Choi Junghye, Suh Chunhui, Lee Jong-Tae, Lee Segyeong, Lee Chae-Kwan, Lee Gyeong-Jin, Kim Taekjoong, Son Byung-Chul, Kim Jeong-Ho, Kim Kunhyung, Kim Dae Hwan, Ryu Ji Young
Department of Occupational and Environmental Medicine & Institute of Environmental and Occupational Medicine, Busan Paik Hospital, Inje University, Busan Paik hospital, 75, Bokji-ro, Busanjin-gu, Busan, South Korea.
Department of Medical Humanities, Inje University, Busan, South Korea.
Ann Occup Environ Med. 2017 Jun 24;29:23. doi: 10.1186/s40557-017-0182-z. eCollection 2017.
Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs.
An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents. The questionnaire was also distributed to 52 specialists and 46 residents who attended the annual meeting of the Korean Association of Occupational and Environmental Clinics in October 2015, and to 240 specialists by uploading the questionnaire to the online community 'oem-doctors' in February 2016. The responses to each question (perception of general ethical conflicts, recognition of various ethical codes for OPs, core professional values in ethics of occupational medicine, and a mock case study) were compared between specialists and residents by the chi-squared test and Fisher's exact test.
Responses were received from 80 specialists and 71 residents. Most participants had experienced ethical conflicts at work and felt the need for systematic education and training. OPs suffered the most ethical conflicts in decisions regarding occupational health examination and evaluation for work relatedness. Over 60% of total participants were unaware of the ethical codes of other countries. Participants thought 'consideration of worker's health and safety' (26.0%) and 'neutrality' (24.7%) as the prominent ethical values in professionality ofoccupational medicine. In mock cases, participants chose beneficence and justice for fitness for work and confidential information acquired while on duty, and beneficence and respect for autonomy in pre-placement examinations.
This study evaluated the current perception of and attitude toward ethical issues among the Korean OPs. These findings will facilitate the development of a code of ethics and the ethical decision-making program forthe Korean OPs.
职业医生与员工、雇主及公众有着复杂的关系。职业医生可能对第三方负有多重义务，这可能导致各种利益冲突。在众多关于职业医生伦理问题的研究中，很少有针对韩国职业医生的。本次调查的目的是探究韩国职业医生面临的伦理情境、实际解决方案以及伦理原则。
向韩国职业与环境卫生医学学会的成员发送了附有自填式问卷的电子邮件，该学会包括150名专家和130名住院医师。问卷还分发给了2015年10月参加韩国职业与环境临床协会年会的52名专家和46名住院医师，并于2016年2月通过将问卷上传至在线社区“oem - 医生”分发给了240名专家。通过卡方检验和费舍尔精确检验比较了专家和住院医师对每个问题（对一般伦理冲突的认知、对职业医生各种伦理准则的认可、职业医学伦理中的核心专业价值观以及一个模拟案例研究）的回答。
收到了80名专家和71名住院医师的回复。大多数参与者在工作中经历过伦理冲突，并认为有必要进行系统的教育和培训。职业医生在有关职业健康检查和工作相关性评估的决策中面临的伦理冲突最多。超过60%的参与者不了解其他国家的伦理准则。参与者认为“考虑工人的健康和安全”（26.0%）和“中立性”（24.7%）是职业医学专业性中突出的伦理价值观。在模拟案例中，参与者在工作适应性和值班时获取的机密信息方面选择了行善和公正，在入职前检查方面选择了行善和尊重自主权。
本研究评估了韩国职业医生目前对伦理问题的认知和态度。这些发现将有助于制定韩国职业医生的伦理准则和伦理决策程序。
