• Title/Summary/Keyword: Medical Act

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The Use of Diagnostic Ultrasound Devise by Oriental Medical Doctors (한의사의 초음파 진단기기 사용은 무면허의료행위인가? -대법원 2022. 12. 22. 선고 2016도21314 전원합의체 판결-)

  • Lee, Dongjin
    • The Korean Society of Law and Medicine
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    • v.24 no.1
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    • pp.3-42
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    • 2023
  • The Supreme Court en banc decision on December 12, 2022 (docket number 2016Do21314) ruled that the diagnosis of endometrial hyperplasia by an oriental medical doctor using a diagnostic ultrasound device was not an unlicensed medical practice for an oriental medical doctor, which shall be scrutinized by the article 27 (1) of the Korean Medical Service Act. This ruling did not determine that a specific medical practice, especially diagnosis, based on the radiology, which is a part of western medicine, was not an unlicensed medical practice for an oriental medical doctor. Rather, it intended to clarify that the prosecutor should specify and prove the way of diagnosis and he should not prosecute mere the use of a diagnostic ultrasound device itself. To that extent, the ruling is agreeable because, as the oriental medicine community has argued, there is no regulation prohibiting the use of certain devices. It is probable, however, that the way of diagnosis established in radiology, which is a part of western medicine, was actually used in the case. In that case, there is undeniably an unlicensed medical practice for an oriental medical doctor. While many of the cases where the demarcation between (western) medicine and oriental medicine have been problematized thus far have been experimental treatment in nature, the above practice of using ultrasound appears to be frequently done in many oriental clinics, and so it is necessary to cope with the possibility of a disguised unlicensed medical practice. Another problem is the prevention of unfair practice or the protection of medical consumers. In fact, many oriental medical clinics' practice appear to have a tendency of inducing medical consumers' misunderstanding that a diagnosis based on radiology, which is a part of western medicine, were provided. It is hard to respond to this problem with demarcation between (western) medicine and oriental medicine. A new regulation against unfair practice might be necessary to implement.

A Study on the Major Issues and Legislative Considerations of CCTV Installation in an Operating Room (수술실 CCTV 설치의 쟁점과 입법방향에 관한 소고(小考))

  • Kim, Sungeun;Choe, A Reum;Bae, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.111-138
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    • 2021
  • 'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

A Proposal for Research Process of Botanical Drug based Clinical Traditional Korean Medicine - Historical Evidence-Based Medicine II - (한의학임상에 기초를 둔 천연물신약 연구과정에 대한 소고 - 역사적 근거 발굴부터 천연물신약 임상시험계획승인신청까지 -)

  • Eom, Seok-ki;Kim, Se-hyun;Kim, Kyung-suk;Park, Sang-jae;Eo, Wan-kyu;Choi, Won-cheol
    • Journal of Korean Medical classics
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    • v.23 no.4
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    • pp.63-102
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    • 2010
  • Purpose : To propose various types of clinical research which is feasible for botanical new drug (IND) development processes, and suggest essential steps to development of study protocol for IND. Methods : Literature-based discussions and one research group's experience is given regarding domestic act, regulation, and system. Results : In order to get an approval of IND for botanical drug in Korea there are several types of clinical research to conduct. In quality control steps for standardized medicinal herbs, case reports or case series can be conducted, and for good manufacturing practice(GMP) steps, we can conduct case reports, case series, and retrospective cohort studies. In addition, as long as we gathered good laboratory practice(GLP) data we can conduct up to quasi-experimental studies and clinical trials including investigator initiated trials. In order to conduct these studies development of study protocol is essential. First, we obtain historical evidence including target disease and indication, efficacy, safety, and endpoints by reviewing medical classics. Second, we obtain clinically and statistically important data by conducting non-clinical studies, observation studies, and quasi-experimental studies. Third, we generate research hypotheses and purposes and explore methodologies, endpoints, clinical practice guidelines, cost-effectiveness, and commercial potential. Finally, we develop study protocol with aid of biostatistician or expert in contract research organization. Discussions and conclusions : This study have obvious limitations in that most thoughts, suggestions, and proposes are from one research group's experience. Therefore, we hope to see various types of research in this topic and process from other research group as well.

Effects of Clematidis Radix Pharmacopuncture Injected at Sinsu ($BL_{23}$) on Neuropathic Pain in Rats (신유(腎兪)($BL_{23}$) 위령선약침이 백서(白鼠)의 L5 Spinal Nerve의 결찰로 유발된 신경병리성 동통에 미치는 영향)

  • Kim, Sung Phil;Choi, Sun Mi;Kim, Jeong Eun;Kim, Joo Hee;Shin, Kyung Min;Kim, Jae Hong
    • Journal of Acupuncture Research
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    • v.31 no.4
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    • pp.57-70
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    • 2014
  • Objectives : The purpose of this study is to examine if Clematidis Radix(CR) pharmacopuncture may be effective to the neuropathic pain(mechanical allodynia) in a rat model of neuropathic pain. Methods : To produce the model of neuropathic, L5 spinal nerve was ligated by 6-0 silk thread. After neuropathic surgery, the author examined if the animals exhibited the plantar withdrawal response of allodynia. The plantar withdrawal response was assessed by dynamic plantar aesthesiometer three days after the neuropathic surgery, CR pharmacopuncture was injected at $BL_{23}$ 1time/week for 6 weeks. After that, the author examined the plantar withdrawal response of rats' leg by dynamic plantar aesthesiometer. And also the author examined mGluR5, Bax, Bcl-2, Bax/Bcl-2 ratio in spinal cord, and c-Fos. Also the author observed the change of aspartate aminotransferase(AST), alanine aminotransferase(ALT) count in the blood serum of neuropathic rats. Results : 1. The withdrawal response of allodynia decreased in the PT3, PT4 group as compared with control group. 2. The mGluR5 increased in the PT1, PT2, PT3, and PT4 group. 3. The Bax and Bax/Bcl-2 ratio decreased in the PT4 group. 4. The c-Fos increased in the PT1 group, and decreased in the PT4 group. 5. The changes of AST in blood serum decreased in the every group excluded control group and the changes of ALT in blood serum isn't shown the signigicant change. Conclusions : These results are suggested that CR pharmacopuncture at BL23 decreased mechanical allodynia, can act on anti-apoptotic, neuroprotective effects and liver fuction in the model of neuropathic pain.

Review of 2017 Major Medical Decisions (2017년 주요 의료판결 분석)

  • Lee, Jung Sun;Lee, Dong Pil;Yoo, Hyun Jung;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.207-254
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    • 2018
  • The major court rulings delivered in 2017 include the ruling that separated the legal character of denture production agreement signed together with medical care agreement and found a subcontracting dimension in the former, and the ruling that overcame the limitations of the theory of entire appearance of a fetus as discussed in civil law by using the legal principle of insurance which suggests that unborn child insurance takes effect after the contract is signed and the first installment of the premium is paid in. As more court rulings find the medical specialists responsible for accidents and injuries from drugs, some argue that medication counseling by the druggist who makes and dispenses drugs should be upgraded. And with respect to a court ruling that denied the hospital's responsibility for an infection-involving accident even if there were no records on specific measures taken in infection management, some criticized the court for being too conservative in recognizing responsibilities. And with respect to infectious disease management, some criticized the court for its interpretation and application of the facts in the direction of denying the negligence. In addition, some claimed that it is necessary to establish institutional system for hospital infection control and its aid for victims, and to improve the system including the reversal of the burden of proof given the special nature of hospital infections. A number of rulings on the duty to disclose included the one which stated that the specific matter did not require a doctor's explanation as it was explained or the specific medical service would have been performed even if no explanation had been given. There was a greatly controversial ruling over the scope of indemnification, which accepted the occurrence of multiple scars and deformation as disorders while regarding breast as a thoracic organ. And a Supreme Court ruling over interpreting Medical Service Act was criticized as overstepping the boundary allowed in the law.

Research on Tongmu I Je-ma's medical idea (동무(東武) 이제마(李濟馬)의 의학사상(醫學思想)에 대한 연구(硏究))

  • Baek Sang-Yong
    • Journal of Korean Medical classics
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    • v.13 no.1
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    • pp.117-145
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    • 2000
  • Tongmu I Je-ma(1837-1900) set up Sasang Constitutional Medicine(四象體質醫學), a medical theory that would be original in the Korean medical history through his book ${\ll}$Tang-uisusebowon(東醫壽世保元)${\gg}$. In this book, he writes that he found the clue to his sasang Constitution(四象體質) theory from ${\ll}$Hwangjenaegyong(黃帝內經)${\gg}$. But the main logic that gives shape to the Constitution(體質) theory is $s{\check{o}}ng-ch{\check{o}}ng$ theory(性情論) of Confucian. Therefore, Tongmu(東武)'s Constitution $s{\check{o}}ng-ch{\check{o}}ng$ theory(體質性情論) is fundamentally based on confucian thoughts. Kongmaeng(孔孟) saw $s{\check{o}}ng$(性) as a base for connecting the entire mankind to be united, and $ch{\check{o}}ng$(情) as a individual thing that can exalted differently according to one's state of mind. Chuja(朱子) weakene the human's active volition by dividing $s{\check{o}}ng$ and $ch{\check{o}}ng$ as ibal(理發) and kibal(氣發) and therefore describing mankind to be submitted to Heaven's will. On the other hand Yolgok(栗谷) generalized $s{\check{o}}ng-ch{\check{o}}ng$ in the active mind of man himself by saying that $s{\check{o}}ng$ is when i-ki(理氣) does not act as a bodily function of the mind and $ch{\check{o}}ng$ is when it does. Furthennore he emphasized man's activeness on pursuing good by saying that the division of good and bad does not start from the origin of motion but is divided by the condition of ki(氣) which leads motion. Tongmu, who was influenced by Yulgok linked both $s{\check{o}}ng$and $ch{\check{o}}ng$ through, happiness, anger, sadness, pleasure(喜怒哀樂), and saw $s{\check{o}}ng$ as the ability to recognize good which is in the kijil(氣質) formed from the integration of i-ki, and saw $ch{\check{o}}ng$ as $s{\check{o}}ng$ blurred by man's greed. In addition to this, he says that the direct connection between each person's divergence in $s{\check{o}}ng-ch{\check{o}}ng$ and the condition of Four-organ(四臟) which is ki, not the mind which is i(理) forms sasangch'ejirin(四象體質人). His theory that illness comes from the partiality of $s{\check{o}}ng-ch{\check{o}}ng$ and therefore can prevent this by clarifying the mind and adjusting $s{\check{o}}ng-ch{\check{o}}ng$ through volition, has led Korean oriental medicine to be human based.

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Technology Convergence & Trend Analysis of Biohealth Industry in 5 Countries : Using patent co-classification analysis and text mining (5개국 바이오헬스 산업의 기술융합과 트렌드 분석 : 특허 동시분류분석과 텍스트마이닝을 활용하여)

  • Park, Soo-Hyun;Yun, Young-Mi;Kim, Ho-Yong;Kim, Jae-Soo
    • Journal of the Korea Convergence Society
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    • v.12 no.4
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    • pp.9-21
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    • 2021
  • The study aims to identify convergence and trends in technology-based patent data for the biohealth sector in IP5 countries (KR, EP, JP, US, CN) and present the direction of development in that industry. We used patent co-classification analysis-based network analysis and TF-IDF-based text mining as the principal methodology to understand the current state of technology convergence. As a result, the technology convergence cluster in the biohealth industry was derived in three forms: (A) Medical device for treatment, (B) Medical data processing, and (C) Medical device for biometrics. Besides, as a result of trend analysis based on technology convergence results, it is analyzed that Korea is likely to dominate the market with patents with high commercial value in the future as it is derived as a market leader in (B) medical data processing. In particular, the field is expected to require technology convergence activation policies and R&D support strategies for the technology as the possibility of medical data utilization by domestic bio-health companies expands, along with the policy conversion of the "Data 3 Act" passed by the National Assembly in January 2019.

A Study on the Minimum Standards of Housing Repair for Older People Living in the Community (지역사회 노인을 위한 주택수리 및 개조 최저기준에 관한 연구)

  • Hong, Hyung-Ock
    • Journal of Families and Better Life
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    • v.23 no.2 s.74
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    • pp.11-22
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    • 2005
  • The purpose of this study is 1) to clarify that the house is no long the safe place through the cases of the senior safety accidents and to argue the need for housing repair and 2) to present the minimum standards for housing repair by comparing the cases here as well as the abroad and to back up the standards with the current senior housing environment 300 people at least 60 years old living in Seoul$\cdot$Metropolitan area were interviewed using the structured questionnaire. As the result, the following conclusions were made: 1. There was high accident rates of the senior residents due to physical deficits within the house, causing excessive medical cost and decreased housing satisfaction. This problem can be sufficiently prevented by housing repair which can not only solve the safety problem but also support self sufficient living for the senior residents. 2. Proper housing repair required the architectural know how as well as the expertise knowledge of the physical characteristics of the senior people. Therefore, it is essential to secure the professional (i.e., occupational therapist) who can analyze the needs of the senior residents and evaluate and/or predict the obstacles during repair. Furthermore, development and distribution of the standardized manual are also needed. 3. The minimum standard for housing repair could be approached in view of 'barrier-free' concept. First, the bumps should be removed, slippery prevented, and safety grab-bar installed for safety. Second, the entrance should be widened and the bathroom and kitchen restructured to support for the senior residents' self sufficiency. To make housing repair policy more efficient, the legal basis is required. It can be incorporated into the existing senior citizens 'Welfare Act' or the 'Senior Residents Medical Insurance' which will be effective starting in 2007.

A Study on the Philosophical Background of HuangdiNeijing - Focused on the Spirit of the Times from Warring Country to Han - (『황제내경(黃帝內經)』의 철학적 배경에 대한 연구 - 전국(戰國) ~ 한(漢) 시대정신(時代精神)을 중심으로 -)

  • Lyu, Jeong-ah
    • Journal of Korean Medical classics
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    • v.30 no.1
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    • pp.145-166
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    • 2017
  • Objectives : The paper aims to study the philosophical background of Huangdineijing by taking into account the fact that its ideas are identical to that of the period between the Warring States and Han. Methods : Through considering the period and the historical backdrop in which Huangdineijing was published, and through considering the book with other texts such as Huangdisijing, the paper draws the common spirit of the time and analyzed the cause and flow of philosophies and ideas that influenced Huangdineijing. Conclusions : 1. Books that upheld Huangdi contained within Hanshu・Yiwenzhi have a common point with the mythical symbol of Huangdi in that they are related to the rule of a nation and the creation of a civilization. Huangdi, who in Huangdineijing bears a need to be understand at this common point of view. 2. The spirit of the period between Warring States and Han can be deduced as "a movement towards unification" and "the development of a civilization infused with spirit of unification." Such spirit of time are reflected in Huangdineijing as Nine Acupuncture(Official Acupuncture) and the establishment of the measuring standards for meridian, bone, and internal organ, and the establishment of the concept of 'Pyungin.' Especially the construction of waterways that connected Huanghe and Yangzijiang river with their tributaries that formed a direct composition of unification was applied to human body in Huangdineijing, thereby establishing the concept of 'Mai'. 3. Unlike Lao Zhuang School of Taoism was not interested in the act of ruling at all, Huangdineijing and its contemporary publication Huangdisijing, present their readers with Number, Law, Rule, Regulation and Governance. Here, the philosophy and the idea which seek "Law" as the methods of ruling the nation by actively participating in the governance of the nation based on the model of natural law and rule appear. Such philosophy and idea is an evidence of the influence of Fajia in accordance with the social and realistic changes witnessed during the time.

Factors Affecting Intention to Use a Paid Health Care Service by Health Check-up Participants in a Local Medical Center (한 지방의료원 건강검진 수검자의 유료 건강관리서비스 이용의도에 미치는 영향 요인)

  • Song, Jin-Sung;Nam, Eun-Woo;Jin, Ki-Nam;Lee, Kyu-Sik
    • Korean Journal of Health Education and Promotion
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    • v.28 no.2
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    • pp.87-97
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    • 2011
  • Objectives: The objective of this study is to analyze factors affecting intention to use a paid health promotion service by using the health belief model. Methods: A self-administered survey was conducted with 276 health check-up participants aged ${\geq}20$ at a local medical center in Korea from November 8 to November 24, 2010. Results: 53.6% of the respondents had intention to use a paid health promotion service, and around 85% of them were willing to pay for 'less than five thousand won per month'. Factors affecting the intention to use paid the service was age, education, income, and health check-up experience. In terms of health belief model constructs, people had greater intention to use a paid the service when they perceived to be sensitive to lifestyle associated diseases and recognized advantages of health promotion services. Conclusions: Approximately half of the respondents had intention to use a paid health promotion service. Reasonable price for the service was less than five thousand Korean won per month. Health promotion service act and services should consider these findings.