• The Korean Society of Law and Medicine
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• v.21 no.3
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• pp.117-144
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• 2020

In accordance with Article 15 of the Medical Law, medical personnel in Korea cannot refuse treatment of a patient unless there is a justifiable reason, and violation of this obligations is subject to criminal penalties. Japan also stipulates the same content in the law. However, this violation of obligations in Japan is not subject to criminal penalties, and is used as a judgment element of the liability for damages of doctors only in the case of damage to the patient. However, in both countries, it is difficult to interpret and apply the law because the regulation is a little ambiguous. In particular, the key is to find out what is the justifiable reason for the doctor to refuse treatment of the patient. Recently, Japan has completed the work of re-examining the discussion on medical refusal from a modern perspective in terms of improving the excessive working environment of doctors. On the other hand, in Korea, it is not clear in what cases it is possible to refuse treatment. because there is a lack of systematic discussion on medical refusal. Rather, unnecessary misunderstandings and controversies have resulted in the loss of trust between patients and doctors. In Korea, there is already a legal right for a doctor to reject it according to his religious beliefs or conscience in the implementation of the suspension of life-sustaining treatment decisions. And in the case of an abortion, debates are underway that doctors should be given the right to refuse it. This study introduces the current state of discussion in Japan, and examines the issues surrounding medical refusal in Korea. It is hoped that this study will facilitate further discussions on the medical refusal.

• The Journal of the Korea Contents Association
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• v.10 no.11
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• pp.294-303
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• 2010

Unexpected results caused by medical service are defined as malpractice, and the doctor must bear the responsibilities following the medical treatment. Malpractice disputes are disputes between patients, who are seen as the only victim in this way, and medical personnel who do not admit to the charges. Unfortunately, in reality, an official approach to mutual understanding and communication in the instance of such disputes does not exit. Based on this background, this study was attempted to prevent similar forms of medical disputes from occurrence and provide fundamental data to prepare by analyzing the medical disputes precedent. Results of the study are as follows: First, For type of medical institution, hospitals accounted for the most part as 62.9%. Second, Among total medical disputes, the cases surgery accounted for 27.8%, violation of duty care accounted for 20.6% and that of medical treatments 11.3%. Third, For a mean agreed amount by medical department, it was the highest in obstetrics & gynecology as 38,384,000 won. In conclusion, the most desirable method of dispute resolution is to prevent a cause of dispute to the root.

• The Korean Society of Law and Medicine
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• v.16 no.1
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• pp.155-190
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• 2015

The court sentenced meaningful decisions related to the medical service in 2014. The court assumed the negligence of medical staff in the accident if being broken while using the medical equipment for not an original purpose at the time of surgery and ruled that the compensation for damage can be recognized in recognition of the causal relationship between the explanation duty violation and side effect's happening when unproven surgery on safety is implemented regarding the duty of explanation, that in the case of cosmetic surgery, the subject on the duty of explanation needs to be expanded compared to the general medical practice and that the duty of explanation cannot be accepted for the range that cannot be expectable. Also, the court has provided the requirement and limitation of self-determination exercise in case of the crash between patient's self-determination and doctor's duty of care and has ruled that as automobile insurance contract is a contract with the insurance company to pay regarding liability for car accidents, treating patients and taking the insurance money is not illegal activity even for the unlicensed hospital violating the medical law while established. The judgment stating the opinion that medical practitioners cannot be punished according to the medical law prohibiting the receiving of rebate in case that medical practitioners did not receive benefit while the medical institution itself gained an unfair economic benefit also stands out. And the court has ruled that even if the medical institution who received a business suspension is closed, the suspension is still effective in case that the same operator opens a new medical institution in the same place, ruled on the requirement to conduct a medical service outside of the medical institution that the doctor opened and ruled that the administrative penalty cannot be conducted prior to the conviction on charge of violating the medical law.

• Proceedings of the Korea Society of Information Technology Applications Conference
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• 2002.11a
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• pp.304-318
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• 2002

본 연구는 종합병원에서 운영중인 병원정보시스템(Hospital Information System)을 기준으로 업무별 데이터 마트를 구성하여 종합병원 데이터 웨어하우스 시스템을 제안하는 연구이다. 본 연구에서 제안한 병원 데이터웨어하우스 모형은 충남대학교병원 데이터 웨어하우스 시스템 구축 보고서, Inmon의 데이터 웨어하우스 개발방법론에 기초를 두었다. 종합병원의 데이터하우스시스템을 제안하면 다음과 같다. 첫째, 원무 데이터마트, 병원의 원무팀에서 주로 사용하는 것으로써 수입에 관련된 정보, 진료인원에 관한 정보, 심사/청구/삭감에 관한 정보들로 구성되어 있다. 둘째, 약국 데이터마트, 처방전달 데이터 마트와 연결되어 외래/입원의 처방에 관한 정보, 약에 대한 효능과 성분에 대한 정보, 투약과 검사에 대한 정보들로 구성된다. 셋째, 의무기록 데이터마트, 의무기록팀에서 관리하는 퇴원 정보, 암환자에 대한 정보, 외래/입원 환자 통계에 대한 정보들로 이루어진다. 넷째, 처방전달 데이터마트, 주로 의사가 환자에게 행한 처치/처방/수술과 진료기록에 대한 정보들을 기준으로 환자진료나 임상연구에 필요한 정보를 제공한다. 다섯째, 병원 행정 데이터마트, 인사정보, 급여정보, 회계정보, 예산정보, 물류정보 등으로 구성되어 병원의 자원활용이나 행정에 대한 전반적인 정보를 제공한다. 여섯째, 경영지원 데이터마트, 병원경영에 필요한 수입정보, 원가분석 정보, 진료인원 정보들을 한 형태로 제공한다. 또한 의사결정 형태도 의료진 중심의 병원에서 환자중심의 병원으로 구조를 바꾸었고 투명한 정보공유와 기초 데이터들의 정제는 부가가치가 높은 정보로 가공할 수 있게 되었으며 각 전문 직종간의 단절된 정보 흐름을 유기적으로 교환할 수 있게 되어 지식의 교환을 촉진시켰다. 그리고 온라인거래처리시스템(OLTP)의 한계점인 하드웨어적인 문제와 성능 저하에 대한 문제를 해결하였고, OLTP시스템에서 분리되고 이원화된 코드체계와 데이터 형태의 이질화를 통일하는 방법으로 데이터웨어하우스 시스템을 제시하였다. 결국 병원에서 데이터웨어하우스 시스템의 구축은 임상, 연구, 교육의 유기적 순환관계를 정립하여 지식의 순환적 고리인 수집, 공유, 확산, 재창출을 지속적 유지할 수 있는 인프라를 구축해 준다. 반면 상이한 정보들간의 충돌과 이에 따른 해석의 오류로 잘못된 의사결정을 위한 정보를 제공할 수 있고 기초정보의 접근 및 추출의 유용성에 의해서 정보유출에 대한 문제가 한계점으로 나타났다.

• Proceedings of the Korea Society for Industrial Systems Conference
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• 2002.11a
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• pp.304-318
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• 2002

본 연구는 종합병원에서 운영중인 병원정보시스템(Hospital Information System)을 기준으로 업무별 데이터 마트를 구성하여 종합병원 데이터 웨어하우스 시스템을 제안하는 연구이다. 본 연구에서 제안한 병원 데이터웨어하우스 모형은 충남대학교병원 데이터 웨어하우스 시스템 구축 보고서, Inmon의 데이터 웨어하우스 개발방법론에 기초를 두었다. 종합병원의 데이터하우스시스템을 제안하면 다음과 같다. 첫째, 원무 데이터마트, 병원의 원무팀에서 주로 사용하는 것으로써 수입에 관련된 정보, 진료인원에 관한 정보, 심사/청구/삭감에 관한 정보들로 구성되어 있다. 둘째, 약국 데이터마트, 처방전달 데이터 마트와 연결되어 외래/입원의 처방에 관한 정보, 약에 대한 효능과 성분에 대한 정보, 투약과 검사에 대한 정보들로 구성된다. 셋째, 의무기록 데이터마트, 의무기록팀에서 관리하는 퇴원요약 정보, 암환자에 대한 정보, 외래/입원 환자 통계에 대한 정보들로 이루어진다. 넷째, 처방전달 데이터마트, 주로 의사가 환자에게 행한 처치/처방/수술과 진료기록에 대한 정보들을 기준으로 환자진료나 임상연구에 필요한 정보를 제공한다. 다섯째, 병원 행정 데이터마트, 인사정보, 급여정보, 회계정보, 예산정보, 물류정보 등으로 구성되어 병원의 자원활용이나 행정에 대한 전반적인 정보를 제공한다. 여섯째, 경영지원 데이터마트, 병원경영에 필요한 수입정보, 원가분석 정보, 진료인원 정보들을 요약한 형태로 제공한다. 또한 의사결정 형태도 의료진 중심의 병원에서 환자중심의 병원으로 구조를 바꾸었고 투명한 정보공유와 기초 데이터들의 정제는 부가가치가 높은 정보로 가공할 수 있게 되었으며 각 전문 직종간의 단절된 정보 흐름을 유기적으로 교환할 수 있게 되어 지식의 교환을 촉진시켰다 그리고 온라인거래처리시스템(OLTP)의 한계점인 하드웨어적인 문제와 성능 저하에 대한 문제를 해결하였고, OLTP시스템에서 분리되고 이원화된 코드체계와 데이터 형태의 이질화를 통일하는 방법으로 데이터웨어하우스 시스템을 제시하였다. 결국 병원에서 데이터웨어하우스 시스템의 구축은 임상, 연구, 교육의 유기적 순환관계를 정립하여 지식의 순환적 고리인 수집, 공유, 확산, 재창출을 지속적 유지할 수 있는 인프라를 구축해 준다. 반면 상이한 정보들간의 충돌과 이에 따른 해석의 오류로 잘못된 의사결정을 위한 정보를 제공할 수 있고 기초정보의 접근 및 추출의 유용성에 의해서 정보유출에 대한 문제가 한계점으로 나타났다.

• The Korean Society of Law and Medicine
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• v.22 no.1
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• pp.3-23
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• 2021

Telemedicine is a field of medicine in which medicine doctors who are in remote distance can treat the patients using audio, video devices which can help the diagnosis. In medicine, even the face-to-face diagnosis and treatment is the traditional way, the telemedicine could provide the convenient way for the patients in long distance, disabled or anyone who want to be stay ones' home. But telemedicine has the task to maintain the quality of medical cares compare with the traditional medicine. Among the several types of telemedicine, the specific type telemedicine in which the medicine doctors examine, diagnosis and do the prescription to the remotely distanced patients could be defined tele-prescription. Under The Medical Service act, it is unclear that teleprescription could be allowed. The Medical Service Act has introduced the specific clause for the prescription. That clause includes the duty of patients who have to receive the prescriptions directly from medical doctors. Under this clause, the constitutional court had decided the tele-prescription was illegal, but the supreme court has been decided tele-prescription could be legalized under the certain circumstances. But the other supreme court decided the tele-prescription was illegal under the article 34 of presenting Medical Service Act. So to understand the interpretations of Supreme court and Constitutional court decisions for the cases of prescription via telephone, we need to understand the history and presented reasons for the revision of prescription clause and also need to understand the other related clauses in the same act. In conclusion, To consider the values of telemedicine should be the level with the ordinary treatments, It is reasonable to interpret that the presenting Medical Service Act only legalize the telemedicine between doctor to doctor and which is regulated by the telemedicine clause.

• The Korean Society of Law and Medicine
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• v.21 no.2
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• pp.37-73
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• 2020

Medical practice with medical adaptability is not illegal. Consent to medical practice is also not intended to exclude causes of Illegality. The patient's consent to medical practice is the exercise of the right to self-determination, and the patient's right to self-determination is take shape through the doctor's information. If a doctor violates his duty to inform, failure to inform or lack of inform constitutes an act of illegality of omission in itself. As a result, the legal interest of self-determination is violated. The patient has the right to know and make decisions on his or her own, even when it is not connected to the benefit of life and body as the subject of the body. If that infringed and lost, the non-property damage shall be recognized and the immaterial damage must be compensated. On the other hand, the violation of the duty of information does not belong to deny the compensation for physical damage. Which the legal interest violated by violation of the obligation to inform is the self-determination, and loss of opportunity of choice is recognized as ordinary damage. However, if the opportunity of choice was lost because of the infringement of the right to self-determination and the patient could not choice the better way, that dose not occur plainly bad results, under the prove of these causal relationship, that bad results could be compensated. But the unexpectable damage could not be compensated, because the physical damage is considered as the special damage due to the violation of the right of the self-determination.

• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.3-48
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• 2021

Among the major rulings handed down in 2020, there were cases involving anaphylaxis, which is timely as a side effect of coronavirus and flu vaccine. And as a rare case, a ruling was handed down that if medical treatment was done so unfaithfully beyond the limit of patience of ordinary people, it can be an independent illegal act and a cause of compensation for emotional distress. Also, there was a ruling in the appellate court that evaluated disability rate applying the Korean Academy of Medical Sciences Guides for the Evaluation of Permanent Impairment, not McBride system. And the supreme court made it clear that telemedicine is illegitimate. In relation to duty of explanation, it is in the process of adding detail criterion on the firm principles in the individual cases. In regard of medical records, there was a case that even when a medical record is strongly suspected to be tampered with, it is not considered to be an obstruction of proof. There were cases that resulted in different conclusion between the court of first instance and the appellate court rulings. Lastly, in the face of a growing number of cases in which doctors are sentenced to prison for malpractice, we reviewed a ruling that sentenced a doctor to prison.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.131-157
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• 2015

NHIS claimed for damages to doctors that by doing the treatment breaching medical insurance criteria caused by doctors, NHIS paid for medicine cost to pharmacy; as a result, the doctors caused the tort to NHIS. Following consecutive rulings afterwards, NHIS also argued that the medicine cost violating medical law or medical treatment expense paid to medical organizations are both the tort in civil law. NHIS claimed for all the damages, and the Supreme Court confirmed this judgment. However, within our national health insurance system, the subject of insurance payment is NHIS and the subject of medical treatment expense are also NHIS since the treatment expense is also insurance payment by asking the treatment to medical organizations. Further, national health insurance law is not made to control the violation of medical treatment cases; therefore, the breach of medical law cannot be covered by illegality of tort in civil law regarding NHIS. If that is the case, in the case that if the patients are treated according to treatment criteria via the doctors delegated the doctors' permission by Health and Welfare minister, NHIS acquired the benefits to remove the duty to give treatment payment to doctors in civil law; thus, even though the doctors have breached the medical law, NHIS does not have any damages. The fact that supreme court confirmed the ruling that the treatment is the tort in civil law towards NHIS is the judgment not counting the benefits of insurance payment as the subject but only considering the fact that NHIS paid to the doctors and this ruling have gone against the principle under civil code section 750. If the doctors have breached the medical law, the case should be sanctioned by medical law not national health insurance law, and the ruling of supreme court is assumed that they have confused both with the principle of national health insurance law and civil law.

• The Journal of the Korea Contents Association
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• v.20 no.12
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• pp.635-645
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• 2020

An "OpenNote" can be defined as the sharing of medical records between patient and doctors by online, and is a new trial to allow patients to access their medical records any time. To identify the need for the introduction of OpenNotes, which is expanding medical recrods, this study has researched the awareness and attitude towards medical records and OpenNotes among hospital workers in charge of part of medical servises. One of the results in this study is that recognizing his or her own records can impact his or her understanding his or her health status. Also, the subjects who were participated in this study generally agreed with the usefulness of the OpenNote and were willing to participate in the OpenNote. Meanwhile the subjects are admitting counterfeiting the medical records or falsifying them. The conclusion has been shown that patient-doctor sharing of medical records could help patients better understand their health information and encourage their self-care. When patients can access their own medical records easily, Unnecessary misunderstandings and distrust of records between patients and medical staff can be markedly reduced then it can help to build up the trust in a doctor-patient relationship. Considering not only the health utility of OpenNotes but also the impact on the trust of doctors, the pilot project of OpneNotes for experimental verification is proposed.