Ethical aspects for the rules and procedures for issuing medical certificates

Writing a medical certificate can be a complicated part of medical practice. A doctor is expected to sign a variety of medical certificates that range in purpose from confirming sickness to certifying death. Medical certificates are legal documents based on clear and relevant evidence and should be written promptly, honestly, accurately, and objectively. Medical certificates may have financial implications for the patient or recipient through benefits, employment, or compensation payments, and a failure to complete a certificate appropriately may have a negative impact on the patient, the patient's family, or the receiving organization. For example, a doctor who certifies a patient to undertake work when he or she is unfit may place the patient or the patient's colleagues or the organization at risk. Society places a great deal of trust in doctors. This article attempts to propose ethical considerations based on the findings of two guides: the "Guide for writing medical certificates" prepared by the Korean Medical Association and the "Statement on medical certification" prepared by the Medical Council of New Zealand. The authors discuss some suggestions for guidance in medical certification to protect each individual involved and to promote good medical practice. The structured step table and self-check list provided may be of assistance.

A Study on Bioethical Consideration to Prospective Clinical Research Papers published in Journal of Korean Society of Emergency Medicine

PURPOSE: There is increasing concern about ethical conduct of human research in the field of medicine. The purpose of this study was to assess the ethical review process by institutional review boards for human research articles published in the journal of Korean Society of Emergency Medicine. METHODS: We reviewed human research papers published in the journal of Korean Society of Emergency Medicine from the 1st edition, 1990 to the 6th edition, 2006. A checklist was used to review the articles. RESULTS: The total number of prospective clinical research paper was 250. Among them, there were 63 papers (25.2%) in which the obtaining of informed consent was described in the article. Only two studies (0.8%) published in the journal were noted to have IRB approval. Invasive techniques were employed in 134 studies (53.6%). Among the 134, only 22 (16.4%) mentioned that informed consent taken was given during the study. Studies which may have involved discrimination totaled 21 (8.4%), and the number of studies that may have violated the patients' right to privacy was 20 (8%). The number of studies that may have a conflict of interest but was not declared was 12 (4.8%). CONCLUSION: There should be greater concern about the ethical conduct of research in studies with human research subjects in the journal of the Korean Society of Emergency Medicine.