한국정신병리진단분류학회

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강누리 Nuri Kang , 이준희 Junhee Lee , 장민경 Min-kyung Jang , 김대진 Dai-jin Kim

DOI:10.36430/kjp.2024.28.2.001

Abstract

Shared decision-making is a process where patients and healthcare professionals share the best evidences, information, and the patient’s values and preferences to collaborate and make decisions together. The concept of shared decision-making is also applied to the practice of medicine as well as the field of psychiatry. This paper provides a narrative review on shared decision-making in a field of general medicine and psychiatry, respectively. Several decision-making models that can be used in the practice of medicine are discussed and specific barriers and limitations that hinder shared decision-making to be applied in psychiatric practice is also overviewed. In addition, the authors take a deeper look into the application of artificial intelligence technology to develop or support shared decision-making in the field of medicine, and the concept of psychiatric advance directives, which is a legal document that allows an individual to specify the preferred treatments in the event of a mental health crisis. Development of proper models for application of shared decision-making in the field of general medicine or that of psychiatry is still in its infancy and future studies with various clinical circumstances and appropriate cutting-edge technologies such as artificial intelligence are warranted.

Key Words

Shared decision making, Advance directives, Artificial intelligence

제철웅 Cheolung Je

DOI:10.36430/kjp.2024.28.2.002

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This paper deals with how to understand the Korean adult guardianship law from the perspective of persons with severe mental health problems. Because adult guardianship law can be traced back to the Roman law in 5th century BC, which aimed to exclude persons with mental health problems, the focus should be on the development of mental health policies in western countries, which have, in turn, influenced Korean policy as well, to correctly understand the current Korean adult guardianship law. Briefly mentioning the development of mental health policies, this paper argues that the right to self determination, including support for it, is the main purpose of guardianship law reform in western countries. This paper suggests that Korean guardianship law, which still contains many elements of old-fashioned guardianship law, should be read and implemented in the light of respecting the right to self determination and that involuntary admission of persons with severe mental illness to psychiatric hospitals, institutions and nursing homes and de-facto involuntary treatment of them, the most controversial issue of the negations of the right to self determination, should be re-interpreted as well.

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Adult Guardianship, Right to Self-Determination, Exclusion, Inclusion of Persons with Mental Health Problems, Mental Health

Su-jin Koh , Ilhak Lee

DOI:10.36430/kjp.2024.28.2.003

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This review examines the current practices, challenges, and advancements of Advance Care Planning (ACP) and Shared Decision-Making (SDM) in clinical settings in Korea. These approaches represent a shift toward patient-centered care, offering patients greater involvement in decisions concerning their treatment, especially for those facing life-limiting illnesses. The Korean context presents unique cultural, legal, and practical factors that influence ACP and SDM’s implementation. This article explores these factors, recent regulatory developments, and future directions for improving ACP and SDM in Korean healthcare.

Key Words

Advance Care Planning(ACP), Shared Decision Making(SDM), Physician Orders for Life-Sustaining Treatment (POLST), Korean context