• Title/Summary/Keyword: 수평적 의료분업

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Vertrauen und Misstrauen in der horizontal arbeitsteiligen Medizin (수평적 분업의료에 있어서 신뢰와 불신)

  • Deutsch, Erwin
    • The Korean Society of Law and Medicine
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    • v.11 no.1
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    • pp.145-158
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    • 2010
  • 현재의 의료 영역은 고도로 전문화되어 있고 더불어 의료의 분업화도 활발히 이뤄지고 있다. 의료의 분업화 과정에는 특히 서로 상이한 전문을 가진 의사들 간의 신뢰와 불신의 문제가 제기되는데 이러한 분업적 의료는 일반적으로 수직적 분업과 수평적 분업으로 구분할 수 있다. 수평적 분업의료에서는 원칙적으로 다른 의사의 주의깊은 행위에 대한 신뢰가 허용된다. 물론 그렇다고 하여 의사에게 검사 내지 재검사의 의무가 없는 것은 아니고 이를 필요로 하는 상황에서는 반드시 재검사가 이뤄져야 한다. 신뢰는 현행법의 과책원칙을 나타내는 '행위에 대한 자유'의 표현이며 의사에게 부주의한 행위가 있는 경우에는 신뢰가 인정될 여지가 없기 때문이다. 결국 재검사를 하여야 할 사정이 존재하지 않는 때에는 다른 영역으로부터의 보고를 원칙적으로 신뢰할 수 있다. 이처럼 본 연구에서는 지속적으로 전문화 및 분업화가 이뤄지고 있는 의료영역에서의 신뢰와 불신에 대한 개관을 통해 이를 재검토하고자 하였다.

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Application of the Principle of Trust to the Medical Service Division between Oriental and Western Medicine (한·양방 의료 사이에서 신뢰의 원칙이 적용되는 경우에 관한 고찰)

  • Bak, Cheol
    • The Korean Society of Law and Medicine
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    • v.16 no.1
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    • pp.125-151
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    • 2015
  • South Korea's medical system has dual systems-that is, Oriental and Western Medicine. Both are different from method for diagnosis or treatment of diseases and Scientific principle. Of the characteristics of Oriental medical practice in comparison with Western medical practice, notably, it is difficult to acknowledge specific constitutions, Oriental medical doctors' discretion is broad, and Oriental medical practice has a low invasiveness. Thus, it is difficult to acknowledge human specific constitutions when grounded on Oriental medical principles, thereby making it difficult for Oriental medical doctors to argue such specific constitutions as a means of defending against their medical negligence. And, it is difficult to prove Oriental medical doctors' negligence because Oriental medical doctors' scope of discretion is broad. Collaboration of Oriental medicine and western medicine can diagnose and treat the patient's diseases from a different viewpoint, making both medicines complementary. Oriental medicine and western medicine are independent of each other, equal, thus making them divided horizontally. Horizontal medical service division involves the principle of trust, but the principle of trust does not always apply to Oriental medicine and western medicine, because if patients shift from one area of medicine to another, the scientific principle, diagnostic method and treatment method of that medical area should be different. Application of the principle of trust to both of them needs to be analyzed according to types of medical institutions where transfers occur, and to the scope of work division between them.

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A Criminal Liability of the Divisional Medical-institution (분업적 의료행위에 따른 형사책임관계)

  • Jeong, Oung-Seok
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.399-434
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    • 2014
  • A criminal liability of the divisional medical-institution is faced a new aspect in the connection with development of the medical techonology. Especially, a division of labor in the medical-institution in Korea will be greatly increased in the foreseeable future. A general hospital will be frequently confronted with sofisticated techniques such as MRI, CT-screen. Accordings to the nature of its functions, a general hospital may make accommodation or services or both available for patients who give undertakings (or for whom undertakings are given) to pay, in respect of the accommodation or services (or both) such charges as the government may determine. It shall be the duty of the government to develop, promote and regulate a criminal liability of the divisional medical-institution. Above all, the government shall have to determine the standard of a criminal liability of the medical-institution in the horizontal specialization and the vertical specialization. But, the court may give finally by directions the standard of the criminal liability of the divisional medical-institution.

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A Legal Study on Division of Labor and Collaboration within the Same Medical Institution (동일 의료기관 내에서의 분업과 협진에 대한 법적 고찰)

  • Baek, Kyoung-hee
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.27-55
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    • 2023
  • The term "Collaborative medical care" commonly used in South Korea refers to the case where doctors from different medical departments work together to treat a patient within the same medical institution. Therefore, "Collaborative medical care" represents the aspect of a medical team where various medical professionals collaborate based on their expertise to treat patients. Additionally, doctors from different specialties within the medical team engage in horizontal division of labor at an equal status, distributing legal responsibilities according to the principles of division of labor. The Supreme Court also acknowledges cases where multiple doctors collectively provide medical treatment through division of labor or collaboration and states that the doctor who initially attended to the patient must accurately inform the subsequent attending doctor about the patient's condition to enable appropriate measures. In medical institutions with multiple specialties, when doctors from different specialties collaborate to provide medical treatment, the doctor who attended to the patient initially must decide whether collaboration is necessary based on the patient's condition. Subsequently, they must inform the doctor from the relevant specialty about the patient's condition accurately to facilitate appropriate actions. The successor doctor who participates in collaborative medical care must actively communicate relevant treatment information related to the patient's condition with the predecessor doctor who requested collaboration, exchange opinions, and do so until the patient's treatment concludes. However, the determination of the necessity of collaborative medical care should be based on the patient's condition at the time, and it cannot be asserted that collaborative medical care is mandatory in all cases. Whether there is negligence in the decision about the necessity of collaboration will be assessed based on the legal principles of a doctor's duty of medical care.

Vertrauen und Misstrauen in der horizontal arbeitsteiligen Medizin (수평적 분업의료에 있어서 신뢰와 불신)

  • Kim, Min-Joong
    • The Korean Society of Law and Medicine
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    • v.11 no.1
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    • pp.159-172
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    • 2010
  • Viele medizinische Ma$\ss$snahmen erfordern ein Zusammenwirken verschiedener $\ddot{A}$Arzte. In der arbeitsteiligen Medizin wird deutlich zwischen vertikaler und horizontaler Arbeitsteilung unterschieden. Mit dem Begriff vertikaler Arbeitsteilung geht es darum, ob ein Arzt einem anderen Weisungen erteilen kann oder nicht. Bei der Horizontalen Arbeitsteilung handelt es sich um selbst$\ddot{a}$andig t$\ddot{a}$atige Mediziner, in gleichen oder aneinander sto$\ss$senden Gebieten, bei denen man sich auf die Angaben oder die T$\ddot{a}$atigkeiten des anderen verlassen kann. Die wirkliche arbeitsteilige Medizin wird horizontal geleistet. In der arbeitsteiligen Medizin, insbesondere in der mehr und mehr spezialisierten Medizin, ist ein gewisser Grad des Vertrauens notwendig, schon aus Zeitgr$\ddot{u}$unden. Die Wiederholung aller m$\ddot{o}$oglichen diagnostischen, aber auch pr$\ddot{a}$aoperativen Untersuchungen, w$\ddot{a}$are zeitaufwendig und kostenreich. Es gibt aber auch Verh$\ddot{a}$altnisse, in denen die Kontrolle oder sogar die Wiederholung dieser Tests notwendig ist. Dann ist, insbesondere wenn sie in einer gewissen Zeitfolge t$\ddot{a}$atig werden, die Problematik des Vertrauens und Misstrauens angesprochen. Der Arzt, der von einem anderen Arzt in herk$\ddot{o}$ommlicher Weise Mitteilungen bekommt oder jedenfalls erwarten kann, darf sich grunds$\ddot{a}$atzlich auf den Vertrauensgrundsatz berufen. Das gilt insbesondere, wenn der mitteilende Arzt in einer personell und apparativ $\ddot{u}$uberlegen ausgestatteten Klinik t$\ddot{a}$atig ist. Wenn sich allerdings Zweifel an der Richtigkeit der Mitteilung aufdr$\ddot{a}$angen, etwa zahlreiche Nachl$\ddot{a}$ssigkeiten vorgekommen sind, ist f$\ddot{u}$r Vertauen kein Platz.

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Standards of Due Diligence and Separation of Responsibilities in the Division of Labor in Medicine (분업적 의료행위에 있어서 주의의무위반 판단기준과 그 제한규칙들)

  • Choi, Hojin
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.41-72
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    • 2018
  • In the division of labor (or teamwork) in medicine, the responsibility of medical and nursing staff should be separated or distributed to justify negligent criminal offenses. The present work refers to the standards by which the due diligence and responsibility of the individual persons are to be determined and delimited. In this context, it has been proven that objective theory as a measure of due diligence is appropriate. From a moral point of view, when assessing due diligence, it makes sense to impose greater individual or higher performance demands on the perpetrator, but law and order require that due diligence should result from socially relevant human behavior. To give objective measure of negligence and to provide the highest level of personal responsibility, so that man can not be burdened too much responsibility and it is accordingly with an equality theorem. Afterwards some points are presented, which should be considered in a concrete fact in the determination of the medical negligence. Medical action has specific characteristics such as professionalism, discretionary and exclusive, unbalance of information. These characteristics distinguish medical actions from general negligence. The general level of knowledge, the urgency, working condition and working environment of the medical facility, duration of the professional practice, assessment of the medical activity are crucial in this context. As a standard of delineation of due diligence, I have used the permitted risk and the principle of trust. In the horizontal division of labor, the principle of trust applies. The principle of trust applies in principle in cases of division of labor interaction, when doctors in the same hospital exercise their own specific occupational field or everyone works in another hospital. However, this is not true for every case. In the vertical division of labor, the principle of trust does not apply and the senior physician can not trust the assistant doctors. In this case, the principle of trust is converted into a duty of supervision for assistant doctors by the senior physician. This supervision requirement could be used as a random check.