연명치료중지시 의사의 역할과 의무

고윤석 대한의사협회 2009 대한의사협회지 Vol.52 No.9

Patients should be treated with dignity and respect toward the end of their lives, being freed from unnecessary and painful life-sustaining therapy in hospitals. In Korea, the quality of endof- life (EOL) care has been variable, a major factor being the physicians’ perception to the care. A firm consensus of EOL care decision-making has not yet explicitly stated in Korean law and ethics until recently. However, movements to make a law of so-called “the death with dignity act” are presently making its way to the National Assembly, initiated by a law case that allowed the hospital to withdraw mechanical ventilator support per request by the patients’ family of a permanently vegetative patient. Socially agreed guidelines for EOL care can facilitate clinical decision process and communication between health service provider and the patient or his/her family. At the same time, EOL care should be individualized also in the same line of guideline to meet patient’ and patient’ family wish regarding the withdrawal of life-sustaining therapy. The painful EOL care experience of the loved one remains in the memory of the relatives who live on. Physicians should identify, document, respect, and act on behalf of the hospitalized patients’ needs, priorities, and preference for EOL care. It has been advocated that competent patients can express their right of self-determination on EOL care through advance directives in Western countries. Advance directives are considered as a tool to facilitate EOL decision making. However, there are barriers to adopt the advance directives as a legitimate tool for an EOL decision making in Korea. For one thing, the reality of death and dying is rarely discussed in our society. In addition, the discussion about EOL care with chronically and critically ill patients has been considered as a taboo in the hospitals. In spite of these difficulties, physicians could do better EOL care by the open communication with patients or with their surrogates. Through the communication, physician should set a goal how to manage the EOL patient. The set goal should be shared among the caregivers to achieve the maximum benefit of the patient. The lack of open discussion with patient prior to EOL care results in inappropriate protraction of a patient’s dying process. In summary, physicians, who know the clinical significance of delivering treatments to EOL patients, should play a central role in assisting patients’ and their families’ to make the best decision on EOL care. Moreover, the concerted actions to improve EOL care in our society among general public, professionals, stakeholders for EOL care, and governmental organizations are required to address ongoing social requests, although a policy or a guideline is made in this time.

종설논문 : 의료인-제약회사 관계윤리의 종설논문을 기획하면서

고윤석 한국의료윤리학회 2011 한국의료윤리학회지 Vol.14 No.2

의료윤리와 의사 자정노력

고윤석 대한의사협회 2013 대한의사협회지 Vol.56 No.4

Consumption of medical services has been expanding since the health insurance system was established in the Republic of Korea. However, physicians do not seem to be satisfied with the current state of medical practice. One of the main reasons for this dissatisfaction seems to be related to underpayment of costs. The monopolistic insurance agency has kept reimbursements for appropriate medical services below cost. The public also seems to have less trust in doctors than in the past because of repeated scandales in the news media such as doctors’accepting inappropriate rebates from the pharmaceutical industry. Patients are vulnerable to illness and depend on their doctors’ decision making and advising. Plus family members and taxpayers must share in caring and the financial burden that patients face. Therefore, society has high ethical standards for physicians. The medical society also has been responding to these practices. To meet society’s expectations, doctors should not abandon self-regulation through the medical society. Furthermore, because the identity of a professional healthcare provider is based on the trust and endorsement of society, physicians should attempt to maintain appropriate care for patients’ best interests. The public should support physicians’ appropriate medical practice via reasonable reimbursement of medical costs. Through self-support and selfregulation to maintain appropriate medical practice for patients, physicians can enhance public trust. In turn, public trust in doctors will address this country’s distorted medical services and restore the eroded reputation of physicians as healthcare professionals.

심포지움 : 기계적 환기 치료중의 감시 및 이탈

고윤석 대한결핵 및 호흡기학회 1993 워크샵 Vol.2 No.-

산업용 분전반 적용을 위한 3상 전력 관리 장치 시작품 제작에 대한 연구

고윤석,신현용,Ko, Yun-Seok,Shin, Hyun-Yong 한국전자통신학회 2010 한국전자통신학회 논문지 Vol.5 No.5

최근, 전력공급의 안정성과 신뢰성 그리고 고품질화를 위해 인터넷을 기반으로 하는 산업용 디지털 분전반이 새롭게 요구되고 있다. 따라서 본 논문에서는 3상 4선식 전력공급방식을 기반으로 하는 산업용 3상 분전반이 설계된다. 그리고 3상 산업용 분전반을 위한 전력관리 모듈이 시험 제작되며, 끝으로, 3상 전구 부하 시험을 통해 시작품의 3상 전압, 전류 측정 기능이 검증된다. Recently, the industrial electric customers require a digital switchgear which can improve the safety and reliability of the power supply, and the quality of electric power by on-line monitoring the electric power information based on the internet under the ubiquitous environments. Accordingly, in this paper, a industrial switch-gear prototype is designed based on the power supply method of three phase, four-line type, and then a three-phase electric management module of the digital switchgear is made for industrial electric customer system. Finally, the three-phase voltage and current measuring function of the prototype is verified from real power load test.

심포지엄 : 의료현장에서 부딪히는 생명윤리의 범주와 해결방안

고윤석 대한내과학회 2010 대한내과학회 추계학술대회 Vol.2010 No.-

심포지엄 : 의료현장에서 부딪히는 생명윤리의 범주와 해결방안

고윤석 대한내과학회 2010 대한내과학회지 Vol.79 No.20

열전 냉각기의 모델링 및 열전달 해석에 대한 연구

고윤석,Ko, Yun-Seok 한국전자통신학회 2014 한국전자통신학회 논문지 Vol.9 No.11

열전 냉각기는 냉온 정밀온도제어가 가능하고, 소형화 및 경량화가 가능할 뿐만 아니라 기계적인 진동이 없어 신뢰성을 높일 수 있다는 장점 때문에 다양한 분야에 적용이 시도되고 있다. 하지만 열적 모델링 및 해석이 요구되기 때문에 적용분야에 최적한 열전 냉각기를 설계하는 것은 쉽지 않다. 따라서 본 연구에서는 SINDA/FLUINT 해석법을 이용하여 열전 냉각기 모델링과 크기 결정 문제 그리고 열적해석 등을 연구함으로서 열전 냉각기의 적용을 위한 기반기술을 확립하고자 한다. The thermoelectric cooler is receiving great interest because of advantages such as the precise temperature control capability, the compact and lightweight cooler, and the mechanical vibrationless structure which enhances the reliability compared with the existing vapor compression cooler. However, it is not easy to design the optimal thermoelectric cooler which appropriate to the application because the thermal analysis should be necessary required. Accordingly, this paper studies the methodology of the modelling, sizing and thermal analysis of the thermoelectric cooler using SINDA/FLUINT analysis tool.

심포지엄 : 의료 및 기술적 측면

고윤석 대한내과학회 2009 대한내과학회지 Vol.77 No.4S

고온 초전도 선재의 전력계통 적용 사례 분석 연구

고윤석,Ko, Yun-Seok 한국전자통신학회 2015 한국전자통신학회 논문지 Vol.10 No.7

Because of the advantages such as the zero electrical resistance effect that disappears in the vicinity of the absolute temperature and the magnetic levitation effect, the superconducting applications are being tried in a variety of fields. But, those have faced many difficulties in the practical use because of the difficulty for the realization of the superconducting critical temperature. Recently, however, because the high-temperature super conductors was discovered newly which show superconductivity more than $30^{\circ}K$, the application researches based on it are being tried in various fields. Therefore, this paper examines the possibilities and issues by surveying the high temperature superconducting applications to electrical power system. 초전도 현상은 절대온도 부근에서 전기적 저항이 사라지고 자기부양 효과를 보이는 등의 장점 때문에 다양한 분야에서 적용이 시도되고 있지만 초전도 임계온도를 실현하기 위한 어려움 때문에 실용화에 많은 어려움을 겪어 왔다. 하지만 최근 $30^{\circ}K$ 이상에서 초전도 현상을 보이는 고온 초전도체가 발견됨으로서 다양한 분야에 대한 적용연구가 시도되고 있다. 따라서 본 논문에서는 최근 각광받고 있는 고온 초전도체의 전력계통 적용 사례들은 조사, 분석하여 그 가능성과 문제점들을 살펴보고자 한다.