• Title/Summary/Keyword: 응급의료에 관한 법률

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Review and Interpretation of Health Care Laws Based on Civil Law - Medical service Act, Emergency medical Act, Act on remedies for injuries from medical malpractice and mediation of medical disputes - (민법에 기초한 보건의료관련 법령 조문의 검토와 해석 -의료법, 응급의료에 관한 법률, 의료사고 피해구제 및 의료분쟁 조정 등에 관한 법률-)

  • Yi, Jae Kyeong
    • The Korean Society of Law and Medicine
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    • v.23 no.3
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    • pp.89-115
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    • 2022
  • In this article, the Medical Act, the Emergency Medical Act, Act on remedies for injuries from medical malpractice and mediation of medical disputes were reviewed and interpreted based on the Civil Act. In the health and medical field, there are various laws that reflect changes in the medical field due to the development of health and medical technology, and their revision is very frequent. And the legislation has become very complicated. They contradict each other or require interpretation. In this situation, a person must take considerable care not to violate the law. In many cases, specific guidelines or authoritative interpretation are required to apply the law. Even guidelines and authoritative interpretations often conflict with civil law. In this article, errors in the legal text related to health care were found. In addition, it found a case that contradicts the civil law perspective in interpretation. Thus, it was confirmed that civil legal thinking was necessary to legislate, interpret, and apply health care-related laws.

A Criminal Responsibility of Aid by 119 Rescuer (119구급대원의 응급구급활동과 관련한 형법적 책임)

  • Yoon, Sang-Min
    • Fire Science and Engineering
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    • v.20 no.4 s.64
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    • pp.77-90
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    • 2006
  • This is for Criminal Law problem that can be happened during the rescue working of 119 rescue member. There are mainly 3sections can be Criminal Law Problem. At first, denying a rescue request. Second, thing that do not transfer patient or people need someone's help by their refusal. Third, emergency medical management. It can be criminal act if somebody do the 3sections thing under Law about emergency medical treatment. It also can be homicide under Criminal Law or accidental homicide, a charge of injuring a person if people need rescue die or become worse through the work. Rescuers are responsible for a criminal case by their carelessness and fault. A plan has to remain to protect them when they do violence to the life and health of a people inevitably. This paper examines the plan can protect them through the analysis and application of related Law about rescuer's work which can be Criminal Law Problem, presents rational establish plan of Rescuer Protect Law to make them their job well as a rescuer.

A Study on the Scope of Practice of Nurses in the Prehospital Emergency Medical Service System (병원 전 응급의료체계에서 간호사의 업무범위에 대한 소고(小考))

  • Bae, Hyuna
    • The Korean Society of Law and Medicine
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    • v.20 no.2
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    • pp.141-171
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    • 2019
  • Nurses are medical personnels under the Medical Service Act and perform medical practice such as medical assistance at medical institutions. The nurse, a medical personnel, provides emergency medical service to emergency patients in the pre-hospital emergency medical system as a 119 rescuer based on the Act on 119 Rescue and Emergency Medical Services. The scope of practice of nurses is comprehensively defined in the Medical Service Act and specified through precedents. In contrast, The scope of work of emergency medical technician is listed in detail. It is understood that nurses in the pre-hospital emergency medical service system have a wider scope of practice than emergency medical technician. In particular, the scope of practice of nurses as emergency medical personnel in the pre-hospital emergency medical system should be interpreted differently within the medical institution, considering the urgency of the patient, being transferred to the emergency medical institution, and the specificity of medical direction through tele-communication.

Informed Consent and Refusal of Treatment in Emergency Medical Situation (응급의료에서의 설명·동의 원칙과 응급의료거부죄)

  • Lee, Jung-eun
    • The Korean Society of Law and Medicine
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    • v.23 no.1
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    • pp.37-80
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    • 2022
  • By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

A Review on the Improvement of the Meaning and Composition Requirements of Interference with Fire Protection Activities - Focusing on Interference with 119 EMS Activities - (소방활동방해죄의 의미와 구성요건 개선에 관한 검토 -119구급활동 방해를 중심으로-)

  • Young Pyo Hong
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.105-124
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    • 2023
  • Modern society is facing an unstable environment due to unexpected accidents and hazardous situations. For example, incidents such as the collapse of the Bundang Bridge and the crushing accident in Itaewon could serve as examples. In addition to these, critical emergencies like sudden cardiac arrests and strokes frequently occur, requiring swift actions and smooth transfers to specialized medical institutions for effective responses. In response to these risks, the country has been establishing various systems to protect the lives and safety of its citizens. Among these, the 119 First Aid Activities plays a crucial role within the emergency medical system. Its goal is to promptly respond to critical emergency situations involving severe trauma patients or patients with serious illnesses, minimizing damage and safeguarding lives by swiftly transferring them to emergency medical institutions for specialized treatment. The core activity related to this is emergency rescue operations. In particular, the 119 First Aid system serves as a crucial institution responsible for the hospital transportation of emergency patients. However, rescue personnel still encounter cases of interference with their activities during their duties. Despite efforts from the police, these interference cases persist, and they share similarities with the crime of obstructing official duties. Interference with emergency activities exhibits a comparable nature to instances such as physical assaults and equipment damage against emergency medical practitioners working within the emergency medical system. Therefore, a comprehensive understanding and improvement efforts regarding the issues of interference that arise during the process of emergency medical activities, including the 119 First Aid system, are necessary. The solution to these problems is to establish and improve the conditions for obstruction of first aid activities, focusing on the "Framework Act on Firefighting" and the "Act on 119 Rescue and Emergency."

Development of a Comprehensive Model of Disaster Management in Korea Based on the Result of Response to Sampung Building Collapse (1995), - Disaster Law, and 98 Disaster Preparedness Plan of Seoul City - (우리나라 사고예방과 재난관리 모형 개발을 위한 연구)

  • Lee, In-Sook
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.289-316
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    • 2000
  • 우리나라의 경우 지역사회 재난 관리계획과 훈련이 보건의료적 모형이라기 보다는 민방위 모형에 입각하기 때문에 사고 현장에서의 환자 중증도 분류, 합리적 환자배분 및 이송, 병원 응급실에서의 대처 등이 체계적으로 이루어지지 못하고 있으며, 지역사회가 이에 즉각적으로 반응할 수 없다. 본 연구는 삼풍 붕괴사고 시에 대응방식과 그 후의 우리나라 응급의료 체계를 분석함으로써 대형사고 예방과 재난관리를 위한 우리나라 응급의료체계의 개선방안과 간호교육에서의 준비부분을 제시하고자 한다. 1 삼풍 사고 발생시에는 이를 관장할 만한 법적 근거인 인위적 재해에 관한 재난관리법이 없었다. 따라서 현장에서는 의학적 명령체계를 확보하지 못했기 때문에 현장에서의 응급 처치는 전혀 이루어지지 못하였다. 현장에서의 중증도 분류. 응급조치와 의뢰, 병원과 현장본부 그리고 구급차간의 통신 체계 두절, 환자 운송 중 의료지시를 받을 수 있도록 인력, 장비, 통신 체계가 준비되지 못하였던 점이 주요한 문제였다. 또한 병원 응급실에서는 재난 계획이 없거나 있었더라도 이를 활성화하여 병원의 운영 체계를 변환해가지 못하였다. 2. 삼풍백화점 붕괴사고 한달 후에는 인위적 재해에 대한 재난관리법이 제정되고, 행정부 수준별로 매년 지역요구에 합당한 재난관리 계획을 세우도록 법으로 규정하였다. 재난 관리법에는 보건의료 측면에서의 현장대응, 주민 참여, 응급 의료적 대처, 정보의 배된. 교육/훈련 등이 포함되어 있어야 한다. 그러나 법적 기반이 마련된 이후에도 한국 재난 계획 내에는 응급의료 측면의 대응 영역은 부처간 역할의 명시가 미흡하며, 현장에서의 응급 대응과정을 수행할 수 있는 운영 지침이 없이 명목상 언급으로 그치고 있기 때문에 계획을 활성화시켜 지역사회에서 운영하기는 어렵다. 즉 이 내용 속에는 사고의 확인 /공고, 응급 사고 지령, 요구 평가, 사상자의 중증도 분류와 안정화, 사상자 수집, 현장 처치 생명보존과 내과 외과적 응급처치가 수반된 이송, 사고 후 정신적 스트레스 관리, 사고의 총괄적 평가 부분에 대한 인력간 부처간 역할과 업무가 분명히 제시되어 있지 못하여, 사고 발생시 가장 중요한 연계적 업무 처리나 부문간 협조를 하기 어렵다. 의료 기관과 응급실/중환자실, 시민 안전을 책임지고 있는 기관들과의 상호 협력의 연계는 부족하다. 즉 현재의 재난 대비 계획 속에는 부처별 분명한 업무 분장, 재난 상황에 따른 시나리오적 대비 계획과 이를 훈련할 틀을 확보하고 있지 못하다. 3. 지방 정부 수준의 재난 계획서에는 재난 발생시 보건의료에 관한 사항 전반을 공공 보건소가 핵심적 역할을 하며 재난 관리에 대처해야 된다고 규정하고 있다. 그러므로 보건소는 지역사회 중심의 재난 관리 계획을 구성하고 이를 운영하며, 재난 현장에서의 응급 치료 대응 과정은 구조/ 구명을 책임지고 있는 공공기관인 소방서와 지역의 응급의료병원에게 위임한다. 즉 지역사회 재난 관리 계획이 보건소 주도하에 관내 병원과 관련기관(소방서. 경찰서)이 협동하여 만들고 업무를 명확히 분담하여 연계방안을 만든다. 이는 재난관리 대처에 성공여부를 결정하는 주요 요인이다. 4 대한 적십자사의 지역사회 주민에 대한 교육 프로그램은 연중 열리고 있다. 그러나 대부분의 교육주제는 건강증진 영역이며. 응급의료 관리는 전체 교육시간의 8%를 차지하며 이중 재난 준비를 위한 주민 교육 프로그램은 없다. 또한 특정 연령층이 모여있는 학교의 경우도 정규 보건교육 시간이 없기 때문에 생명구조나 응급처치를 체계적으로 배우고 연습할 기회가 없으면서 국민의 재난 준비의 기반확대가 되고 있지 못하다. 5. 병원은 재난 관리 위원회를 군성하여 병원의 진료권역 내에 있는 여러 자원을 감안한 포괄적인 재난관리계획을 세우고, 지역사회를 포함한 훈련을 해야 한다. 그러나 현재 병원은 명목상의 재난 관리 계획을 갖고 있을 뿐이다. 6. 재난관리 준비도를 평가할 때 병원응급실 치료 팀의 인력과 장비 등은 비교적 기준을 충족시키고 있었으나 병원의 재난 관리 계획은 전혀 훈련되고 있지 못하였다 그러므로 우리나라 재난 관리의 준비를 위해서는 현장의 응급의료체계, 재난 대응 계획, 이의 훈련을 통한 주민교육이 선행되어야만 개선될 수 있다. 즉 민방위 훈련 모델이 아닌 응급의료 서비스 모델에 입각한 장기적 노력과 재원의 투입이 필요하며, 지역사회를 중심으로 대응 준비와 이의 활성화 전략 개발, 훈련과 연습. 교육에 노력을 부여해야 한다. 7. 현장의 1차 응급처치자에 대해서는 법적으로 명시하고 있는 역할이 없다. 한국에서는 응급구조사 1급과 2급에 대한 교육과 규정을 1995년 이후 응급의료에 관한 법률에서 정하고 있다. 이 교육과정은 미국이 정하고 있는 응급구조사 과정 기준과 유사하지만 실습실이나 현장에서의 실습시간이 절대적으로 부족하다. 덧붙여 승인된 응급구조사 교육 기관의 강사는 강사로서의 자격기준을 충족할 뿐 아니라 실습강사는 대체적으로 1주일의 1/2은 응급 구조차를 탑승하여 현장 활동을 끊임없이 하고 있으며, 실습은 시나리오 유형으로 진행된다. 그러므로 우리나라의 경우 응급 구조사가 현장 기술 인력으로 역할 할 수 있도록 교과과정 내에서 실습을 강화 시켜야하며, 졸업생은 인턴쉽을 통한 현장 능력을 배양시키는 것이 필요하다. 8. 간호사의 경우 응급전문간호사의 자격을 부여받게 됨에 따라, 이를 위한 표준 교육 지침을 개발함으로써 병원 전 처치와 재난시 대응할 수 있는 역량을 보완해야 한다. 또한 현 자격 부여 프로그램 내용을 고려하여 정규자격 간호사가 현장 1차 치료자(first responder)로 역할 할 수 있도록 간호학 교과과정을 부분 보완해야한다.

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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.

A Study on the Interhospital Transfer of Emergency Patients (응급환자 전원에 관한 판례의 태도 - 대법원 2005. 6. 24. 선고 2005다16713 판결 -)

  • Lee, Jae-Yeol
    • The Korean Society of Law and Medicine
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    • v.10 no.1
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    • pp.389-420
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    • 2009
  • Main Issue of Supreme Court Decision 2005Da16713 Delivered on June 24, 2005 is about the duty of medical care in the interhospital transfer of patients. According to the above Supreme Court Decision, in the interhospital transfer of patients, the decision to transfer should make from the aspect of medical treatment. The hospitals and doctors keep the duty of medical care. In addition to the duty for hospitals/doctors to check the capacity and availability of the hospital to which the patient is transferred, there are also duties to inform about emergency medical service and to sufficiently explain the need for the transfer, the medical conditions of the patient to be transferred and the hospital from which the patient is transferred. The hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer. including information upon referral, completeness of medical records, patient monitoring and so on. The interhospital transfer requires the consent of doctor belonging to the hospital to which the patient is transferred after the consideration of capacity and availability of the hospital and the informed consent of patients or legal representatives.

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A Study on Civil and Criminal Liabilities of 119 Rescue and Its Legal Protection (공무원인 119구급대원의 직무수행과 관련하여 발생할 수 있는 민$\cdot$형사상 책임과 그에 따른 법적 보호를 위한 대책에 관한 연구)

  • Bae Hyun-A;Yun Soon-Young;Jung Koo-Young;Lee Kyung-Whan;Kim Chan-Woong
    • Fire Science and Engineering
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    • v.19 no.2 s.58
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    • pp.45-62
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    • 2005
  • This thesis has defined the legal status of 119 rescue who plays a major role in the Korean prehospital emergency medical system and reviewed the various issues that may occur depending on work related legal liabilities. As a result, the purpose of this study was to represent the countermeasures for legal protection of 119 rescue required for the quality improvement of prehospital emergency medical system and as well as the countermeasures for risk management prepared for its related lawsuits. The legal liabilities of 119 rescue officers can be divided largely into public law liabilities and civil and criminal liabilities. In order to decrease the incidences of legal problems and provide the legal protection to rescue officers, the liability of supervising physician should be emphasized when the emergency medical practice is performed by a rescue officer under their supervision by consolidating medical control and the rescue officer should have legal liability on his emergency medical practice. itself Also, the emergency medical service guideline for 119 rescue officers should be prepared and their works should be performed according to such a guideline and procedures. In addition, the accurate legal documentation on emergency medical system from on-site to ER and related mobilization should be framed and preserved. Moreover, it is required to enact a new law such as the Good Samaritan Act or the Rescue Officers Protection Act.