• The Korean Society of Law and Medicine
• /
• v.14 no.1
• /
• pp.355-401
• /
• 2013

The first legislation for terminal health-care decision was California's Natural Death Act (NDA) of 1976 that permitted any adult person to execute a directive directing the withholding or withdrawal of life-sustaining procedures. Advance directive legislation has subsequently progressed on a state-by-state basis. By 1992, all 50 states, as well as the District of Columbia, had passed legislation to legalize some form of advance directive. This state legislation, however, has resulted in an often fragmented, incomplete, and sometimes inconsistent set of rules. Statutes enacted within a state often conflict and conflicts between statutes of different states are common. In an increasingly mobile society where an advance health-care directive given in one state must frequently be implemented in another, there is a need for greater uniformity. In 1993, the Uniform Law Commissioners approved the Uniform Health-Care Decisions Act (UHCDA) in order to bring order to the existing chaos. Unfortunately, the Commissioners waited too long to act. By the time the UHCDA was approved, nearly all states had passed legislation governing advance directives. Consequently, the UHCDA has achieved only a limited success, picking up but one or two enactments a year. The UHCDA is currently in effect in around 10 states: Alabama, Alaska, California, Delaware, Hawaii, Kansas, Maine, Mississippi, New Mexico, Tennessee, Wyoming. In these states the previous laws related to the subjects have been all repealed. The overall objective of the UHCDA is to encourage the making and enforcement of advance health care directives including living will or individual instruction, power of health-care attorney and to provide a means for making health care decisions for those who have failed to plan. The U. S. House of Representatives in 1991 enacted the Patient Self-Determination Act (PSDA). The Act stipulates that all hospitals receiving Medicaid or Medicare reimbursement must ascertain whether patients have or wish to have advance directives. The Patient Self- Determination Act does not create or legalize advance directives; rather it validates their existence in each of the states. Now in America, terminal health-care decision or advance directive for health care is common and universal system. The problem, however, is how to let more people use these good tools to make their lives more beautiful and honorable.

• Journal of the Korean Society of Radiology
• /
• v.79 no.5
• /
• pp.247-253
• /
• 2018

The purpose of this study was to summarize the results of a survey for physicians with specialties other than radiology about imaging studies of patients referred from other institutions. The survey was promoted through individual contacts or social network service and physicians who voluntarily responded to the survey were the subjects of the study. The questionnaire consisted of 11 questions about basic information and referrals about medical imaging. A total of 160 physicians from 30 specialties participated in the survey and 95.6% of the respondents worked in tertiary care center or general hospital. Patients were frequently referred with outside medical images. The most frequently referred imaging modalities were computed tomography and magnetic resonance imaging. However, radiological reports from outside institutions were rarely referred. Most physicians thought that reinterpretation for outside imaging is necessary to acquire a secondary opinion. In conclusion, considering that outside radiological reports are frequently missing and there are high demands on reinterpretation for outside imaging, guidelines for referral of radiological reports with medical imaging, basic elements of radiological reports, and reinterpretation need to be developed.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.2
• /
• pp.38-40
• /
• 2010

Purpose: This study was performed to find the current problems of PET/CT data from other hospitals. Materials and Methods: The subjects were acquired from 64 hospitals referred to our department for image interpretation. The formats and contents of PET/CT data were reviewed and the phone questionnaire survey about these were performed. Results: PET/CT data from 39 of 64 hospitals (61%) included all transaxial CT and PET images with DICOM (Digital Imaging Communications in Medicine) standard format which were required for authentic interpretation. PET/CT data from the others included only secondary capture images or fusion PET/CT images. Conclusion: The majority of hospitals provided limited PET/CT data which could be inadequate for accurate interpretation and clinical decision making. It is necessary to standardize the format of PET/CT data to transfer including all transaxial CT and PET images with DICOM standard format.

• Journal of Periodontal and Implant Science
• /
• v.27 no.3
• /
• pp.533-547
• /
• 1997

In periodontics, much progress was made in the understanding of periodontal disease from 1960s to 1980s and in prevention and management of periodontal disease since the end of 1980s. This presentation will discuss about the prevalence of periodontal disease, treatment need, and provision of periodontal treatment in Korea, and how we could manage the periodontal disease efficiently in the future. According to an epidemiological study in Korea, periodontal disease(including gingivitis) was present in 82% of general population and periodontitis in 30-40% in adult population over 30y and juvenile periodontitis in 0.1% of adolescents. If we consider that at least 17% of these patients may have recurrent or refractory forms, there is obviously an abundance of disease that needs treatment, As a result of increase in life expectancy, senile population over 65 y will be increased from 6% in 1996 to 6.9% in 2000, and tooth retention rate and periodontal treatment need are expected to increase. Periodontists need all the help they can get from the general dentists to control periodontal disease. As for provision, postgraduate course in periodontics started in 1957 in Korea and produced over 700 specialized dentists in periodontics. One report indicated that the periodontists as well as general practitioners did periodontal therapy on only a few periodontal patients, because of specific control by current medical insurance system in Korea. Comprehensive periodontal examination is rarely done in local dental clinic. Therefore, enhancement of periodontal care in medical insurance system and education of simplified periodontal examination such as Periodontal Screening & Recording will make dentists diagnose and manage the management of adult patients is based on the recognition that there are multiple diseases, including gingivitis, chronic adlt periodontitis, and other more aggressive forms of periodontitis, and requires the earliest possible recognition of these three disease categories. In this presentation, we discuss practical approach using PSR to diagnose, manage and refer the patients, to facilitate the separation of the simple from the complex and the predictable from the unpredictable form of periodontal diseases and to integrate diagnostic and therapeutic techniques into private practice today.