• Title/Summary/Keyword: 유사의료행위

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치과의료보험의 문제점

  • Gang, Tae-Uk
    • The Journal of the Korean dental association
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    • v.30 no.3 s.274
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    • pp.229-230
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    • 1992
  • 사회보험으로서 다구나 각 진료행위마다 수가를 정해놓은 행위별 수가체계를 시행하면서, 의료의 상품화는 필연적인 것이 되어버린 현 여건에서, 유사한 교육을 받고 교육기간도 유사하며, 유사한 직종간에 진료행위에 대한 보수의 차이가 이렇게 크게 나는 것은 어떻게 생각을 해야하는 것인가.

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Legal Review of Similar Medical Practice (유사의료행위에 관한 법적 검토)

  • Kim, Han-Nah;Kim, Kye-Hyun
    • The Korean Society of Law and Medicine
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    • v.10 no.2
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    • pp.427-453
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    • 2009
  • This study aims to review legal problems of similar medical practice and suggest methods of improvement. Similar medical practice refers to all medical practices conducted in the state that human qualification is not fulfilled. It may cause serious damages on health and lives of national people. Currently, similar medical practices are recognized as unlicensed medical practices and prohibited based on the Medical law and additionally punished by then special law in Korea. However, the current Medical Law does not provide clear and accurate concept of medical practices so that it is difficult to regulate similar medical practices. The issue of complementary and alternative therapy related to similar medical practices is also in special state different from other countries. In addition, since similar medical practices lack of evidences in terms of safety, the dangerousness of accidents is high and it may affect badly on health of national people and health care policies. Methods of improvement in order to resolve problems regarding similar medical practices are: first, concept and scope of medical practice should be clear, accurate and concrete. Second, complementary and alternative therapies related to similar medical practices need to be strictly examined and the supervisory right should be given to doctors should be given even though a part of it is allowed. Third, research institutes specialized in the field should be established for scientific examination of complementary and alternative therapy and objective research results should be open to the public. Finally, since damage cases caused by similar medical practices by non-medical personnel, national management and supervision for similar medical practices should be reinforced.

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Regarding Issues on the Lawsuit of Medical Malpractice in the Implant Procedure -Focusing on the contract's legal character and the mitigation of burden of proof- (임플란트 시술상 의료과오의 소송상 쟁점에 관하여 -계약의 법적성격 및 입증책임 완화를 중심으로-)

  • Han, Taeil
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.143-163
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    • 2018
  • Implant procedure belongs to so called a commercialized medical treatment, its procedure is simple and clear, and the possibility of success is almost 100%. In addition, it is a selective method rather than an inevitable method for a patient's health, so the importance of liability for explanation is especially emphasized for protection of autonomous decisions by patients. Considering these characteristics, the plaintiff in the relevant case said that the contract of implant procedure has the characteristic of subcontract, and only the failure of implant itself and the violation of liability for explanation should be the defendant's fault liability. In addition, although the above procedure contract is considered as delegation rather than subcontract, whether it's the defendant's malpractice should be judged by general people's common sense rather than average people in the industry. Therefore, if all the implanted teeth were removed due to bleeding and pains, and the patient suffered from dysaesthesia during the process, the defendant's malpractice is fully proved. When the judgements of implant medical malpractice were researched, the court doesn't consider implant contract as subcontract, but it judges dentist's malpractice by whether the implant itself is successful, so it seems that the court acknowledges similar characteristics with subcontract whose purpose is completion of work to some degree. In addition, considering the detailed contents of presented medical malpractices, it seems that judging medical malpractice is based on the common sense of general people. Therefore, the argument of the plaintiff is valid when the fact the adjustment amount is relevant to the amount that the plaintiff initially claimed is considered even though the relevant case was decided to be compulsory mediation.

Effects of Camping Programs on Self-efficacy and Sick-role Behavioral Compliance in Juvenile Diabetes Mellitus Patient (소아 당뇨 환자의 캠프 프로그램이 자기효능과 환자 역할 행위이행에 미치는 영향)

  • Park, Yeon-Hee
    • Korean Journal of Health Education and Promotion
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    • v.14 no.2
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    • pp.59-68
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    • 1997
  • 당뇨병은 고혈당을 조절 안할 경우에는 돌이킬 수 없는 신체적 합병증은 물론 정신적 손상까지 받지만, 고혈당은 노력만 하면 조절이 가능하며, 정상에 가까울 정도로 조절되면 정상인과 같은 삶을 영위할 수 있다. 그러나 보건의료 전문가의 인슐린 주사 요법, 식사 및 운동요법 등의 일방적인 처방만으로 성공적인 당조절을 기대하기에는 어려움이 있다. 그래서 당뇨병 환자에게 당뇨병이라는 것이 무엇이며, 어떻게 이 병을 스스로 조절할 수 있게 만드느냐가 더욱 중요한 것이다. 따라서 우리나라에서도 당뇨병에 대한 관심이 높아짐에 따라 각 지역과 의료기관마다 다양한 당뇨병 교육 프로그램이 실시되고 있다. 특히 소아 당뇨병 환자는 이러한 전통적인 당뇨병에 관한 교육을 통해서 당뇨병에 관한 지식은 많이 가지고 있지만, 당뇨병 자가 조절을 위한 환자 역할 행위(sick-role behavior)를 변화시키는데는 그다지 성공절이라 할 수 없다. Bandura(1977)는 자기 효능은 ‘할 수 있다는 자신감’으로 수행 성취, 대리 경험, 언어적 설득, 정서적 각성에 관한 정보에 의해 결정된다고 하였다. 따라서 이러한 정보들은 자기 효능을 증진시키기 위한 중재의 방향을 제시해 준다. 오늘날 이러한 정보를 활용한 중재 프로그램 중에서 가정과 학교를 떠나 자연 환경 속에서의 집단 활동을 통하여 사회 학습 경험을 하는 캠프 프로그램에 대한 관심이 높아지고 있다. 캠프에 참여한 당뇨병 아이들은 캠프 활동속에서 다른 동료 아이들이 자신이 갖고 있는 문제들을 성공적으로 해결해 나가는 것을 관찰하여 대리 경험하게 될 때 희망을 가지게 되며, 당뇨병을 가진 다른 동료들과 공통의 경험을 공유할 수 있는 기회를 갖게 되어 그들은 자신이 더 이상 혼자가 아니며 남과 ‘다르지’도 않다는 것을 깨닫게 되어 점차 자신감을 가지고 살아갈 수 있게 된다. 본 연구는 캠프 프로그램이 소아 당뇨병의 자기 효능을 증진시키고, 당뇨병 환자 역할 행위 이행 정도를 높여주는지를 규명해 봄으로써, 소아 당뇨병 환자를 위한 효과적인 간호 중재 방안을 제시하고자 비동등성 대조군 전후 실험 설계의 유사 실험 연구를 시도하였다. 1996년 8월 10일 부터 12월 12일까지 종합병원에서 추후 관리하고 있는 소아 당뇨병 환자중 선정 기준에 맞는 환자 41명을 연구대상으로 하였으며, 그 중 19명은 실험군으로 Bandura의 자기 효능 증진을 위한 정보원을 활용한 캠프 프로그램을 5박 6일간에 걸쳐 실시하였고, 다음 22명은 대조군으로 캠프 프로그램을 실시하지 않았다. 자료수집은 자기 효능 척도와 환자 행위 역할 이행 척도를 캠프 프로그램을 실시하기 전에 사전 조사를 하고 중재 후 4주째 사후 조사를 하였다. 수집된 자료는 SPSS/PC+로 Chi-square test, t-test, ANCOVA, Pearson correlation을 이용하여 분석하였으며, 그 결과는 다음과 같다. 캠프 프로그램은 소아 당뇨병 환자의 자기 효능을 증진시키고 환자 역할 행위 이행을 높여주는데 효과적 이었다. 소아 당뇨병 환자의 자기 효능은 환자 역할 행위 이행과 순 상관 관계가 있어, 자기 효능이 증진될수록 환자 역할 행위 이행 정도가 높아졌다.

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진단검사(Diagnostic test)의 정확도 추정

  • 박선일
    • Journal of the korean veterinary medical association
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    • v.37 no.11
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    • pp.1001-1022
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    • 2001
  • 수의사의 의사결정 과정에는 모든 의료행위에 내재된 본질적인 특성인 불확실성 (uncertainty)이라는 문제가 필연적으로 개입되는데 특히 진단검사와 관련된 신뢰도와 정확도 측면에서는 더욱 그러하다. 기존의 진단방법에 대체할만한 새로운 검사법이 개발되었을 때 실제로 이를 임상적 진단에 활용하기 위해서는 이 검사의 민감도와 특이도를 추정하는 작업은 필수적이다. 예컨대 표준검사법 (gold standard)이 제시되어 잇을 경우 비교적 간단한 계산으로 추정이 가능하지만 대부분의 질병에서와 같이 표준검사법이 없을 경우에는 상당한 통계적 지식을 요구한다. 또한 소위 표준검사법이라고 하는 검사도 실제로 질병에 이환된 집단과 이환되지 않은 집단을 완벽히 이분해주는 (dichotomize) 능력을 가진 것이라고는 볼 수 없기 때문에 추정과정에 신중을 기해야 한다. 본 원고에서는 다양한 상황에서의 진단검사의 민감도와 특이도를 추정하는 방법에 대하여 기술하며 본 원고에서 설명한 내용과 유사한 자료에 대하여 분석을 원하는 독자는 저자에게 연락을 주면 자세한 분석절차에 대하여 논의가 가능하다.

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4차 산업혁명 대비 중소기업 창업 벤처 지원 대상 업종에 관한 연구

  • Kim, Ju-Mi
    • 한국벤처창업학회:학술대회논문집
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    • 2017.04a
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    • pp.62-62
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    • 2017
  • 최근 인공지능 시대 및 제 4차 산업 혁명 시대의 도래로 제품 간, 제품과 서비스 간, 서비스 간 산업이 다양한 형태로 진화 중이며, 이종기술 산업 간의 융 복합화로 새로운 제3의 신산업이 등장하고 있다. 또한 소위 말하는 O2O(Online to Offline)는 이미 운송, 금융(핀테크), 자동차(카테크), 숙박, 음식, 의료(헬스케어테크) 등 많은 산업 분야에 진출, 기존 전통 산업과 충돌, 인허가에 어려움을 겪고 있으며 이러한 O2O는 IOT(사물인터넷)로 급속도로 가속화 되고 있다. 이렇듯 4차 산업 혁명에 따른 신산업의 탄생은 산업의 경계를 붕괴하고 있음에도 산업별로 구분된 제도, 규제, 지원정책 등은 여전히 신산업 창업의 장애가 되고 있다. 이에, 본 연구에서는 국내 벤처특별법, 창업지원법, 1인 창조기업법 내 투자 지원 업종과 미국을 비롯한 해외 창업 관련법 내 창업 지원 제한 업종과의 비교 분석, 몇 가지 중요한 시사점을 도출했다. 먼저, 우리나라가 선진국에 비해 지나치게 투자 제한 업종이 많음을 확인했다. 또한 선진국은 미풍양속을 해치는 업종, 투기적 사업 등 사회통념상 문제가 되는 사행성 업종을 제외하고는 대다수의 업종이 정책 지원 대상이다. 업종과 더불어 투자 행위로 투자 심사를 해 신산업 투자에 매우 탄력적으로 운영할 수 있게 설계되어 있다. 심지어 미국의 경우, 적극적 창업 투자를 위해 업종 및 투자 행위에 대한 심의를 중소기업청이 직접 수행한다. 특히, 우리나라의 중소기업창업투자회사제도는 미국의 중소기업투자회사(SBIC) 제도와 유사한 반면 투자 제한 업종 뿐 아니라 제도 운영 특히, 창업투자회사에 대한 관리 측면에서 매우 큰 차이가 있음을 보여주고 있다. 우리나라 중기청은 간접관리를 하는 반면, 미국은 중기청 내에서 직접 관리를 하고 있다. 따라서 본 연구에서는 우리나라 창업 벤처 투자 제한을 미국을 비롯한 기타 외국의 사례에서와 같이 사회통념상 불가피한 업종과 더불어 투자 행위로 정의하길 제안한다.

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Determination of Alcohol Blackout and Insanity in the Sexual Crimes - Focus on the Supreme Court on 2018-Do-9781 Sentenced on Feb 4, 2021 - (성범죄에 있어서 알코올 블랙아웃과 심신상실의 판단 -대법원 2021. 2. 4. 선고 2018도9781 판결을 중심으로-)

  • Kim Doo Sang
    • The Korean Society of Law and Medicine
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    • v.23 no.4
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    • pp.103-131
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    • 2022
  • 2021, the Supreme Court recognized the foundation of the quasi-indecent act by force by the concept of 'alcohol blackout' although there were multiple situations that it was hard to judge insanity of the victims was evident in the cases with drunken victims. This means the consideration of insanity state due to temporary false memory rather than the total loss of mental capacity from the existing concept of insanity. However, the interpretation of insanity in the criminal law has to be strict and its application could be difficult. In particular, the comparison precedent which is very similar to the subject one was determined not to be the same with the state of the insanity or inability to resist during the sexual relation though the victim had the symptoms of alcohol blackout, denying the quasi-indecent act by force. This argument is determined to be logical remarkably, and insanity and quasi-indecent act by force should be discussed considering the medical review on the alcohol blackout of the victims sufficiently when determining the individual precedents. In addition, the most important point in the sexual crimes is the consent, and there may be possibility of negligence in case that uncertain consent is determined as the consent to continue the following act. Also, in case of uncertain consent or suspicious, universal determination not to follow the act should be able to realized. Therefore, strong evidence is required for criminality, determining that the victim is the state not to be able to do the normal judgment and the minimum willful negligence is existed that the accused uses this. In the subject ruling, the act of the accused has to be clearly punished, however, it is determined to be unreasonable for the punishment with the quasi-indecent act by force under the interpretation of the current regulations.

Bundled Discounting of Healthcare Services and Restraint of Competition (의료서비스의 결합판매와 경쟁제한성의 판단 - Cascade Health 사건을 중심으로 -)

  • Jeong, Jae Hun
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.175-209
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    • 2019
  • The bundled discounting which the dominant undertakings engage in is problematic in terms of competition restraint. Bundled discounts generally benefit not only buyers but also sellers. Specifically, bundled discounts usually costs a firm less to sell multiple products. In addition, Bundled discounts always provide some immediate consumer benefit in the form of lower prices. Therefore, competition authorities and courts should not be too quick to condemn bundled discounts and apply the neutral and objective standard in bundled discounting cases. Cascade Health v. Peacehealth decision starts ruling from this prerequisite. This decision pointed out that the dominant undertaking can exclude rivals through bundled discounting without pricing its products below its cost when rivals do not sell as great a number of product lines. So bundled discounting may have the anticompetitive impact by excluding less diversified but more efficient producers. This decision did not adopt Lepage case's standard which does not require the court to consider whether the competitor was at least as efficient of a producer as the bundled discounter. Instead of that, based on cost based approach, this decision said that the exclusionary element can not be satisfied unless the discounts result in prices that are below an appropriate measures of the defendant's costs. By adopting a discount attribution standard, this decision said that the full amount of the discounts should be allocated to the competitive products. As the seller can easily ascertain its own prices and costs of production and calculate whether its discounting practices exclude competitors, not the competitor's costs but the dominant undertaking's costs should be considered in applying discount attribution standard. This case deals with bundled discounting practice of multiple healthcare services by the dominant undertaking in healthcare market. Under the Korean healthcare system and public health insurance system, the price competition primarily exists in non-medical care benefits because public healthcare insurance in Korea is in combination with the compulsory medical care institution system. The cases that Monopoly Regulation and Fair Trade Law deals with, such as cartel and the abuse of monopoly power, also mainly exist in non-medical care benefits. The dominant undertaking's exclusionary bundled discounting in Korean healthcare markets may be practiced in the contracts between the dominant undertaking and private insurance companies with regards to non-medical care benefits.

Determining on Model-based Clusters of Time Series Data (시계열데이터의 모델기반 클러스터 결정)

  • Jeon, Jin-Ho;Lee, Gye-Sung
    • The Journal of the Korea Contents Association
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    • v.7 no.6
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    • pp.22-30
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    • 2007
  • Most real word systems such as world economy, stock market, and medical applications, contain a series of dynamic and complex phenomena. One of common methods to understand these systems is to build a model and analyze the behavior of the system. In this paper, we investigated methods for best clustering over time series data. As a first step for clustering, BIC (Bayesian Information Criterion) approximation is used to determine the number of clusters. A search technique to improve clustering efficiency is also suggested by analyzing the relationship between data size and BIC values. For clustering, two methods, model-based and similarity based methods, are analyzed and compared. A number of experiments have been performed to check its validity using real data(stock price). BIC approximation measure has been confirmed that it suggests best number of clusters through experiments provided that the number of data is relatively large. It is also confirmed that the model-based clustering produces more reliable clustering than similarity based ones.

The Fiduciary Duties of Doctor in Clinical Trials (임상시험에서 의사의 선량한 관리자의 주의의무)

  • Lee, Jiyoun
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.163-207
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    • 2020
  • Korea has been positioned as the leading country in the industry of clinical trials as the clinical trail of Korea has developed for the recent 10 years. Clinical trial has plays a significant role in the development of medicine and the increase of curability. However, it has inevitable risk as the purpose of the clinical trial is to prove the safety and effectiveness of new drugs. Therefore, the clinical trial should be controlled properly to protect the health of the subjects of clinical trial and to ensure that they exercise a right of self-determination. In this context, the fiduciary duties of doctors who conduct clinical trials is especially important. The Pharmaceutical Affairs Act and the relevant regulations define several duties of doctors who conduct clinical trials. In particular, the duty to protection of subjects and the duty to provide information constitute the main fiduciary duties to the subjects. Those are essentially similar to the fiduciary duties of doctors in usual treatment from the perspective of the values promoted by the law and the content of the law. Nonetheless, clinical trials put more emphasis on the duties to provide explanation than in usual treatment. Further research and study are required to establish the concrete standard for the duty of care. However, if the blind pursuit of higher standards for the duty of care or to pass the burden of proof to doctors may result in disrupting the development of clinical trials, limiting the accessibility of patients to new treatment and even violating the principle of sharing damage equally and properly. In addition to these duties, the laws of clinical trials define several duties of doctors. Any decision on whether the violation of the law constitutes the violation of the fiduciary duty and justifies the demand for compensation of damages should be based on whether relevant law aims to protect the safety and benefit of subjects, even if in an incidental way, the degree to which such violation breaches the values promoted by the law and the concrete of violation of benefit of law, the detailed acts of such violation. The legal interests of the subjects can be protected effectively by guaranteeing compliance with those duties and establishing judicial and administrative controls to ensure that the benefit of subjects are protected properly in individual cases.