푸코의 자기기술 및 통치성 개념이 의료윤리 담론에 주는 몇 가지 함의

강명신 한국의철학회 2012 의철학연구 Vol.13 No.-

표준적인 의료윤리의 논의에서는 의사의 힘(권력)이 거의 들어오지 못했고 주로 의료사회학에서 다루어졌다. 푸코의 임상권력의 논의가 들어와서 의사의 힘이 논의되는 경우에도, 지배기술 위주의 구조주의적 논의에 머물렀다는 한계가 있었다. 대안 모델은 굴복(submission)이 아닌 주체화(subjection)로서, 이는 주체가 되는 과정과 권력에 의해 종속되는 과정을 포함한다. 권력은 억압적이기만 한 것이 아니다. 사회질서 속에서 지위를 생산한다. 환자는 의사가 휘두르는 권력의 지배하에 놓인 굴종의 존재이기만 한 것이 아니며, 의사 역시 권력의 대상이 되기도 한다. 푸코는 성의 역사에서 자기기술을 논하고, 이후에는 지배기술과 자기기술의 조합으로서의 통치성(governmentality) 개념을 도입하게 된다. 특히 통치성 개념은 지배기술 외에 자기기술을 포함한 역동적인 개념으로 주체화 개념과 이에 따른 권력의 생산성을 끌어낼 단초가 된다. 또한 푸코의 생명정치, 인구, 안보의 논의는 자유주의의 역설과 정당화를 끌어내고 있어 앞으로의 의료윤리의 논의에 주는 함의가 중요하다. 최근 의료윤리 논의에 일어나고 있는 두 가지 중요한 전환이 있다. 하나는 소위 공공 전회(public turn)로서 그간 의사-환자 관계 위주로 다루어지던 의료윤리의 논의가 최근 공공철학이나 보건(정책)윤리의 관점에서 논의되는 것이다. 다른 하나는 제도 전회(institutional turn)로서 의사의 전문직 윤리를 병원조직이나 이를 둘러싼 보건의료제도의 틀 안에서 논하는 것을 이른다. 기존의 의료윤리 논의의 한계와 새로운 전회의 움직임을 배경으로 볼 때, 푸코의 자기기술과 통치성 개념, 인구, 안보와 생명정치 논의는 중요한 대목이다. 물론 하워드 브로디나 카를 야스퍼스가 의사의 힘에 대한 논의를 했지만, 둘 다 의사-환자관계에서의 의사역할하기(doctoring) 차원이므로, 앞으로 통치기술이나 통치성 개념을 끌어들이면, 공공 전회와 제도전회 움직임과 맞물리면서 의료윤리담론의 발전가능성이 크다고 하겠다.

Sustainability of Korean National Health Insurance

강명신,Hoo Sun Jang,이민지,박은철 대한의학회 2012 Journal of Korean medical science Vol.27 No.-

Korean National Health Insurance (NHI) was established during only 12 yr from its inception (1977-1989), providing universal medical coverage to the entire nation and making a huge contribution to medical security. However, the program now faces many challenges in terms of sustainability. The low birth rates, aging population, low economic growth, and escalating demands for welfare, as well as unification issues, all add pressure to the sustainability of NHI. The old paradigm of low contribution - low benefits coverage - low NHI’s fee schedule needs to be replaced by a new paradigm of proper contribution -adequate benefit coverage - fair NHI’s fee schedule. This new paradigm will require reform of NHI’s operating system, funding, and spending.

인터넷에서의 저작권에 대한 이해집단들의 갈등에 관한 고찰

강명신 한국외국어대학교 국제커뮤니케이션연구소 1999 東西言路 Vol.11 No.-

Binder 증후군 1예: 코 성형의사의 관점

강명신,정주용,윤진,이재훈 대한이비인후과학회 2019 대한이비인후과학회지 두경부외과학 Vol.62 No.5

Binder syndrome, also called the congenital flat nose syndrome, is a rare congenital malformationwith a flat facial profile, intermaxillary hypoplasia and malocclusion. Rhinoplastyplays an important part in the multidisciplinary surgical protocol for this syndrome, for whichweak nasal framework and soft tissue underdevelopment have been considered a great challenge. We present a case of Binder syndrome of a 27-year-old male. The nose was reconstructedwith a caudal septum replacement graft and bilateral extended spreader grafts using costalcartilage.

Imaginary Nation of Wakanda in Black Panther: The Neo-colonized African Continent

강명신 문학과영상학회 2021 문학과영상 Vol.22 No.1

Ryan Coogler’s Black Panther as a high-profile black superhero film has been lauded especially by African descendants for its features such as diversity of actors and expression of Afrofuturism. As a Hollywood film that is produced under the grand project of Marvel Cinematic Universe, Black Panther is celebrated for representing African (American) characters without distorting them. Thus, in this stance, the film is located within the historical context of African American film production that has long attempted to represent just and empowering images of the Black race. On the other hand, few scholars criticize Black Panther for its way of using African continent which does not differ from popular and everlasting culture prop. Starting from this point, this paper explores in particular the power dynamics surrounding Africa as the Third World via Wakanda as an imaginary space which generates the multi-layered perspectives for approaching the representation of Africa. Although this imaginary nation is supposed to be a leading image of liberating Africa through a cinematic imagination, it only comes to reiterate the existing position which dismisses and devalues African continent since it fails to embrace the continent. In further focusing the relationship among the African, the African American, and Wakanda, this paper also delves into what lies behind the idealistic surface of Black Panther. The detailed examination of the tension between T’Challa, the African, and Killmonger, the African American, will allow this paper to critically engage with Pan-Africanism the film stands for, and concludes that the film, although unintentionally, reinforces U.S. nationalism.

Ombudsman制度의 導入에 關한 硏究

강명신 대한신학대학 행정학회 1993 행정학보 Vol.8 No.-

Possibilities of “Moments of Ordinariness” in Mobility in Dionne Brand’s Love Enough

강명신 한국현대영미소설학회 2019 현대영미소설 Vol.26 No.2

Dionne Brand’s Love Enough ponders the positionality of alienated characters in the cosmopolitan city of Toronto. Brand particularly depicts her characters in their mobile status, which is peculiar as they are restlessly moving, either physically or psychologically, while being stuck at the same time. The scholars including Sara Ahmed point out that the mobility does not always entail the positive value due to the certain circumstances that drive people into mobility. For Brand’s characters, the central cause for their static-mobility, notwithstanding the various roots of the cause, lies in their troubled body schema. This paper therefore first explores the different forms of static-mobile state of main characters in Love Enough in order to argue that Brand attempts to find the possibility for the alienated characters to negotiate their position in the city space of Toronto in the “moments of ordinariness” within the endless movement. In this brief moments, which are short but influential, the characters in Love Enough become able to reestablish their relation to the world and the people they encounter by re-viewing the same space and situation in their own perspective.

새로운 의료시술의 도입과 임상적용 시의 윤리적 절차

강명신,이윤성,최보문,이동수,이상무,이선희,구영모,박재현,이일학,박지용,고윤석 한국의료윤리학회 2013 한국의료윤리학회지 Vol.16 No.1

Medical care largely depends on developments of medical sciences and technologies. Development of innovative medical procedure have to be based on medical evidence. And ethical climate among individual physicians, academic societies, specialists' organization, and healthcare institution which applies the procedure is as much critical as the ethical stance of the developer. Therefore, it is necessary to make decisions on clinical application and evaluation, social costs and benefits, reimbursement through rational procedure and standards taking into account issues like medical evidence and conflict of interests. Especially, in the case of innovative surgical and surgico-medical procedure, the adoption has almost been up to non-formal studies until recently. Formal review process based on basic principles of biomedical research ethics and evidence-based medicine, is to be proposed for development of innovative surgical and medical procedures. And this process is to be an integral part of biomedical technology assessment and ethical regulation. This paper suggests an ethical guideline for ethical review and evaluation of a new medical procedure from its initial attempt to clinical application. Though focused on innovations, this suggested guideline is also applicable to a new medical procedure. The paper consists of four parts. Firstly, it outlines the general discussion about surgical innovations from the ethical viewpoint. Secondly, prior researches about the need of guideline are reviewed. Thirdly, under this background, basic principles for process of review and evaluation, and fourthly, the very process is proposed. Lastly, the further suggestions in connection with health care policy are given.

『신이 절대로 답할 수 없는 몇 가지』

강명신 한국의철학회 2013 의철학연구 Vol.15 No.-

의료윤리의 개념과 의료윤리 교육의 필요성

강명신 대한산업의학회 2009 대한직업환경의학회 학술대회 논문집 Vol.42 No.-