Kim, Kyeong-Ok;Kim, Hee-Kyung;An, Hyo-Ja;Shin, Heon-Tae
Journal of Society of Preventive Korean Medicine
/
v.17
no.1
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pp.163-179
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2013
Objectives : After analyzing the proficiency of medical communication of the students in College of Korean Traditional Medicine using standardized patients, we suggests ways to improve clinical practice in the future class and medical communication curriculum development. Methods : 20 students before clinical practice class (3rd grade) and 20 students after 1 year clinical practice class (4th grade) participated and did their medical interview on Standardized patient. They were evaluated on patient-physician communication skills by standardized patients and professor evaluator. In addition to be evaluated on patient-physician relationship, medical interview skills by professor evaluator. Results : As follows in the evaluation of clinical practice with standardized patients 1. More than half of the participated students regardless of their grade received poor score in their medical communication evaluated by SP(Standardized patient) and PE(Professor evaluator). 2. Greeting, History taking parts were higher in the 4th students who received 1 year clinical practice class, but verbal-nonverbal response, voice tone parts were higher in the 3rd students who do not received clinical practice lesson. 3. Pronunciation&Voice tone parts were higher in the male students but, gathering information part was higher in the female students. Conclusions : We think that the current clinical practice lessons are insufficient as a way to learn and improve medical knowledge and medical communication skills, and it is necessary a new form of clinical practice class. Participatory lesson using standardized patient could be a good alternative of that in the future class.
The Supreme Court's en banc decision on December 12, 2022 (docket number 2016Do21314) presented a new standard for determining whether the use of diagnostic medical devices by Korean medical doctors constitutes oriental medical doctors constitutes unlicensed medical practice. Based on this standard, it was determined that the use of ultrasound by Korean medical doctors was not an unlicensed medical practice. Supreme Court's Decision 2016Du51405 on August 18, 2023, is the first case in which a new standard was applied to determine that an Korean medical doctor's use of electroencephalography to diagnose Parkinson's disease and dementia was not an unlicensed medical practice. The Supreme Court abolished the previous standard that Western medical knowledge and technology should not be required for Korean medical doctors to use medical devices. However, it was unclear whether Western medical diagnosis of Korean medical doctors using diagnostic medical devices would be viewed as an an auxiliary method of diagnosis. Parkinson's disease and dementia are Western medical diagnoses. The Supreme Court judged that the Western medical diagnosis of Korean medical doctors was not an unlicensed medical practice. This clearly explains what an auxiliary method of diagnosis means. In addition, the Supreme Court excluded the principles of development and production of electroencephalography from its judgment criteria. Automatic extraction and automatic reading of test results were also excluded. The criminal court's view that the meaning of oriental medical practice should be clearly and strictly interpreted from the perspective of an oriental doctor, and it was clarified that diagnostic medical devices were excluded from criminal punishment unless it was clear that they were not related to the principle of oriental medical practice. As a result, the Supreme Court made it clear that the use of diagnostic medical devices is excluded from criminal punishment unless it is clear that they are not related to the principles of Korean medicine.
Life nurturing medicine mentioned in this paper refers to medical practice based on health preservation. This practice embraces alimentotherapy, respiration practice, qi gong, lacking food method as well as preventive medicine and geriatrics based on this theory. This life nurturing practice are noticeable through korean history. There were Korea own's xianjia(仙家) yangseng practice which after the transmission of Taoistic yangseng, it has been developed to take a field in medicine. The first publication that proofs this unification of life nurturing practice and medicine is Donguibogam ("東醫寶鑑"). Life nurturing method took more proportion in medical practice as medical books emphasized on preventive medicine like Yiyangpyun("二養編"), Boyangji were published distinguishing from other field of medicine.
The Medical Affairs Law regulates that Medical Doctor and Korean Medical Doctor(KMD) can practice in the boundary of each licence. But there is no clear provision to explain what practice in the boundary of MD's permitted region and what is KMD's. Moreover practice over the boundary of licence could be punished as a violation of the Law. KMD's use of medical devices have been objects of legal conflicts in the field. Because there is no clear provision in the Law, judical precedents have played the role as practical and final regulations. In this study, analyses on some judical precedents could show some rationales whether an issued KMD's use of medical devices is in the boundary of license. The courts considered the theories based on the practice, the level of required specialty and education, and the probability of danger to a patient. The judical precedents should be reviewed more precisely in the respects that it is adaptable in "the written law system"and it is desirable to divide boundaries between MD's and KMD's.
The healthcare industry is a digital healthcare that combines technology based on the 4th Industrial Revolution, dealing with information on individual health and medical care, and is a fusion of health care services and medical science and technology. It is questionable whether digital healthcare according to the paradigm change can be discussed by the concept of medical practice under the existing Medical Act. There is no clear definition of the concept of medical practice in the Medical Service Act, but the concept is established through precedents. In addition, under the Medical Service Act, the subject of medical practice is limited to medical personnel. However, digital healthcare sometimes diagnoses and treats diseases using digital technology by medical personnel. On the other hand, what is possible by non-medical personnel is digital healthcare. This is because digital healthcare is understood as a concept that includes health care such as exercise, eating habits, and weight control. For this reason, if the concept of medical practice under the "Medical Act" on digital healthcare is included, it is subject to criminal punishment for "unlicensed medical practice" prescribed in Article 27 of the "Medical Act". In the health and medical industry, digital transformation and convergence with information and communication technology are rapidly progressing. As a result, there is a need to newly define it as 'digitalized medical practice' or 'information and communication technology (ICT)-based medical practice' separately from existing medical practices. The concept of medical practice has variability, not a fixed and invariable concept. However, in response to this demand, it is not an infinite expansion of the concept of medical practice, but a request to reset its scope. Therefore, the concept of medical practice should be legislated by reflecting the demand of consumers for the medical service system.
Under the existing law, an act included in medical practice by medical personnel seems to be irrelevant to whether the act concerned in the "Life World" is in the category of medical practice. In spite of the act having been done according to the custom for a long time, and generally done by individuals in the "Life World", these kinds of acts have been banned by law, because if these acts were done by the general individuals, it would be considered as harmful behavior to human life and body. And it is not sure that individuals know such a ban or notification. This cause a "Mistake of Law". Also it is happened if someone knows the existence of law but believes that his/her act is not included. For treating the problem of "Mistake of Law" of unlicensed medical act, in this study I inquired thoroughly into the category and regulation of unlicensed medical act, uncertainty of the Medical Services Law the first Section of Article 27, the prohibition of unlicensed medical act. The "Composition Condition" of the first Section of Article 27 of the Medical Services Law is not certain, it doesn't meet the "Doctrine of Clearance", and it cause the "Mistake of Law". Also it doesn't meet standardization of constitutional state. An exceptional decision of Pusan District Court, the debate about unlicensed medical practice, constitutional decision on unlicensed medical practice of the Constitutional Court of Republic of Korea and point of view of support of regulation. Also I examined the problem of "Mistake of Law" that the regulation of unlicensed medical practice has. I tried to solve uncertainty of "Composition Condition" and proposed a direction of regulation for solving the "Mistake of Law" and the use of existing law.
This article analyses the concept of medicine in the legal context. It is not easy to define the concept of medicine because medical practice has various dimensions and the situation in which the practice is performed has a broad variety. The duty of medical law is to build the boundary of protection in that the nature of medicine would not be distorted by the factors of social systems like industry or governmental authorities. Without understanding the various dimensions - especially the dimension of Humanities and Sociology - of the medicine it is not possible to draw the limit on the performance of medicine appropriately. Concerning the medical practice (especially in the context of the regulation of medical licence), the enacted law (Medical Act) defines the concept just for form's sake and it finally depends on the interpretation of the legal enforcement authorities. Moreover, between the judgments of the courts there exists no coherent principles for the regulation and the interpretation of the Medical Act depends often on the riskiness, the abstract concept, which finally leads the interpretation to depend on the subject of the practice. On the contrary, the development and scientific movement of the technology tends to tighten the range of the medical professionals of medical practice and the perspectives of the medicine. Medical act is actually oriented at the patient's understanding of him- or herself. The above-mentioned tendency of the interpretation and the legal policy could lead the medicine away from its nature.
Objectives : Korean medicine practice is not specifically described in medical law, and then has always been a quarrel. So far The criteria for judgment in Korean Medicine Doctor's Medical Devices Using should clinically prove it only by Korean medicine theory and academic Traditionally descending from old ancestors. Comprehensively review of Korean Medicine Doctor's Medical Devices Using and Duty of Care, and then present a new understandings to determine future Korean Medicine Practice. Method : An existing court cases of Korean Medicine Doctor's Medical Devices Using and Duty of Care were reviewed. After reviewing various papers published for several years, various opinions were reviewed and suggested. Results : The range of Korean Medicine Doctor's Medical Devices Using has changed since the 1951 National Medical Law stipulated Korean medicine as medical professionals. The issue of the recent ruling that distinguishes medical practice from Korean medicine practice were condensed into what emphasis to interpret amongst 1) The basic principles of learning, 2) Curriculum and professionalism, 3) Risks. The Constitutional Court's ruling was important in order of 'Risk', 'curriculum and expertise', and 'basic principles of learning.' A duty of Care means an obligation to pay attention to something. A duty of Care does not mean a "highest level," but requires a "best care" and does "best under given conditions." Even in the duty of Care, Because Korean medicine has a purpose to protect and promote the health of the people, Some standards of western medicine have to be adapted to the current general medical technology. Korean Medicine doctors can recognize the duty of care in the "some basic range" of knowledge belonging to western medicine. Conclusions : The interpretation of Korean Medicine practice are currently in compatible the argument that should clearly divide Korean medicine from Western medicine, and that should be changed in light of the changing medical environment. Therefore If Korean medicine's standard is applied to the extent to which Korean Medicine doctors are educated, it is necessary to define a new definition to actively interpret Korean Medical practice. The academic basis of Korean medicine and the level of Korean medicine practice based on the books that are traditionally available, and then current textbooks of Korean Medicine College, Korean Medicine Clinical Care Guidelines, and classification of Korean standard medical practices should be standardized. Increasingly, Korean Medicine practice should be interpreted according to reality, focusing on protecting and promoting the health of the people rather than academic differences.
As the number of medical disputes regarding nurses has increased after medical disputes have increase, there is a need for a study on it. However, the legal relationship between nurses and patients has not yet been analyzed. Recently, the role and function of nurses are expanded according to the development of the science of nursing; moreover their activity and limitation of responsibility are also expanded. For this reason, the medical disputes regarding nurses have been increasing. However, the majority of these kind of dispute are just passed over because their practice is usually considered to be a mere action to assist doctor's role. In addition, nurse practice is not a secondary action of doctor's role, but forms part of a medical treatment. Of course, nurses handle many secondary tasks after doctors finish their medical treatment. But this is only part of the whole tasks of nurses. Furthermore, the general details of their medical treatment are not different from those of doctors because they also belong to the medical service personnel. Considering these features of nurse and the medical condition in South Korea, their task is becoming increasingly developed and specialized and they are also establishing their own field. With this stream of times, there is a growing interest in enacting a Nursing Practice Act, in other words, the independent law on nurse for the sake of patient safety and national health promotion. Then, their responsibility will distinctly be expanded as much more. That is, the time that nurses practice their medical care by following doctors' order and also pass over their responsibility to doctors is closed. Thus, this study examines the features and responsibilities of nursing practice, and discusses an institutional framework to efficiently cope with the legal disputes between nurses and patients. It aims to throw light on the decision making on nurse-patient disputes in future.
Purpose: This study aimed to identify the factors affecting the practice of medical waste management of nurses in tertiary general hospitals after the coronavirus disease 2019 (COVID-19). Methods: The participants were 154 nurses working in two tertiary general hospitals. Data were collected using structured questionnaires and analyzed using an Independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis using the SPSS/WIN 27.0 program. Results: Factors significantly influencing the subject's practice of medical waste management include medical waste education(β=.18, p=.013), recognition of infection control organizational culture (β=.26, p=.007), and attitudes toward medical waste management (β=.23, p=.011). The explanatory power of these variables for medical waste management practice was 29.0% (F=7.34, p<.001). Conclusion: To improve the practice of medical waste management, a strategy to provide positive attitudes toward medical waste management should be needed when developing medical waste management training programs, and various measures are necessary to make the organizational culture positive for the implementation of infection control guidelines at the organizational level.
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