• Title/Summary/Keyword: 강제입원

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The review of the 2016 amended Korean Mental Health promotion Act from the Perspective of Human Rights and Inclusion of Persons with Mental Disabilities (정신장애인의 인권과 지역사회통합의 관점에서 본 2016년 정신건강증진법의 평가와 과제)

  • Park, Inhwan
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.209-279
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    • 2016
  • The Korean Mental Health Act was amended 2016 overall. This paper examines and evaluates the old Korean Mental Health Act since 1995 and the new Korean Mental Health Promotion Act 2016 from the Perspective of Human Rights and Inclusion of Persons with Psychosocial Disabilities. The persons with mental disabilities was separated and ruled out from society by the enactment of the Mental Health Act in 1995 and five times amendment. That has been justified and institutionally supported by medical viewpoint. The medical approach which reconsider the persons with mental disabilities as patients conceal that the aims of the involuntary admission in Mental Hospital are protection of society and the relief of the family member's duty of support for person with mental disabilities. This is institutionally supported in the 1995 Korean Mental Health Act by involuntary admission through the consent of family members as protectors. According to the old Act, the family members as protectors are authorized to consent to involuntary admission of persons with mental disabilities. Also, the psychiatrist that diagnoses the person with mental disabilities and evaluates the need for treatment by admission is not impartial in this decision. Family members as protectors may want to lighten their burden of support for the person with mental disabilities in their home by admitting them into a mental hospital, and the psychiatrist in the mental hospital can be improperly influenced by demand of hospital management. Additionally, Article 24 of the Korean Mental Health Act for the Involuntary Admission by the Consent of Family Members as Protector might violate personal liberty, as guaranteed in the Korean Constitution. The Mental Health Promotion Law was amended to reduce the scope of the persons with mental illness which are subject to forced hospitalization and to demand that a second diagnosis is made by another psychiatrist and screening by the committee concerning the legitimacy of admission in the process of the involuntary admission by the consent of family members as a method of protection. The amended Mental Health Promotion Law will contribute to reducing the number of the involuntary admissions and the inclusion of persons with mental disabilities. But if persons with mental disabilities are not providing some kind of service to the community, the amended Mental Health Promotion Law does not work for Inclusion of them.

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Assisted Outpatient Treatment and Crisis Intervention in USA and their Implications for Korea (미국의 외래치료명령제도 및 위기대응과 국내적 시사점)

  • Park, Inhwan;Han, Meekyung
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.23-80
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    • 2018
  • Since the 1960s, the United States' (U.S.) deinstitutionalization policy has reinstated people with mental illness into communities. Unfortunately, when untreated, some people with psychiatric disorders become homeless, and some commit serious crimes during a psychological crisis. Assisted Outpatient Treatment (AOT), also known as Kendra's Law in New York and Laura's Law in California, provides treatment, services and support to people with mental illness in the community. AOT has repeatedly been found effective and is recognized as an evidence-based practice. The response to the mental health crisis (crisis intervention) in the U.S. has also been successful in preventing worsening mental illness and related criminality and other issues. This paper provides an opportunity to create a platform from which to learn how to successfully apply the AOT and crisis intervention of the U.S. to South Korea within the cultural and societal context when establishing social services for people with mental illness in South Korea's communities.

The Assurance and Restriction on Human Rights of the Mentally Ill (정신장애인의 인권보장과 제한에 관한 연구)

  • Seo, Mi-Kyung
    • Korean Journal of Social Welfare
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    • v.55
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    • pp.231-254
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    • 2003
  • The main premise of this study is that the assurance on human rights of the mentally ill is contradictory to 'the greatest happiness of the greatest number' or 'therapeutic benefits'. Accordingly this study aims to find out the conceptual framework of assurance and restriction on human rights of the mentally ill. Using qualitative method, this study conducted the in-depth interview with 10 general public, 9 professionals, 6 mentally ill regarding the several issues of human rights included long-term hospitalization, restriction on driver's licence, involuntary hospitalization, restriction on communication in psychiatric ward. Research results are as follows ; two sets of dimensions are inferred from the analysis of interview transcript. First dimension is the focus of justification, ranging from the emphasis on positive consequences influenced to 'the greatest numbers'(the utilitarian thought) to the emphasis on assurance of rights without any conditions(the deontological thought). Second dimension is the locus of decision, raging from the formal system included the professionals and the government agency to the informal system included the families and the mentally ill. And there are differences in attitudes toward assurance and restriction on rights of the mentally ill among general public, professionals, and the mentally ill. In detail, general public regarded that 'involuntary hospitalization' and 'restriction on driver's license' which are apt to be directly harmful to people must be justified by consequence-centered and decided by the formal system, while 'long-term hospitalization' which is less harmful to people could be justified by right-centered and decided by the formal-system. And they thought that 'restriction of communication' could be justified by right-centered and decided by the informal system. Based on the findings, this study would conclude that practical guidelines for the promotion of human rights of the mentally ill must be developed.

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The Implementation and limits of Involuntary Detention of the Tuberculosis Prevention Act (결핵예방법의 격리명령의 실행과 한계에 관하여)

  • Kim, Jang Han
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.55-84
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    • 2015
  • The tuberculosis is the infectious disease. Generally, the active tuberculosis patient can infect the 10 persons for one year within the daily activities like casual conversation and singing together. The infectivity of tuberculosis can continue for a life time, and infected persons can remain at risk for developing active tuberculosis. To control this contagious disease, along with the active tuberculosis patients, non-infectious but non-compliant patients who can be infectious if their immune systems become impaired have to be managed. To control the non-complaint patients, medical treatment order should be combined with the public order. Because tuberculosis is the risk of community health, the human rights like liberty and freedom of movement can be restricted for public welfare under the article 37(2) of constitution. Even when such restriction is imposed, no essential aspect of the freedom or right shall be violated. The degree of restriction on the rights of citizens is different what methods are chosen to non-complaint patients. For example, under the directly observed therapy program, the patients and medical staffs make an appointment and meet to confirm the drug intakes according to the schedule, which is the medical treatment combined with the mildest public order. If the patients break the appointments or have the history of disobedient, the involuntary detention can obtain the legitimate cause. The Tuberculosis Prevention Act has the two step programs on this involuntary detention, The admission order (Article 15) is issued when the patients are infectious. The quarantine order (Artle 15-2) is issued when the patients are infectious and non-complaint. The legal criteria for involuntary detention are discussed and published through the international conventions and covenants. For example, World Health Organization had made guidance on human rights and involuntary detention for tuberculosis control. The restrictions should be carried out in accordance with the our law and in the legitimate objective of public interest. And the restriction should be based on scientific evidence and not imposed in an unreasonable or discriminatory manner. We define and adopt these international criteria under our constitution and legal system. Least restrictive alternative principle, proportionality principle and the individual evaluation methods are explained through the reviews of United States court decisions. Habeas Corpus Act is reviewed and adopted as the procedural due process to protect the patient rights as a citizen. Along with that, what conditions and facilities which are needed to performed quarantine order are discussed.

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The Effects of Task Oriented Activity and Modified Constraint Induced Movement Therapy on Quality of Life for Patients With Stroke (과제 지향적 훈련과 수정된 강제유도 운동치료가 뇌졸중 환자의 삶의 질에 미치는 영향)

  • Lee, Jong-Min;Kim, Bo-Ra
    • Therapeutic Science for Rehabilitation
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    • v.1 no.2
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    • pp.23-34
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    • 2012
  • Objective : The purpose of this study was to investigate the effect of task oriented activity and modified constraint induced movement therapy (mCIMT) on Quality of Life (QOL) for patients with stroke. Methods : Thirty stroke patients were participated voluntarily and were assigned randomly into task oriented activity and mCIMT groups. The QOL of both groups were assessed using Stroke Specific Quality of Life (SS-QOL). Results : The QOL showed a statistically meaningful difference for both groups (p<.05), but after the intervention, the both groups showed no statistically meaningful difference in terms of the QOL (p>.05). Conclusion : We found that task oriented activity and mCIMT improve the QOL of patients with stroke through increasing their affected upper extremity function and movement. It is expected that task oriented activity and mCIMT will have a positive effect on the QOL of stroke patients by applying them to clinic with occupational therapy.

Comparison of Inpatient Medical Use between Non-specialty and Specialty Hospitals: A Study Focused on Knee Replacement Arthroplasty (전문병원과 비전문병원 입원환자의 의료이용 비교 분석: 인공관절치환술(슬관절)을 대상으로)

  • Mi-Sung Kim;Hyoung-Sun Jeong;Ki-Bong Yoo;Je-Gu Kang;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.1
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    • pp.78-86
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    • 2024
  • Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

Non Face-to-Face Treatment and Not-informed Medication to Persons with Mental Disorders (정신질환자에 대한 비대면진료 및 비고지투약 -치료적 대화의 복원을 위한 모색적 고찰-)

  • Jung, Sangmin
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.149-192
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    • 2024
  • People with mental illness are generally either unaware of their illness or unwilling to voluntarily seek treatment, which makes treatment difficult and the pain mainly passed on to their families. Accordingly, non-face-to-face treatment, in which the patient is diagnosed by interviews with the family and unannounced medication, in which medication is secretly administered through the family, can be performed, and this has been considered a necessary evil. Even considering realistic aspects such as the special nature of mental health care and families' suffer, not-informed treatment without consent violates not only medical laws, but also human rights of mentally ill patients. Above all, if the patient finds out about this late, the trust between the patient, family, and doctor is completely broken, and a treatment is absolutely refused. Japan's Chiba decision, which presents exceptional conditions for allowance might be a solution. However, it would not be a right solution, considering that it could lead to long-term unannounced medication and completely cut off treatment through therapeutic dialogue. Ultimately, it need to approach this problem and seek alternatives through restoration of therapeutic dialogue.

A Study on an acceptance of CDC guideline on practical emergency department planning -Focusing on comparison CDC guideline to Emergency Medical Service Act- (응급실에서의 감염관리 표준지침의 반영에 관한 연구 -응급실에서의 감염관리 표준지침과 응급의료에 관한 법률의 반영 비교를 중심으로-)

  • Yoon, Hyung Jin;Oh, Joon-Gul
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7237-7243
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    • 2015
  • Korea Centers for Disease Control and Prevention(CDC) has been provided not only manual of managing infectious patient but also functional requirement of space in emergency department(ED) by distributing "Guideline for infection control in emergency department(GICED)" in 2009. To understand how much the guideline enforces its functional requirement on ED planning practice, it is compared to Emergency Medical Service Act(EMSA) a basic standard for ED planning. As a result, it is clear that those have different focal point in functional program and don't share infection control issue. By reviewing target hospitals' EDs opened around 2009, all ED have satisfied with the EMSA requirement but guideline. Those are selectively adapted infection control related spaces CDC guideline suggested regardless of open year so that target EDs are not to be influenced by the guideline. This research can support as a reference research when the EMSA are going to be reinforced by infection contol issue.

Caring of Family of Persons with Mental Disabilities who uses the Psychiartric Rehabilitation Facility - Using the Photovoice Methodology (정신재활시설을 이용하는 정신장애인 가족의 돌봄 경험 - 포토보이스방법론을 적용하여)

  • Ryu, Se-Na;Jo, Hyun-Mi
    • The Journal of the Korea Contents Association
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    • v.22 no.3
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    • pp.547-559
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    • 2022
  • This study is a qualitative study to explore caring of a mentally disabled family using mental rehabilitation facilities. As a result of the analysis, the life of a mentally disabled family appeared in 6 topics and 12 sub-themes. Life before the outbreak was warm and comfortable like an electric stove, and a frustrating and difficult life like a parrot in a cage due to family conflicts. The feeling of looking at the child who is starting to develop symptoms is fear and hopelessness that is hard to see ahead, and a sense of guilt for a child trapped in a disease before blooming his life. Forced hospitalization, and my feelings were torn apart, and my thoughts were confused by opaque recovery and worries about future life. The experience I felt as the disease lasted for a long time and hospitalized and discharged repeatedly feared that the mental illness of the family would be known to the people around me, and found that they struggled to cope with repeated recurrence and worsening symptoms. While using mental rehabilitation facilities, the changed life was comforted in a comfortable shelter, and turned out that there was hope for the future and that there was room to smile. The life expected in the future and the theme of hope turned out to be grateful for small changes and determined to be a warm fence for recovery.