Background: In 1999, the Organ Transplantation Act legalized organ donation from brain-dead patients. As a result of the government's continued efforts, the number of brain-dead donors steadily increased from 2002 through 2016. However, the number has declined since 2017. This paper examined the possible reasons behind the decline in brain-dead organ donation. Methods: This investigation was an analysis of published data from the Korea Organ Donation Agency annual reports from 2013 to 2018. Results: The number of brain-dead organ donors in Korea rose steadily until 2016, declined in 2017 for the first time since 2002, and then dropped sharply in 2018. Although the number of brain-dead potential organ donors increased between 2017 and 2018, the number of eligible donors decreased, suggesting that patient families rejected the braindeath determination process and brain-dead organ donation. Statistics gathered during identification of brain-dead potential donors and actual donations confirm that rejection or withdrawal of consent by the family has increased. During the same period when donation from brain-dead patients decreased, five events occurred: 1) compensation for donor families was abolished; 2) an incident of mistreatment of a brain-dead donor's remains occurred; 3) the Life-Sustaining Treatment Act was enacted, providing a legal procedure whereby families of brain-dead patients could forgo life-sustaining treatment; 4) residents' work week was limited to 80 hours; and 5) the Labor Standards Law was amended. Conclusion: Fewer eligible donors in spite of an increase in brain-dead potential organ donors suggests that reduction in these donations resulted mainly from factors associated with family consent. Among such factors, implementation of the Life-sustaining Treatment Act appears to be most important. Abolition of family compensation and the incident in which a brain-dead donor's remains were mistreated may also have influenced family consent.

Three East Asian countries, Korea, China, and Japan, have shared a similar cultural background throughout history. This is the basis of the assumption of Asian values in the field of bioethics. However, different processes of modernization and healthcare systems have resulted in considerable differences. Along with the aging process, end-of-life care issues have been increasing in importance in these three countries. We conducted a study of 899 lay persons in 3 countries regarding their perspectives about end-of-life decisions; favorable ways of decision-making in end-of-life care; institutional and legal devices; withdrawal of life-sustaining treatment; and euthanasia. We confirmed several similarities and noted some differences among the three countries.Key words: end-of-life decision, advance directives, assisted dying, asian bioethics Decisiones al final de la vida: una encuesta sobre las perspectivas de las personas en Corea, China y Japón Resumen: Tres países del Este Asiático, Corea, China y Japón, han compartido una cultura bioética similar. Sin embargo, los procesos diferentes de modernización y los sistemas de cuidado de la salud han resultado en diferencias considerables. Junto con los procesos de envejecimiento, los temas del cuidado al final de la vida han ido creciendo en importancia en estos tres países. Realizamos un estudio con 899 personas legas en los tres países, respecto de sus perspectivas sobre decisiones al final de la vida; formas favorables de toma de decisiones en el cuidado al final de la vida; disposiciones institucionales y legales; retirada de tratamiento de sostenimiento vital; y eutanasia. Confirmamos varias similitudes y notamos algunas diferencias entre los tres países. Palabras clave: decisiones al final de la vida, directivas anticipadas, asistencia al moribundo, bioética asiáticaDecisões de final-de-vida: uma pesquisa sobre as perspectivas da população na Coreia, China e Japão Resumo: Três países asiáticos, Coreia, China, e Japão, têm compartilhado uma semelhante formação cultural através da história. Esta é a base da aceitação de valores asiáticos no campo da bioética. Contudo, diferentes processos de modernização e sistemas de cuidado à saúde resultaram em consideráveis diferenças. Ao logo do processo de envelhecimento, temas sobre cuidados no final-de-vida incrementaram em importância nestes três países. Nós conduzimos um estudo em 899 pessoas leigas nos 3 países considerando as suas perspectivas sobre decisões a cerca do final-de-vida; modos favoráveis de tomada de decisão em cuidados de final-de-vida; dispositivos institutionais e legais; suspensão de tratamento de sustentação da vida; e eutanasia. Nós confirmamos inúmeras semelhanças e notamos algumas diferenças entre os três países.Palavras-chaves: decisão de final-de-vida, diretivas antecipadas, morte assistida, bioética asiática

Background: In 2019, the Constitutional Court of South Korea ruled that the anti-abortion provisions in the Criminal Act, which criminalize abortion, do not conform to the Constitution. This decision will lead to a total reversal of doctors' legal duty from the obligation to refuse abortion services to their requirement to provide them, given the Medical Service Act that states that a doctor may not refuse a request for treatment or assistance in childbirth. I argue, confined to abortion services in Korea that will take place in the near future, that doctors should be granted the legal right to exercise conscientious objection to abortion. Main text: Considering that doctors in Korea have been ethically and legally obligated to refrain from abortions for many years, imposing a universal legal duty to provide abortions that does not allow exception may endanger the moral integrity of individual doctors who chose a career when abortion was illegal. The universal imposition of such a duty may result in repudiation of doctors as moral agents and damage trust in doctors that forms the basis of medical professionalism. Even if conscientious objection to abortion is granted as a legal right, most patients would experience no impediment to receiving abortion services because the healthcare environment of Korea provides options in which patients can choose their doctors based on prior information, there are many doctors who would be willing to provide an abortion, and Korea is a relatively small country. Finally, the responsibility to effectively balance and guarantee the respective rights of the two agents involved in abortion, the doctor and the patient, should be imposed on the government rather than individual doctors. This assertion is based on the government's past behaviours, the nature of its relationship with doctors, and the capacity it has to satisfy both doctors' right to conscientious objection and patients' right to legal medical services. Conclusion: With regard to abortion services that will be sought in the near future, doctors should be granted the legal right to exercise conscientious objection based on the importance of doctor's moral integrity, lack of impediment to patients, and government responsibility.

Background The Education and Training Centre for Public Healthcare of the National Medical Centre plays a key role in providing continuing professional development (CPD) to 221 public health and medical institutions in South Korea. To assess the realization of the Centre’s core value and the intended changes, program evaluations are required. The context, input, process, and product (CIPP) model is particularly suitable for evaluating CPD in the public sector, as it allows for recognizing the dynamic nature of the program environment. Methods This research applied the CIPP model to the evaluation of CPD programs, particularly abdominal and thoracic ultrasound programs implemented in 2017 and 2018. Data were collected from 2017 to 2019. The program and its feedback were reviewed in the context evaluation. Based on this, a subsequent program strategy was established for the input evaluation. Observing the program in real time and recording its progress was followed in process evaluation. Finally, the outcomes and impacts of the program were reviewed and compared with baseline data in the product evaluation. Results In context evaluation, the educational needs of the Centre’s CPD program recipients, impediments that inhibit participation in education, and resources that the Centre can utilize were identified through an online survey, focus group interviews and expert consultation. Through input evaluation, we identified the best alternative that satisfied all pre-selected criteria, which were responsiveness to priority system needs, potential effectiveness, fit with existing services, affordability, and administrative feasibility. Observing the program in real time and recording its progress were conducted in process evaluation, demonstrating that the augmented program went as planned, and even had to be expanded due to increased demand. The impact of the program was measured, interpreted, and assessed in the product evaluation. The review committee decided that the intended change had been occurred, thus the Centre decided to maintain the program. Conclusion A thorough evaluation is necessary to determine the potential benefits of CPD. The CIPP methodology is valuable for executing formative and summative evaluations. The CIPP model is particularly useful for securing accountability data for large-scale nationwide educational programs supplied by public funds.

Objectives:There are several problems which hamper the successful teaching of writing in medical education. To deal with these problems, teachers should be conscious of two general questions; what to teach in writing class for premedical students; and how to utilize the writing class time. This paper examines the value of peer assessment and peer feedback in dealing with those questions. Methods: This paper reviews a subject in premedical education, Logical Thinking and Writing, from the perspective of peer assessment and peer feedback. Results: Students accomplished the learning objectives and they recognized the value of peer assessment and feedback. Conclusion: Peer assessment and peer feedback foster students' participation in class and accelerate the learning process. This strategy reminds students of the fact that they are writing an essay for an audience. (Ewha Med J 2017;40(1):41-49)