presents that a natural death has a thread of connection with an eternal death. This death it can be in the perception of structural world. However, it has problem if the concept is an excessively simplified resolution of matter; death has yet to be overcome, though still shows itself through the darkness. If it is going to be, death pushes human life towards its destiny. The physical nature of death does not have the power to act can be superior to human being's life once life has become destiny. And life that focuses solely on destiny is inclined to be lived only with fateful pessimism.

Factors Associated with Death Acceptance among Thai Patients with Advanced Cancer

Maliwan Krapo,Sureeporn Thanasilp,Janya Chimluang 충남대학교 아시아여론연구소 2018 Asian journal for public opinion research Vol.6 No.1

Patients with advanced cancer cope with various issues, especially psychological symptoms, such as anxiety about death. Previous research from various countries indicates that most advanced cancer patients perceive distress before death, which means they cannot accept death peacefully. The purpose of this study was to examine the factors associated with death acceptance of Thai patients with advanced cancer. The participants were 242 adult patients with advanced cancer from three tertiary hospitals in Bangkok, Thailand. The research instruments consisted of 7 questionnaires: a personal information questionnaire, the death anxiety questionnaire, Buddhist beliefs about death questionnaire, the unfinished task questionnaire, general self-efficacy scale, family relationship questionnaire, and death acceptance scale. These instruments were tested for their content validity by a panel of experts. All instruments except the first one were tested for reliability, and their Cronbach's alpha coefficient were .86, .72, .74, .74, .89, and .70, respectively. Descriptive statistics, Pearson's correlation, Point-biserial correlation coefficient, and stepwise multiple regression were used to analyze the data. The results revealed that a total of 42% of variance of death acceptance among Thai patients with advanced cancer was explained by death anxiety, Buddhist beliefs about death, and self-efficacy. Knowing these factors provides further information for nurses to help patients to cope with their death. From this crucial knowledge, nurses can develop interventions in decreasing or controlling anxiety about death, promoting Buddhist beliefs about death, and enhancing self-efficacy of advanced cancer patients. Therefore, a better quality of life and good death can be achieved.

염상섭 문학에 나타난 '죽음'

장두영(Chang Du-yeong) 한국현대문학회 2012 한국현대문학연구 Vol.0 No.37

본고는 다수의 염상섭 작품에서 죽음이라는 소재가 빈번히 다루어지는 현상에 주목하여 염상섭 소설에 나타난 죽음의 형상화와 죽음에 대한 인식을 살펴보았다. 1920년대 초반 염상섭의 작품에 나타나는 죽음은 부정적인 현실에서 초월하여 영원, 진·선·미 등 형이상학적 가치들로 표상되는 진정한 삶에 진입하는 구원의 방편으로 제시되며, 이것은 죽음을 신비적이고 낭만적인 기호로 취급하는 당대 문단의 담론과 이어진다. 염상섭의 작품에서 데카당스의 대표작이나 죽음에 깊은 관심을 표명한 러시아 작품이 산발적으로 언급되고 있는 것을 볼 때 작가의 죽음에 대한 인식은 일차적으로 서구문학의 독서체험과 연결됨을 알 수 있다. 그러나 구체적인 작품에서 나타나는 죽음의 형상은 서구의 것과는 일정한 차이를 보이고 있는데, 이것은 창작과정을 거치면서 작가 고유의 미학적 관념이 투영된 결과로 해석된다. 염상섭이 죽음과 창작에 대해 가졌던 생각은 '죽음의 예술화'로 정식화되는데, 죽음은 그 자체로는 일종의 자연현상에 속하지만 주관적 관념을 거치면서 미를 멱출할 수 있다는 것이다. 주관적 관념의 매개를 강조한 결과 1920년대 초반 발표된 염상섭의 작품에서는 죽음이 사건으로서의 의미보다는 인물의 내적 성찰을 이끌어내기 위한 계기로 설정되는 경향이 강하게 나타난다. 서사 전체가 죽음에 이르는 인물의 내적 고민과 방황의 과정을 드러내는 데 중점을 두는 작품의 특성상 죽음은 주로 작품의 결말 부분에 집중적으로 제시되고 현상으로 이어지게 된다. 한편 1930년대의 대표작에서 죽음이 형상화되는 방식을 살펴보면 이전 시기의 작품에서와는 뚜렷한 차이가 발견된다. 이상적인 구원이나 신비적인 형이상학적 가치와 연결되던 모습이 사라지고, 죽음에 이르는 인물의 내면을 표현하려는 '죽음의 예술화'가 생략되어 있는 것이 특징이다. 이것은 한 인물이 죽음에 이르는 과정을 다루는 것에서 벗어나 주변 인물의 반응이라든지 죽음 이후의 이야기 전개에 더 큰 관심을 기울이게 되는 서사적 차원에서의 변화로 이어진다. 이러한 변화는 죽음의 미적 인식에 관한 작가의 전면적인 태도 변화와 관련이 깊다. 1920년대 중반 염상섭의 산문에서는 죽음에 대한 미화가 일본적인 미의식과 깊이 연관된 것임을 강조하고 있는데, 이를 볼 때 죽음에 대한 인식의 변화는 일본적인 감수성에서 탈피하려는 작가의식의 소산임을 알게 된다. 또한 죽음을 계기로 인간의 내면 탐색을 추구하려는 시도가 약화된 자리에는 민족이나 사회에 대한 관심이 대체되고 있다는 점을 확인할 수 있었다. This thesis researches on the figure of death in Sangseop Yeom's fictions. Until now, researchers regard Yeom as the representative of the realist writers in Korean literature. So the theme of death in Yeom's fictions is untouched. In Yeom's fictions that were presented in early 1920s, death means entering a state of enlightenment. Death is not the termination of life, but the entrance of new stage that is filled with metaphysical value like truth, goodness, and beauty. This imagery about death seems the results of influence by romanticism. Yeom bethought how to make art with the subject matter of death. He came to a conclusion that death in itself is part of nature but passing through writers subjective, death can be part of art. The meaning of events is reduced to the lowest minimum and death is the medium that leads a person to introspection. Meanwhile, the figure of death in Yeom's works that were presented in 1930s went through a lot of changed. He did not make a mystery of death; consequently, death is treated as event for unfolding the plot. In mid-1920s, Yeom realized that the aesthetic of death have relevance to Japanese traits. (E.g. Japanese enjoy going cherry-blossom viewing and admiring the falling blossoms as the symbol of death) So the changes about the figure of death inform us that Yeom took a position contrary to Japanese sensibility. Furthermore, we can confirm that attempt to introspect with the theme of death is substituted with research on the reality of colony.