• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.203-249
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• 2009

It is the so-called Shinchon Severance Hospital Case brought to an end by the decision of the Supreme Court that opened the real discourse of withholding or withdrawing of LST (Life-Sustaining Treatment) in the legal profession as well as medical profession in Korea. Everyone has sympathy with the validity and necessity of legal regulation on withdrawing-including withholding-of LST save the requirements & procedure of withdrawing of LST. In this situation, the legislative bill of amendment to the Korean Civil Law introducing of adult guardianship was pre-announced by the Ministry of Justice on September 18th 2009. The adult guardianship is a guardianship system that supports an mentally handicapped adult to deal with his affairs by support of a guardian. The object of adult guardianship includes affairs of body or well-being as well as property of adult wards. In particular, affairs of medical matters are of importance in the duty and authority of adult guardians. So, the introduction of adult guardianship is of much importance de lege lata as well as de lege ferena in the discussion of withdrawing of LST as a medical treatment. Since the legislation on withdrawing of LST intents to protect the right of death with dignity on the basis of patients' autonomy, the ratio legis of withdrawing of LST is variant from that of adult guardianship. In this context, it seems reasonable to legislate the withdrawing of LST separately from the adultguardianship. In the meantime, the adult guardianship of the legislative bill of amendment to the Korean Civil Law is related to the withdrawing of LST, since the main purpose of adult guardianship is to protect patients' quality of lives and to regulate guardianship contracts based on patients' autonomy. In that context, it seems reasonable to incorporate the legislation of withdrawing of LST into the adult guardianship system. In the latter case, it is not easy to adopt the withdrawing of LST into the legislative bill of the Korean Civil Law for the bill is pre-announced already as previously stated. However, the legislation of withdrawing of LST is not inferior to the legislation of adult guardianship as a matter of urgency. Moreover, it is likely that the legislative bill of Amendment to the Korean Civil Law generates discrepancies in interpretation of the requirements & procedure of withdrawing of LST as the amended German Civil Law did. In short, it is desirable for the legislator to revise the legislative bill despite delay.

• Korean Journal of Social Welfare
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• v.58 no.2
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• pp.33-56
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• 2006

Primary care takers, especially older parents, who live with and care for an adult child with mental illness struggle with the dilemma of who will provide for their child's social and emotional needs and physical care requirements when they can no longer care so. Therefore, 'Permanency plan(financial, residential, legal plan)' is very important for social integration and normalization of mental illness adults. This study aims to introduce the mental health systems in New Zealand and to investigate the permanency plan strategies(benefit, supplements, and the laws) of the government and community support services of NGOs through the interviews with team leaders of representative NGO, Te Korowai Aroha. Permanency plan strategies of New Zealand Government and NGOs are as follows. 1) Financial plans for adults with mental illness include main benefit(invalid benefit), various allowances(family allowance and disability allowance), and wage subsidies for employment. 2) The Government provide accommodation supplement and re-establishment grant for residential plan. And NGOs have supported accommodation program to provide support and accommodation that are important for social integration. 3) Adult mental illness is provided the support of welfare guardian and property manager under the Protection of Personal and Property Rights Act. According the results, this study concluded that social services for the mental illness which secure supported accommodation and benefits is strongly needed. At the same time, mental health delivery system is needed to make distinction between social services and clinical services.

• Korean Journal of Childcare and Education
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• v.10 no.6
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• pp.265-289
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• 2014

This study analyzed the change of after-school guardians' absence types during the first 3 school years, and the relations of after-school care, family environment(family income, parental monitoring) to self-regulatory learning ability and emotional-behavioral problems in each gender of early school-age children from dual income families. The data from 526 boys and 483 girls among 3rd graders of Korean Child and Youth Panel Survey(KCYPS) were statistically analyzed by Friedman's test, t-test, correlational coefficient analysis, regression analysis. The results showed that 45% of boys and 50% of girls were with a guardian for their after-school care in each of the first 3 school years and after-school care had changed gradually into the types of temporal or contingent absence of a guardian. Family income and children's self-regulatory learning ability were different from adult-care and self-care in each gender, but there were differences in the parental monitoring of girls and emotional-behavioral problems of boys according to the care types. Both of boys and girls showed that family environment meaningfully related with the ability and the problems, and also showed the relatively different effects of after-school care and family environment on those ability and problems variables. The results suggested some implications for after-school care.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.103-128
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• 2023

According to the current act of Decision-Marking in Life-Sustaining Medicine, the decision to withhold or discontinue life-sustaining treatment is primarily based on the wishes of a patient in the dying process. Decision-making regarding life-sustaining treatment for these patients is made by the patient, if he or she is conscious, directly expressing his/her intention for life-sustaining treatment in writing or verbally or by writing an advance medical directive and physician orders for life-sustaining treatment. It can be exercised. On the other hand, if the patient has not written an advance medical directive or physician orders for life-sustaining treatment, the patient's intention can be confirmed with a statement from the patient's family, or a decision to discontinue life-sustaining treatment can be made with the consent of all members of the patient's family. However, in the case of an unrelated patient who has no family or whose family is unknown, if an advance medical directive or physician orders for life-sustaining treatment are not written before hospitalization and a medical condition prevents the patient from expressing his or her opinion, the patient's will cannot be known and the patient cannot be informed. A situation arises where a decision must be made as to whether to continue or discontinue life-sustaining treatment. This study reviewed discussions and measures for unbefriended patients under the current law in order to suggest policy measures for deciding on life-sustaining treatment in the case of unbefriended patients. First, we looked at the application of the adult guardian system, but although an adult guardian can replace consent for medical treatment that infringes on the body, permission from the family court is required in cases where death may occur as a direct result of medical treatment. It cannot be said to be an appropriate solution for patients in the process of dying. Second, in accordance with Article 14 of the Life-Sustaining Treatment Decision Act, we looked at the deliberation of medical institution ethics committees on decisions to discontinue life-sustaining treatment for patients without family ties.Under the current law, the medical institution ethics committee cannot make decisions on discontinuation of life-sustaining treatment for unbefriended patients, so through revision, matters regarding decisions on discontinuation of life-sustaining treatment for unbefriended patients are reflected in Article 14 of the same Act or separate provisions for unbefriended patients are made. It is necessary to establish and amend new provisions. In addition, the medical institution ethics committee must make a decision on unbefriended patients, but if the medical institution cannot make such a decision, there is a need to revise the law so that the public ethics committee can make decisions, such as discontinuing life-sustaining treatment for unbefriended patients.

• The Korean Society of Law and Medicine
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• v.20 no.2
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• pp.43-82
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• 2019

In Korea surrogate medical decision makings happen without legal grounds. The purpose of this article is to research the issues in preparing policies for decision-making on behalf of unrepresented patients. As aspects of comparative law, there are two approaches. One of them is to regulate default surrogate list. If no agent or guardian has been appointed, some legislatures provide that members of patient's family who is reasonably available, in descending order of priority of not, may act as surrogate: (1) the spouse, unless legally separated; (2) an adult child; (3) a parent; or (4) an adult brother or sister. If none of them is eligible to act as surrogate, some legislatures allow close friends to make health-care decisions for adult individuals who lack capacity. On the other hand there are other legislatures which provide no surrogate decision maker list but oblige the responsible authority to determine with advice of family members or friends of the patient. In the end the first approach can not guarantee that the surrogate decision maker like family members or friends will determine in the best interest of the patient.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.22 no.10
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• pp.1347-1354
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• 2018

A bedridden patients, elderly people, and dementia who are subject to special care at a medical institution can not handle the feces themselves and need the help of a guardian or care-giver. In particular, toxic substances are contained in the stools, which can cause eczema, dermatitis and urticaria, so it is important to replace diapers. In this paper, we propose a wearable device design for the detection of excretions in consideration of the various excretion requirements of the elderly. The device is a form in which a module are attached to an adult diaper used in a nursing hospital to detect excreta, and the presence or absence of a wearer can be confirmed by an LED. The measured data is transmitted to the smartphone app in real time via Bluetooth in the module and can be checked for popup notification. The validity of this study was verified by comparing the actual excretion with the data collected through the designed module.

• Journal of Korean Clinical Nursing Research
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• v.28 no.3
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• pp.270-276
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• 2022

Purpose: The purpose of this study was to validate the Edmonson psychiatric fall risk assessment tool (EPFRAT) for psychiatric inpatients. Methods: Data from retrospective study were collected from 670 adult inpatients in two departments of mental health medicine of a tertiary general hospital by reviewing their electronic medical records. There were 41 patients who experienced falls and 629 patients who did not experience falls during the period from January to December 2019. Data were analyzed by sensitivity, specificity, positive predictive value, negative predictive value, and a receiver-operating characteristic curve (ROC) for validity assessment using the IBM SPSS/WIN 26.0 program. Results: Factors affecting falls were the participant's age, guardian's residence, high-risk determination at the time of admission, and comorbidity. At the 85 points where the point of sum of the sensitivity and specificity was largest, the sensitivity, specificity, positive predictive value, and negative predictive value of EPFRAT were 92.7%, 79.7%, 22.9%, and 99.4%, respectively. The area under the ROC to assess the overall validity of the tool was .92 (95% CI 0.89~0.94). Conclusion: The EPFRAT was proved to be valid and reasonable for predicting falls in psychiatric inpatients. Based on the results of this study, it could be used for the assessment of high-risk patients for falls in psychiatric units.