• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.47-73
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• 2017

Medical certificate is a document to demonstrate a patient's health status, made up and signed by a physician, dentist, or oriental physician who attended the patient. It serves as an evidence in many official process including civil or criminal law suit, especially for one's personal injury. The Korean legal system also acknowledges and protects the evidentiary function of medical certificate by mandating physicians etc. to issue medical certificate in good faith and only when they personally attended the patient, and by criminally punishing them when they do not comply with these legal requirements. There are some reasons, however, that medical certificates often do not reflect the true health status of the patient: When physicians attend the patient and collect information regarding the health status of the patient, their priority is and should be the most cost-effective way to meet the health needs of the patient. It does not necessarily correspond to the accurate examination of the health status of the patient. Even when the patient's report on the history of the illness or the injury seems suspicious, physicians might have to avoid disproving it because that kind of attitude might harm the rapport between the physician and the patient. All these can distort the perception of the physicians and this distortion can be reproduced in the medical certificate they made up. Some of these problems might be resolved or at least enhanced by introducing new form of medical certificate which would guide physicians to reveal the nature, factual and theoretical grounds, and the limit of their findings more accurately. Others, however, would not be able to address, because it stems from the conflict between the physician's primary duty, duty to be loyal to the patient's life and health, and his secondary duty to serve as a public or neutral witness on the health status of the patient, and when both values or duties conflict with each other, they should choose the duty to the patient sacrificing the duty to the public or the court.

• Journal of the Korean Society of Radiology
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• v.6 no.2
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• pp.137-142
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• 2012

This study is investigated dose change on intra-oral radiography when same conditions under the others unit and same unit under the different exposed conditions. Three different radiation devices were studied. Exposure to the upper anterior, premolar and molar on the variant time and dose measure was using semiconductor radiation dose meter. Obtained film density value was analyzed to the belong in the range of diagnosis. Results for dose of each region were less dissimilar between the maximum and minimum. Its value was different 10 times as many as 3 times. In addition, the range of film density was 2.10 ~ 2.95. These values were exceeded on the allow density of diagnostic value '0.25 ~ 2.0'. Even if the same device and the same condition, measured dose was considerable differance and film density was showed show the inappropriate density range. Those can be caused the patient's re-take and patient's diagnostic errors so patients has affected direct and indirect radiological harm. Therefore, dental radiography devices will be required periodical maintenance and also provided standard on the exposure and processing conditions.

• Journal of the Korean Society of Radiology
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• v.7 no.6
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• pp.383-387
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• 2013

Diagnostic imaging systems play a critical role in obtaining anatomical images, which increases the frequency of inspection all over the world. However the likelihood that patients are exposed to relatively high radiation dose increases, which may lead to an increase of patient dose due to unnecessary radiation exposure unless appropriate management is accompanied. Thus the revised edition of IEC 60601-2-44 which is constancy tests for CT equipment which is designated as special medical equipment and is subject to safety management was studied. The results suggested the 3rd has been revised rationally in order to overcome the limitations in the 2nd by adopting clear and enhanced references, which implies the replacement of IEC 60601-2-44 2nd edition with IEC 60601-2-44 3rd will prevent the patients from the harm from improper medical equipment.

• Journal of Preventive Medicine and Public Health
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• v.38 no.2
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• pp.141-146
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• 2005

Objectives: Particulate contaminants, such as total and respirable dusts, can harm the health of farm workers via several routes. The principal aims of this field study were to determine the concentrations and emissions of particulate contaminants: total and respirable dusts, in the different types of swine houses used in Korea, and allow objective comparison between Korea and the other countries in terms of swine housing types. Methods: The swine houses investigated in this research were selected with respect to three criteria: the manure removal system, ventilation mode and growth stage of pigs. Measurements of total and respirable dust concentrations and emissions in the swine houses were carried out on 5 housing types at 15 different farm sites per housing type. The swine houses investigated were randomly selected from farms situated within the central districts in Korea: province of Kyung-gi, Chung-buk and Chung-nam. Results: The total and respirable dust concentrations in the swine houses averaged $1.88\;and\;0.64mg/m^3$, ranging from $0.53\;to\;4.37mg/m^3$ and from $0.18\;to\;1.68mg/m^3$, respectively. The highest concentrations of total and respirable dusts were found in the swine houses with deep-litter bed systems: $2.94mg/m^3\;and\;1.14 mg/m^3$, while the lowest concentrations were found in the naturally ventilated buildings with slats: $0.83mg/m^3\;and\;0.24mg/m^3$, respectively (p<0.05). All the swine houses investigated did not exceed the threshold limit values (TLVs) for total ($10mg/m^3$) and respirable ($2.5mg/m^3$) dusts. The mean emissions of total and respirable dusts, per pig (75 kg in terms of live weight) and area ($m^2$), from the swine houses were 97.33 and 9.55 mg/h/pig and $37.14\;and\;12.83mg/h/m^2$, respectively. The swine houses with deep-litter bed systems showed the highest emissions of total and respirable dusts (p<0.05). However, the emissions of total and respirable dusts from the other swine houses were not significantly different (p>0.05). Conclusion: The concentrations and emissions of total and respirable dusts were relatively higher in the swine houses managed with deep-litter bed systems and ventilated naturally of the different swine housing types tested. In further research, more farms than the number used in this research should be investigated, which will present objective and accurate data on the concentrations and emissions of total and respirable dusts in Korean swine houses. In addition, personal sampling should be performed to objectively assess the exposure level of farm workers to particulate contaminants.

• Korean Journal of Ecology and Environment
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• v.47 no.4
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• pp.239-246
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• 2014

To cope with the potential risks associated with invasive alien species, the Korean Government implemented the Biodiversity Act in 2014. Among the alien species not yet introduced into that country, 24 have been designated as alert species. These include mammals, birds, fish, mollusks, insects, and plants that may invade and cause serious harm to the ecosystem. Approval from the Ministry of Environment is required to import or carry any of them. Although these measures are more advanced than those from the previous legal framework, several terms still need to be improved. First, the category of alert species should cover not only those not yet introduced but also those that are being raised or cultivated at aquariums, botanical gardens, and zoos. Second, for applicants who intend to import or carry alert species, the government must provide them with detailed standards for the ecological risk assessment of alert species as well as guidelines for their safe use in Korea to prevent their unregulated release from confinement facilities into natural environments. Third, tools and protocols should be developed for early detection and rapid responses to those escapes.

• Journal of Hospice and Palliative Care
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• v.11 no.2
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• pp.99-105
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• 2008

Purpose: In terminally ill cancer patients, accurate prediction of survival is necessary for clinical and ethical reasons, especially in helping to avoid harm, discomfort and inappropriate therapies and in planning specific care strategies. The aim of the study was to investigate prognostic factor of dying patients. Methods: We enrolled the terminal cancer patients from Kangnam St. Mary's Hospital from 2004 until their death. We observed symptoms shown in dying patients and assess 17 common symptoms shown in terminally ill cancer patients, performance status, pain and analgesic use. Results: Average period from hospitalization to death was 11.7 days. The most important prognostic factor is performance status (KPS), average KPS at enrollment is 48% and at last 48 hours is 25%. Physical symptoms that have significant prognostic importance are poor oral intake, weakness, constipation, decreased Karnofsky performance status, bed sore, edema, jaundice, dry mouth, dyspnea. Dying patients showed markedly decreased systolic blood pressure, cyanosis, drowsiness, abnormal respiration, death rattle frequently at 48 hours before death. Conclusion: If we assess the symptoms more carefully, we can predict the more accurate prognosis. The communication about the prognostic information will influence the personal therapeutic decision and specific care planning.

• Journal of radiological science and technology
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• v.31 no.3
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• pp.217-222
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• 2008

Radiation dose to radiologists working at three hospitals in Seoul was investigated from Jan 1, 2006 to Dec. 31, 2006. The results are as follows. First, radiation dose to radiologists at a cardiac angiography room was measured as 1.41mSv, the highest while radiation dose to radiologists at a department of radiation oncology was measured as 0.64 mSv, the lowest. Second, radiation dose proves to be in direct proportion to the number of X-ray treatment. Third, as for the radiation dose in X-ray treatments, radiologists in cardiac angiography room are exposed to the largest amount of radiation while radiologists in diagnostic radiology department are exposed to the smallest amount of radiation. Last, radiation dose at a cardiac angiography room is the largest and is followed by nuclear medicine, diagnostic radiology, and radiation oncology departments in order. According to ICRP, exposure less than 20mSv per year is highly recommended while radiation dose is allowed as long as it is ranged less than 50mSv per year or 100mSv within a 5-year period. Taking into account the results, radiation exposure does not do any harm to radiologists at any related departments in Korean hospitals because the dose per year is less than 1.60mSv.

• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.119-142
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• 2013

It is not easy to regulate the amount of radiation used for the medical purpose as there usually is more good than harm to the patient's health and life caused by the medical exposure to the radiation. However, the rapid increase of the use of diagnostic radiation involves a high possibility of increasing the radiation hazard exposure. Therefore, it is imperative to implement effective regulations in order to secure the safety of diagnostic radiation. The one and only rule we currently have for the diagnostic radiation is "Medicine Act" with only one clause dedicated to regulate the safety management that does not include any rules for the medical radiation. A set of inclusive rules for the whole medical radiation inclusive of diagnostic radiation and therapeutic radiation need to be based on the "Medicine Act" rather than "Nuclear Safety Act" in order to protect the medical professionals, patients and the guardians of patients from the hazards of diagnostic and/or therapeutic radiation that was not used the purpose of medical treatment. If there is an administrative measure to be imposed to secure the safety of diagnostic radiation, it is considered as exertion of governmental authority of administrative agency. There must be clear and realistic legal guidelines for in-fringe on people's interests. The administrative measures for the safety management of the diagnostic radiation must be clearly and specifically based on the law and the detailed standards for the administrative measures must be dele-gated by the presidential decree or departmental ordinance. Accordingly, the restrictions imposed by the administrative measures to the "Safety Inspection Institute of Radiation along with Radiation Exposure Measuring Institutes" should have clear legal basis as well and the detailed standards for the administrative measures should be regulated by the Ministry of Health and Welfare decree instead of the notification by the Director of Korean Centers for Disease Control and Prevention. While securing the safety of radiation on one side, careful review and up-grade on our legal system for the safety management of the diagnostic radiation is required on the other side to guarantee the legality, interest balance and reliability of the administrative measures.

• The Korean Society of Law and Medicine
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• v.19 no.1
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• pp.81-111
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• 2018

Recently in Korea, public interest about patient safety has increased because patient safety incidents occurred continuously. In addition, as the way of coping with medical personnel and medical institutions after occurrence of patient safety incident became controversial, the necessity of introducing apology law and disclosure law was raised. We analyzed the contents of apology law and disclosure law in U.S.A and critically examined the legislative movements in Korea. First, the Apology law requires that a medical personnel provide apology, consolation, sympathy to the patient for discomfort, pain, damage or death, and that the expression of apology shall be inadmissible as evidence of an admission of liability in civil action or administrative proceeding. The Apology law is divided into 'full apology law' and 'partial apology law' depending on whether mistake, error, fault, liability, and legal liability shall be inadmissible. Meanwhile, Disclosure law enforces or voluntarily enforces the law to communicate with the patient regarding the disclosure of the incident, the cause of incident, the compensation plan, and the measures to prevent the recurrence in the adverse incident that serious harm to the patient. In Korea, the concern about patient safety incidents has been amplified, and as the importance of communication between the medical personnel and patient has been recognized, the revision bill for the "Patient Safety Act", which adopted the U.S.A apology or disclosure law, was submitted to the National Assembly. The purpose of this study was to critically review the contents of the revised legislation based on the analysis of the apology law and disclosure law in U.S.A. and to provide implications for future legislative direction.

• The Korean Society of Law and Medicine
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• v.19 no.1
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• pp.3-20
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• 2018

Pharmacopunture is a new combined method of acupunture and oriental drugs. Recently, this method is widely used to treat traffic accident patients in oriental medicine. However, there is no evidences of treatment, no information of effects and side-effects of this method, and no information of drugs used. In South Korea, western medicine and oriental medicine are regulated differently. When a new technology is invented in the area of western medicine, that method should pass several stages of clinical trials. After that processes, that method can be done as a medical practice. However, in the area of oriental medicine, there is no process like that. According to in South Korea, medical practice without license are composed of two behaviors. First type is that medical practice is done by a person who has no medical license. Second type is that medical practice is done by a person who has a medical license but the area of the license is different. Because of this reason, the distinction between the western medical practices and the oriental medical practices is very important. Medical practices are protected by license mainly because they can harm human life or body. When we invented new medical practice and try to practice it to the patients, we should consider the risk of that method whether it is western medical practice or oriental medical practice. It is not clear that the pharmcopunture which has been done is satisfied the standard of medical treatment.