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The Cosmetic Operation without Healing Purpose - A comparative insight into the ruling of BSG and BGH - (미용성형의료 - 우리 판결례와 독일 판결례의 비교·분석적 소고 -)

  • Ahn, Bup-Young
    • The Korean Society of Law and Medicine
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    • v.16 no.1
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    • pp.3-82
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    • 2015
  • This paper is concerned in the theme of the liability for the breach of duty to inform(Haftungszurechnung der $Aufkl{\ddot{a}}rungspflichtverletzung$) and the malpractice of cosmetic surgery. Here, the terms, treatments for healing purposes and purely medical-technical cosmetic operations are well integrated in the category of "medical conduct(medizinische Handlung)" within the meaning of the public and administrative 'Medical Law'. In the judgment of 6. 13. 2013 Az. 2012DA94865 provides the KHGH(Korean Highest Court of Justice) to inform the patient about the prospects and risks of cosmetic surgery(Infrabrow Excision Blepharoplasty) stringent requirements, similar to the judicature of BGH(cf. BGH, Urt. v. 6. 11. 1990, Az.: VI ZR 8/90). Even in the judgment of 5. 12. 2014 Az. 2013GASO865646 the SZLG(Seoul Central Regional Court) recognizes the physician contract for 'cosmetic septoplasty' as a sort of contract for work. The medical treatment(${\ddot{a}}rztliche$ Heilbehandlung) is still regarded as a prototype of the medical activity, therefore in the meaning of the 'Civil Law(KBGB)', its term needs to be used immediately for healing purposes. The cosmetic operation, desired by a patient, differs from the healing treatment by the element of "indication" and the fact that the "healing purpose(Heilzweck)" itself is missing. In comparative context - methodically fully aware that the unreflective term transfer between different laws might contradict their legal purposes - a series of judgments BSG(BSGE 63, 83, BSGE 72, 96, BSGE, 82, 158, BSGE 93, 252 etc.) and some judgments of LSG are reviewed. In addition, also the dogmatic topic for the "legal natur of a medical treatment contract" is to reconsider by comparative introducing BGHZ 63, 306. Now in view of the current state of greater popularity of artificial cosmetic surgery still indeed is the sentences: The doctor is minister naturae, a helper of nature. A doctor promises regularly only the proper treatment of the patient, but the contractual liability for work should not be excluded in medical conditions for cosmetic surgeries altogether. "With cosmetic operations, seeking to eliminate the external deformities, the doctor may miss the medical profession entirely." - A. Laufs, Medical Law, 5th ed. P. 18.

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Policy suggestions for active reporting of medical professionals for early detection of child abuse (아동학대의 조기발견을 위한 제도적 개선 방안: 「아동학대범죄의 처벌 등에 대한 특례법」이 정한 의료인에 의한 신고를 중심으로)

  • Bae, Seung Min;Lee, Sun Goo
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.143-169
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    • 2017
  • The Act on Special Cases Concerning the Punishment, etc. of Child Abuse Crimes intends to encourage reporting and punishment of child abuse by using the concept of 'crime' in child abuse cases. Article 10 of the Act imposes duty to report child abuse on a number of different professions, including medical professionals. Currently, more than 80% of child abuse cases occur among family members and the detection rate of child abuse is as low as 0.5% in Korea. On the other hand, medical professionals can identify child abuse relatively clearly with specific medical opinions. Therefore, it is necessary that medical professions are informed of this duty and does not bear disincentive from reporting. This paper makes policy suggestions in this regard. First, it is necessary that medical students and medical professionals receive regular education about the obligation to report child abuse. Education should include details of the reporting duty, as well as the fact that there is legal obligation to report even if the child abuse is "suspicious", not certain. Second, it is imperative to establish and implement protective programs for medical professionals who report child abuse. The current law provides a rough framework for protection of people who report child abuse, but it is necessary to produce detailed guidelines that are applicable in the context of medical setting. Education for medical students and medical professionals should include the contents of these guidelines, so that they do not hesitate reporting because they fear the aftermath of reporting. Third, it is highly recommended that physicians use the national Baby/Infant Health Checkup Program as an opportunity to detect child abuse. In Korea, the Baby/Infant Health Checkup Program provides physicians to periodically monitor health condition of all babies and children until the age of 71 months. In order to utilize this program for early detection of child abuse, it is imperative that the bBaby/Infant Health Checkup Program is modified to involve child abuse experts and medical professionals who participate in the program are educated about child abuse.

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DEVELOPMENT OF SAFETY-BASED LEVEL-OF-SERVICE CRITERIA FOR ISOLATED SIGNALIZED INTERSECTIONS (독립신호 교차로에서의 교통안전을 위한 서비스수준 결정방법의 개발)

  • Dr. Tae-Jun Ha
    • Proceedings of the KOR-KST Conference
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    • 1995.02a
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    • pp.3-32
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    • 1995
  • The Highway Capacity Manual specifies procedures for evaluating intersection performance in terms of delay per vehicle. What is lacking in the current methodology is a comparable quantitative procedure for ass~ssing the safety-based level of service provided to motorists. The objective of the research described herein was to develop a computational procedure for evaluating the safety-based level of service of signalized intersections based on the relative hazard of alternative intersection designs and signal timing plans. Conflict opportunity models were developed for those crossing, diverging, and stopping maneuvers which are associated with left-turn and rear-end accidents. Safety¬based level-of-service criteria were then developed based on the distribution of conflict opportunities computed from the developed models. A case study evaluation of the level of service analysis methodology revealed that the developed safety-based criteria were not as sensitive to changes in prevailing traffic, roadway, and signal timing conditions as the traditional delay-based measure. However, the methodology did permit a quantitative assessment of the trade-off between delay reduction and safety improvement. The Highway Capacity Manual (HCM) specifies procedures for evaluating intersection performance in terms of a wide variety of prevailing conditions such as traffic composition, intersection geometry, traffic volumes, and signal timing (1). At the present time, however, performance is only measured in terms of delay per vehicle. This is a parameter which is widely accepted as a meaningful and useful indicator of the efficiency with which an intersection is serving traffic needs. What is lacking in the current methodology is a comparable quantitative procedure for assessing the safety-based level of service provided to motorists. For example, it is well¬known that the change from permissive to protected left-turn phasing can reduce left-turn accident frequency. However, the HCM only permits a quantitative assessment of the impact of this alternative phasing arrangement on vehicle delay. It is left to the engineer or planner to subjectively judge the level of safety benefits, and to evaluate the trade-off between the efficiency and safety consequences of the alternative phasing plans. Numerous examples of other geometric design and signal timing improvements could also be given. At present, the principal methods available to the practitioner for evaluating the relative safety at signalized intersections are: a) the application of engineering judgement, b) accident analyses, and c) traffic conflicts analysis. Reliance on engineering judgement has obvious limitations, especially when placed in the context of the elaborate HCM procedures for calculating delay. Accident analyses generally require some type of before-after comparison, either for the case study intersection or for a large set of similar intersections. In e.ither situation, there are problems associated with compensating for regression-to-the-mean phenomena (2), as well as obtaining an adequate sample size. Research has also pointed to potential bias caused by the way in which exposure to accidents is measured (3, 4). Because of the problems associated with traditional accident analyses, some have promoted the use of tqe traffic conflicts technique (5). However, this procedure also has shortcomings in that it.requires extensive field data collection and trained observers to identify the different types of conflicts occurring in the field. The objective of the research described herein was to develop a computational procedure for evaluating the safety-based level of service of signalized intersections that would be compatible and consistent with that presently found in the HCM for evaluating efficiency-based level of service as measured by delay per vehicle (6). The intent was not to develop a new set of accident prediction models, but to design a methodology to quantitatively predict the relative hazard of alternative intersection designs and signal timing plans.

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A Study on Factors Affecting Social Welfare Centers and Facilities' Resource Mobilization (사회복지시설의 민간자원 동원에 영향을 주는 요인 연구: 후원을 중심으로)

  • Kim, Mee-Sook;Kim, Eun-Jeong
    • Korean Journal of Social Welfare
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    • v.57 no.2
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    • pp.5-40
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    • 2005
  • Social welfare centers and residential care facilities where provide the socially disadvantaged with proper social services, face financial difficulties. This is because not only of the lack of governmental support, but also of social welfare centers and residential care facilities' lack of skills in developing abundant resources from the private sector. In this context, this study tried to find factors affecting resource mobilization of the social welfare facilities to devise policies in resource development. Mail survey was conducted with the structured questionnaire. Employees in charge of community resource development were asked to answer the questionnaire. The study population were welfare centers and residential care facilities. A total of 293 community welfare centers and 632 residential care facilities responded to the survey. The response rate was about 62%. The dependent variables of the study were the amount of resource mobilization in the year 2001 which was measured as the number of donors, the total amount of donation, and estimated amount of gift-in-kind. Three types models were constructed per each welfare institution. Independent variables were selected based on the previous research findings: community environment factor, structural factor, and resource development factor. Multiple regression was utilized to analyze the data. The resource development factor turned out to be significant variable in various models. In the models of donors, the amount of donation, and the amount of gift-in-kind (except for the welfare center model), at least one out of six variables of the resource development factors was significant welfare center. Welfare centers which establish the resource development department or hire employees to take care of resource development, utilize computer softwares to file donors, and utilize donor management programs, have more donors and/or donations than their counterparts. In addition, residential care facilities located in urban area have more donors and donations, and among residential facilities those for the disables, those with longer history and more employees, receive more donations than their counterparts. As for the gift-in-kind model, the welfare centers located in high income area and residential care facilities for the elderly, children and mentally retarded receive less gift-in-kind than their counterparts Based on the above findings, this study suggested that to mobilize resources the welfare centers as well residential care facilities need to have community resource development department or resource development staffs, adopt computer software to systematically organize donors, and utilize donor mobilizing and maintaining programs.

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Measurement of competency through self study in basic nursing lab. practice focused on cleansing enema (기본간호학 실습에 있어 자가학습을 통한 능숙도 측정 - 배변관장을 중심으로 -)

  • Ko Il-Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.532-543
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    • 1999
  • This study was conducted to provide the basic data necessary for the improvement of the teaching method for basic nursing practice as well as the effectiveness of the practice by examining the students' competency in cleansing enema after doing the self study instead of the traditional education. To examine the competency in cleansing enema after the self study, this study is an one group pretest-posttest design that subjects did the enema practice through the self study. The subjects were 89 sophomore students at Y University. College of Nursing. In basic nursing lab practice class, cleansing enema self study module was given to the students which was developed by the researcher based on the literature review and asked them to finish doing the pre study and checking the self study evaluation criteria after reading the goal, learning activities and theoretical guideline. After watching the video tape, students practiced the process in the module by themselves. For the competency in cleansing enema. repeated autonomous practices were done during the open lab other than the regular class. Whenever the practice was done, the frequency and time were measure and documented. When the student felt confident through repeated practices, the competency was evaluated by the researcher and two assistants based on the evaluation criteria. And the process was repeated till the student could perform all the items on evaluation criteria completely. The data were collected for 42 days from Oct. 15 to Nov. 26 in 1996. Collected data were analyzed by frequency, percentage, Pearson correlation coefficient and variance analysis. The results are summarized as follows : 1. 43.2% of the students were favorable to nursing and 63.6% like lecture, but 71.6% like practice. So they were more interested in practice than in lecture. 2. 62.3% of the students scored high in written test, 97.8% scored high in practice. So the practice score was better. 3. The frequency of repeated practice to pass the test ranged from 1 to 4 and the average is 2.2. 4. The average time needed in preparation and the performance was nearly the same regardless of the frequency. It took 5 to 38 minutes for those who passed the test after practicing once and the average was 16 minutes. 5 to 60 minutes were taken for those who practiced twice to pass the test and the average was 21 minutes. Those who passed the test after three practices needed 8 to 30 minutes and the average was 15 minutes, which was similar to the time that the students who passed the test for the first trial. Only one student passed the test after 4 practices and it took 10 minutes. 5. 64% of the students agreed that the context and the content of the module were appropriate for the self study and 68.2% were satisfied. And 71.9% said that the module helped them to practice the enema self study 6. Though only 42% of the students were satisfied with the video. 50.6% said that it was helpful for the self study. 7. 52.3% of the students were satisfied with the self study method, and 86.6% obtained self-confidence when performing the enema. 8. The lower the student's practice score was, the more practices were needed for them to pass the test(r=-.213, P<.05). As a result, for performing the enema practice competently, two or more practice opportunities were needed to be given. And it is possible to obtain the less complex nursing skills through the self study, when enough learning resources and assistance such as learning guidance or video tapes are provided. Based on this study. I want to suggest that. 1. There must be college policy that can support the new method instead of the traditional learning method for the students to attain the proficiency in basic nursing skills. 2. The assistant materials should be developed as soon as possible to promote the self study of basic nursing skills.

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In Search of "Excess Competition" (과당경쟁(過當競爭)과 정부규제(政府規制))

  • Nam, II-chong;Kim, Jong-seok
    • KDI Journal of Economic Policy
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    • v.13 no.4
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    • pp.31-57
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    • 1991
  • Korean firms of all sizes, from virtually every industry, have used and are using the term "excessive competition" to describe the state of their industry and to call for government interventions. Moreover, the Korean government has frequently responded to such calls in various ways favorable to the firms, such as controlling entry, curbing capacity investments, or allowing collusion. Despite such interventions' impact on the overall efficiency on the Korean economy as well as on the wealth distribution among diverse groups of economic agents, the term "excessive competition", the basis for the interventions, has so far escaped rigorous scrutiny. The objective of this paper is to clarify the notion of "excessive competition" and "over-investment" which usually accompanies "excessive competition", and to examine the circumstances under which they might occur. We first survey the cases where the terms are most widely used and proceed to examine those cases to determine if competition is indeed excessive, and if so, what causes "excessive competition". Our main concern deals with the case in which the firms must make investment decisions that involve large sunk costs while facing uncertain demand. In order to analyze this case, we developed a two period model of capacity precommitment and the ensuing competition. In the first period, oligopolistic firms make capacity investments that are irreversible. Demand is uncertain in period 1 and only the distribution is known. Thus, firms must make investment decisions under uncertainty. In the second period, demand is realized, and the firms compete with quantity under realized demand and capacity constraints. In the above setting, we find that there is "no over-investment," en ante, and there is "no excessive competition," ex post. As measured by the information available in period 1, expected return from investment of a firm is non-negative, overall industry capacity does not exceed the socially optimal level, and competition in the second period yields an outcome that gives each operating firm a non-negative second period profit. Thus, neither "excessive competition" nor "over-investment" is possible. This result will generally hold true if there is no externality and if the industry is not a natural monopoly. We also extend this result by examining a model in which the government is an active participant in the game with a well defined preference. Analysis of this model shows that over-investment arises if the government cannot credibly precommit itself to non-intervention when ex post idle capacity occurs, due to socio-political reasons. Firms invest in capacities that exceed socially optimal levels in this case because they correctly expect that the government will find it optimal for itself to intervene once over-investment and ensuing financial problems for the firms occur. Such planned over-investment and ensuing government intervention are the generic problems under the current system. These problems are expected to be repeated in many industries in years to come, causing a significant loss of welfare in the long run. As a remedy to this problem, we recommend a non-intervention policy by the government which creates and utilizes uncertainty. Based upon an argument which is essentially the same as that of Kreps and Wilson in the context of a chain-store game, we show that maintaining a consistent non-intervention policy will deter a planned over-investment by firms in the long run. We believe that the results obtained in this paper has a direct bearing on the public policies relating to many industries including the petrochemical industry that is currently in the center of heated debates.

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A Study on the Continuing Education of Dental Technicians (치과기공사의 보수교육에 관한 연구(I) -보수교육 실태와 인식을 중심으로 -)

  • Moon, Je-Hyuk
    • Journal of Technologic Dentistry
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    • v.22 no.1
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    • pp.179-198
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    • 2000
  • Since dental prosthesis is made possible only when dental technicians give themselves to the study of knowledge and the acquisition of updated skills, continuing education is of great importance in that it makes up for the efforts of dental technicians. Accordingly, continuing education relates to a system designed to contribute to the enhancement of the talents of dental technicians and the dental health of the nation. Specialized knowledge and information may work as the best weapon to preserve their jbs. This is true of this modern society where no one can expecth to survive without acquiring knowledge and information constantly for work is getting more classified and more divirsifide. This paper is dedicated to take a look at the current condition of the continuing education of dental technicians and to come up with measure to make general evaluation and to improve continuing education. This research resorts to 609 questionnaires among 6433 copies save unfaithfully responded 34 copos with 6.431 dental technicians as the subjects enrolled in the Dental technician Association. The collected questionnaires consist of 365 dental technicians living in Seoul and of 244 ones, Which account for 11.8 percent of dental technicians enrolled in the association. Because dental technicians live more in local areas than Seoul, the generalization of this survey leaves something to be desired. I have come up with the following findings. 1. 6,431 dental technicians, or 36.3 percent of an total of 14,956 licensed dental technicians, were admitted as numbers of the Dental Tachnician Association as of October 31, 1999. In the '98 continuing education. 4,141 dental technicians among 4,711 dental technicians got relevant training, and in the '99 continuing education, 4,075 technicians, or 75.9 percent of 5,365 technicians got relevant training while 1,290 technicians or 24.2 percent, fail to get relevant training. 2. The survey has it that 38.1 percent of dental technicians are ignorant of the laws on continuing education, and that technicians staying in local communities(146 persons, or 61.6%) take more part in education than those living in the capital of Korea(159 persons, or 146%), and that the older they are, the more money they earn, the more carrer they have, the higher position they hold, the more part they take in education 3. According to the survey, those who have the experience of getting training more than three times account for 52 persons(16.8%) in Seoul and 47 persons(22.4%) in local districts(p<0.01). In terms of sanctions in relation to continuing education, 26 dental technicians(4.6%) say that they have ever gotten sanctions, and 533 dental technicians(95.4%) say that they haven't. And those who were absent from continuing education(72 technicians : 13.51%) didn't get any sanction. 4. In terms of the degree of understanding continuing education, local technicians(46.8% : 110 persons) have a higher understanding of continuing education than their countparts staying in Seoul(36.0% : 130). Continuing education is not the ultimate goal itself. It should be changed to motivate those who get education to be willing to take part in contunuing education, and to help dental technicians in a practical and specific way. And the branch societies should be developde to engage in more specialized and classified expert fields. Of course, the curriculum should be so selected that the conceptions of dental technicians may be reflected to the maximum extent, and the ultimate effores should be made to effect diversity in the ways of educational methods and to perfect the preparation of continuing education on the part of instructors. Regulations should be established in relation to continuing education with a veiew to enhancing the participation of continuing education and its effectiveness. The supervision of the Ministry of Health and Welfare is of great importance in this context. The regulation of continuing education is not administrative regulation, but the expression of national will to guarantee the medical service of the nation at highest level. Therefore, it is necessary that the Ministry of Health and Welfare should change their understanding of the needs for the continuing education of dental experts, and that the expertise of government employees in charge of continuing education should be expanded. It goes without saying that the government should suppory continuing education in a financial way so as to supply the person in charge of public welfare and control the quality of national medicine.

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Analysis of the Practical Reasoning Process Presented in Home Economics Textbooks of 2007 Revised Curriculum (2007년 개정 교육과정에 기초한 7학년 가정 교과서에 반영된 실천적 추론 과정의 분석)

  • Lee, Min-Jung;Yoo, Tae-Myung
    • Journal of Korean Home Economics Education Association
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    • v.22 no.4
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    • pp.109-138
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    • 2010
  • This study examined how practical reasoning process is reflected in the 2007 revised home economics textbook of the 7th grade that is being used in schools since 2010. For a textbook analysis of the components of practical reasoning process, 12 published textbooks were all analyzed, and analysis areas were decided by reconstructing the textbook system into introduction, body contents, learning activities, evaluation. Analysis criteria were extracted from the previous literatures. Practical reasoning process was classified into Valued Ends, Context and Background, Alternatives and Means, on sequence, and Action and Reflection. As a result of analyzing categories and problems that practical reasoning process is reflected in the textbook, firstly, here was a category, which Valued Ends was absent in the practical reasoning process. In the relevant category, general problem solving progress and practical reasoning process could not be differentiated, and activity was developed with 'strategies for solution' as objective. Second, there was a category that the practical reasoning process was reflected in body contents. In this category, knowledge, concept, principle, and theory were insufficiently dealt with. Third, there was a category that reflected components of practical reasoning process but was covered with general problem solving process. Fourth, there was a category that described theme of sub-unit and body contents from the different curriculum perspectives. A curriculum perspective works as the foundation of preparing class contents or consistency of methods when developing lessons. Therefore, confusion might occur when a teacher plans a class with this kind of textbook. Fifth, a category that suggested partial components of practical reasoning process was shown the most and this category is difficult to maximize effects of practical reasoning process.

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The Learning Experience of 7th Graders on NOS (Nature of Science) as a Process in Research-Based "Becoming a Scientist" Mentor-mentee Program (중학생의 "과학자 되어보기" 멘토-멘티 프로그램 참여를 통한 과정으로서 과학의 본성 학습 경험)

  • Jung, Chan-Mi;Shin, Dong-Hee
    • Journal of The Korean Association For Science Education
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    • v.35 no.4
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    • pp.629-648
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    • 2015
  • This study is a case study examining how research-based 'authentic' science education program contextually facilitates students' learning on NOS as a process. We developed 'Becoming a Scientist' mentor-mentee program and applied it to six Korean 7th graders for 8 months. A mentor, who is also a researcher, provided scaffolding and coaching, and her mentees were to perform the whole process of science research, including selecting the research subject and questions, planning research design, doing experiments, collecting and analysing data, writing research paper, and experiencing poster presentation at an academic conference. The research questions are 1) What would the students experience at every step of their research process?, and 2) Which perceptions would they construct NOS as a process? Data include classroom observations, interview, mentor's journal, and students' learning products. The results show that the mentees have experienced their views of NOS as a process in various ways such as role of research question and purpose, validity of measured value, researcher's subjectivity in interpreting data, experience of making public and peer review, and significance of academic conference. This study has shown that students' actual experience in scientific research enhanced their views about NOS as process without explicit and reflective approaches. We defined 'authenticity' associated with not only with its similarity to what scientists do but to learner's identity as scientific researcher. Based on the situated learning theory, this study sheds light on the necessity of reconsideration about the meaning of authenticity and embodying authentic context in science education for better NOS learning.

Role Formation by Interaction Function and Pattern for Group Discussion Activity using the case of Environmental Education Camp for Undergraduate Student (대학생 환경교육캠프 사례에서의 집단 토의 활동에 있어서 상호작용 기능과 양상에 따른 역할 형성 양상)

  • Jung, Won-Young;Lee, Go-Eun;Shin, Hyeon-Jeong;Cha, Hyun-Jung;Kim, Chan-Jong
    • Journal of The Korean Association For Science Education
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    • v.32 no.4
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    • pp.555-569
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    • 2012
  • Many science education research and practices are recently emphasizing the importance of collaborative learning. This study also understands learning in aspects of socio-cultural context, and regarded the creation of meaning in a same-age group as an important learning process. This is most especially true in the premise that the formation of roles in a collaborative learning is important for successful interactive learning. This study aims to find out how roles form in a group. For this purpose, university students participating in a group discussion activity about energy flow and circulation of material were selected as research participants. Discussions among the nine students in one group consisted of cognitive conversations on the topic and operational conversations for preparing a presentation. Video-clips of the discussions were made and transcribed. For the analysis, we developed a framework that includes four interaction functions (cognitive, organizational, meta-cognitive, operational), four action elements (question, simple answer, providing opinion, response to opinion), and two to four intention elements by each action elements. As a result, a total of nine roles were revealed through the interaction function and element; cognitive questioner, operational questioner, simple answerer, operational suggester, organizational commander, operational commander, cognitive explainer, terminator, reflective thinker. These roles are re-classified into seven utterance patterns by the utterance order and object, and they were categorized into three role groups (facilitating interaction, sustaining interaction, finishing interaction). The result means that role formation and function can have influence on learning and interaction. This study is meaningful to the suggestion to collaborative learning including project-based learning, investigation, club activity, and for the re-illumination of the role in an aspect of the interaction.