• 의료법학
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• 제21권1호
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• pp.107-152
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• 2020

2019년 선고된 의료판결 중에는 의료행위로 인한 합병증이 발생하였다는 것만으로 과실이 추정되지 않는다는 사건, 최근 소제기가 많이 되고 있는 낙상사고 관련 사건, 세간을 떠들썩하게 했던 유명 가수의 사망사건, 최근 국내를 포함하여 전 세계를 강타하고 있는 전염병인 COVID-19로 인한 피해와 관련되어 더욱 의미가 있는 2015년 메르스로 인한 손해배상사건 등 관심의 대상이 되었거나 의미 있는 판결들이 다수 선고되었다. 법원은 의료행위로 인한 합병증이 발생하였다는 것만으로 과실이 추정되지 않는다는 법리를 설시하면서 '과실이 추정되지 않는 합병증의 범위'를 재판부에 따라 달리 판단하였는 바, 그 기준을 구체적으로 제시하지 못하고 있었다. 낙상사고와 관련하여 의료기관의 과실을 인정하면서 의료기관의 책임을 제한하는 구체적인 사정들이 제시되었다. 손해배상 범위와 관련하여 연예인의 일실수입 판단기준, 의료사고로 유족연금을 받게 된 경우 일실수입 판단기준, 의료사고 발생 당시 이미 노동능력이 상실된 경우 일실수입을 부정한 사건 등 일실수입 산정과 관련된 쟁점에 관한 판단들이 이루어졌으나, 좀 더 명확하고 합리적인 기준에 따른 판단이 이루어져야 할 것으로 보인다. 의료광고와 관련하여 의료법 위반의 기준인 의료법 제27조 제3항에서 나열한 구체적 금지행위에 준하는 것으로 해석되거나 의료시장의 질서를 현저히 해친 것에 해당하는지 여부에 관한 구체적 판단논리가 제시되었다. 의료기관 중복운영 금지조항에 대하여 헌법재판소는 과잉금지원칙에 위배되지 아니하여 합헌이라고 판단하면서, 금지되는 '중복운영'의 범위를 합리적으로 제한하였고, 대법원은 의료법을 위반하여 개설 및 운영된 의료기관이라 하더라도 의료 기관에서 시행한 모든 요양급여가 국민건강보험법에 따라 수령이 불가능한 것은 아니라고 최초로 판단하는 의미 있는 판결을 선고하였다. 감염병 관리에 있어서 국가의 국민에 대한 구체적 보호의무의 존재를 인정한 의미 있는 판결들이 확정되었다.

• Safety and Health at Work
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• 제4권3호
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• pp.160-165
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• 2013

Background: Occupational accidents are unplanned events that cause damage. The socio-economic impacts and human costs of accidents are tremendous around the world. Many fatalities happen every year in workplaces such as electricity distribution companies. Some electrical injuries are electrocution, electric shock, and burns. This study was conducted in an electricity distribution company (with rotational 12-hour shift work) in Iran during an 8-year period to survey descriptive factors of injuries. Methods: Variables collected included accident time, age of injured worker, employment type, work experience, injury cause, educational background, and other information about accidents. Results: Results indicated that most of the accidents occurred in summer, and 51.3% were during shift work. Worker negligence (malpractice) was the cause of 75% of deaths. Type of employment had a significant relationship with type of injuries (p < 0.05). Most injuries were electrical burns. Conclusion: High rate of accidents in summer may be due to the warm weather or insufficient professional skills in seasonal workers. Shift workers are at risk of sleep complaints leading to a high rate of work injuries. Acquiring knowledge about safety was related to job experiences. Temporary workers have no chance to work all year like permanent workers, therefore impressive experiences may be less in them. Because the lack of protective equipment and negligence are main causes of accidents, periodical inspections in workshops are necessary.

• 한국의료질향상학회지
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• 제29권2호
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• pp.15-31
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• 2023

Purpose: This study aimed to identify the characteristics of patient safety incidents (PSIs) related to nursing and to provide primary data for preventing the recurrence of similar incidents. Methods: This secondary analysis study included damage claims rulings filed for clinical negligence from 2014 to 2018 that contained the keyword 'nurse'. It excluded judgments irrelevant to nursing care and in which clinical negligence or causal damages were overruled. A total of 93 cases were analyzed. The characteristics of PSIs were derived through descriptive statistics, and two instances of nursing-related PSIs were examined by qualitative content analysis focusing on root causes. Results: The analysis of PSIs related to nursing suggested that the medical institutions where the PSIs occurred most frequently were hospitals, and the most common types of PSIs were medication, surgery, and treatment/procedure, in that order. In addition, it indicated that nursing-related PSIs occurred most frequently in general wards during the day shift, with the most common related nursing practice being managing potential risk factors. The qualitative analysis showed that careless monitoring and institutional inertia were causes of PSIs. Conclusion: To prevent nursing-related PSIs, nurses need to individually monitor and assess patient conditions. In addition, support should be accompanied by the improvement in the systems in place aimed at preventing the recurrence of nursing-related PSIs at the institutional and national level, such as securing appropriate nursing personnel and improving labor conditions.

• 보험의학회지
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• 제3권1호
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• pp.55-61
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• 1986

In life insurance the goal of medical examination is to exclude medical, environmental adverse-selection to the utmost. And keeping the principle of equity and the homogeneity of risk in the group of the insured, you are able to manage the company reasonably and realize the orginal ideal of life insurance, namely, the mutual assistance. And yet, the cases of the misrepresentation have been occurred frequently so far. As a result of them, the development of life insurance industry has been obstructed, and public criticism has been caused. Carrying medical examination, you have to know how the representation is important, And citing what the misrepresentation and false representation influenced the results, I want you to refer to medical exam-business.

• 의료법학
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• 제16권1호
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• pp.125-151
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• 2015

우리는 한방과 양방의 이원화적 의료체계를 가지고 있다. 한방의료와 양방의료는 학문적 원리, 진단이나 치료방법 등에서 서로 차이가 나며 이를 한방의료와 양방의료의 상위성(相違性)이라 부를 수 있다. 한 양방 의료행위의 구별기준으로는 학문적 기준, 진단방법, 치료방법 등이 있고, 양방의료행위에 비하여 한방의료행위는 침습성이 낮고, 체질성을 보다 중시하며, 높은 재량성을 지닌다는 특성이 있다. 한 양방 의료사이에서 분업적 관계가 이루어질 때 양자의 관계는 종속적 관계가 아니라 상호 동등한 관계로 보는 것이 타당하며 기본적으로 이들의 관계는 상호 분리적 독립적인 관계로 볼 수 있으므로 수평적 분업관계로 보아야 한다. 수평적 분업이라면 신뢰의 원칙이 적용이 가능하나 양자의 상위성으로 인하여 이의 적용은 제한적이며, 이 경우는 양방의료 내의 각 과들 간의 의료분업이 이루어질 때의 신뢰원칙의 적용과는 다르게 생각할 필요가 있다. 이때의 신뢰원칙의 적용은 양자 간의 업무분담의 범위, 분업이 이루어지는 의료기관들의 형태 그리고 어떠한 방법으로 진단하는가의 여부에 따라 판단할 필요가 있다. 양방에서 진단을 맡고 한방에서 치료를 맡는 형태의 분업에서 이때 양방의 진단을 의료기기를 이용한 진단과 그렇지 아니한 진단으로 나누어 신뢰원칙의 적용여부를 살필 수 있는데, 한방에서는 진단하기 어려운 것으로서 양방의 의료기기를 이용한 진단결과에 대해서는 한의사가 이를 신뢰할 수 있다. 이 경우 한 양방 의료 간의 상위성으로 인하여 양방의 진단결과에 대하여 한의사는 한방적 관점에서 환자에 대한 증세를 확인할 진단의 주의의무가 있으나, 후자의 경우와는 달리 전자의 경우의 한의사의 진단의 주의의무의 의미는 한의사가 양방의 진단결과를 신뢰하여 이를 인지한 채 다만 치료를 위하여 환자의 증세를 파악한다는 것이다. 한편, 양방의 진단과실에 대하여 치료를 맡은 한의사도 한 양방 간의 상위성으로 인하여 그 진단과실의 책임이 문제될 수 있는데, 이 경우 한의사에게 형사적으로는 진단과실에 대한 책임을 묻기 어려울 것이다.

• 근관절건강학회지
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• 제28권1호
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• pp.30-40
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• 2021

Purpose: This study aims to present nurses' legal conflicts and legal basis through the precedent analysis of a crime of professional negligence resulting in death and injury for the past 20 years and provide vital references to cultivate the correct and high-level legal consciousness of nurses. Methods: This study was conducted in five stages of the systematic content analysis method. It amalyses the precedents of a crime of nurses' professional negligence resulting in death and injury from 2000 to 2020. The application system for the provision of the written judgment was used to collect precedents. A total of 67 cases were analyzed in this study, and they were classified according to the type of nursing error, and the contents were systematically analyzed. Results: A total of 52 cases (77.5%) of nursing errors were caused by independent nursing practices. They were classified as 38 cases (A1) in the violation of patient supervision obligations, 12 cases in the violation of progress observation obligations (A2), one case in the violation of medical equipment inspection obligations (A3), and one case in the violation of explanation and verification obligations. Among the non-independent nursing practices (code B), B1 was 10 cases related to administrative acts, one blood transfusion accident (B2), and one anesthesia accident (B3). Conclusion: To prevent nurses from being involved in legal confits, the advocation of systematic training such as nurses' legal obligations and judgment grounds through case-based learning from the recent precedent analysis and promote nurses' legal perspective, and preventive activities are essential.

• 의료법학
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• 제12권1호
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• pp.177-225
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• 2011

Verdicts related to major medical litigation given by the Seoul Central District Court, the Seoul High Court and the Supreme Court in 2010 were analyzed. It's shown that in cases of the medical negligence regarding the occurrence of neonatal cerebral palsy, the plaintiff claims were dismissed using criteria proposed by associations of Obstetrics and Gynecology and Pediatrics in US, and thereof the burden of plaintiffs to prove the medical negligence has increased. In addition, in case of that the expected survival period of infants gets longer, payments for treatment and nursing after survival period determined by judges are made and it was judged to compensate it as a periodical indemnity. In case for the explanation obligation the most frequently mentioned in the medical litigation, in addition to cases of invoking the existing theory of explanation obligation, verdicts to mention the instructions of theory regarding instruction explanation obligation and the possibility of compensation for damages on property are given. Particularly, in cases for a liability of reparation by exaggerating the effects and not disclosing the risks related to treatment with stem cells, even if the treatment not approved by Food and Drug Administration is in violation of the Pharmaceutical Affairs Law, it's not illegal as violation in Pharmaceutical Affairs Law itself. But there is a certain verdict to present the possibility of an extension of the theory of explanation obligation by acknowledging the liability of reparation caused by illegal acts with no explanations of effects and risks of treatment with stem cell by doctors and pharmaceutical companies. In an incident in which a mental patient fell and died through the opened door of the roof at the hospital, a liability of reparation was acknowledged due to defects in structure installation management and this verdict drew an attention since the overall management responsibility about patients including structures was acknowledged to the hospital besides the obligations on medical practice. In case of the verdict without giving the opportunity to state the opinion with respect to the main legal issues, the responsibility of the court was emphasized since the court did not fulfill the explanation obligations. There were some cases in which payments for nursing and caring to a patient in vegetative state during the plastic surgery was admitted. However, in dental-related incidents, the proportion of cases in which plaintiff won was low since the difficulty of proving may be reflected. In the area of administrative litigation, unlike the existing position regarding arbitrary medical charge cover collected from patients in hospital, the verdict to admit the legitimacy of collection of medical treatment was given and attracted the attention of people. Verdict in which the expression related to medical advertisement was not exaggerated disposed the original verdict and pointed out the problem of excessive regulations on medical advertisement. The effort to analyze the trend of verdicts of court through reviewing the decisions and to organize should be continued, but the full decision should be disclosed as a base, and people and systems to enable the all time monitoring should be prepared.

• 의료법학
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• 제9권1호
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• pp.197-257
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• 2008

Current crown law punishes crime related to unborn child with abortion crime. So we might think that any infringement on unborn child is pretty well protected. But, in terms of illegal abortion, a charge of injuring person and homicide, there are lots blind spots in punishing criminals. Especially, there are numerous unclear cases in illegal abortion. If a doctor killed an unborn child by accident in medical operations, we can't punish him because it was an accident. There still exist controversial cases such as, if an unborn child was somehow damaged and was dead after birth, or was born with disabilities, how are we supposed to punish that? Recently, in a case where a doctor left alone a mother who had a baby and the baby died, our Supreme Court of Korea (Supreme Court of Korea 2007.6.29 2005do 3832) had given a verdict of "not guilty". It looked like they were very fair with current crime law. But, we want this case to be investigated if there weren't any logical contradictions as well as concurrent translation within Constitution Law.

• 대한산업공학회지
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• 제1권2호
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• pp.65-72
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• 1975

A System of evaluation is developed which determines a uniform and individualized monetary redress. It can be applied not only to permanent disability but to temporary disability cases and considers all factors affecting monetary redress in determining process. As objects of compensation this model considers five factors, the degree of injury, the change of earning capacity, medical fee, job suspension and the degree of contributory negligence. For each object is defined a subfunction measuring its magnitude. Then by assigning reasonable weighted values to these five subfunctions according to their relative importance, we get main function which determines appropriate monetary redress.

• 의료법학
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• 제15권2호
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• pp.317-343
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• 2014

In order to account for whether a doctor should indemnify damages resulted from violation of duty of care, the fact that a doctor violated duty of care, that damages were incurred, and the link between violation of duty of care and damages incurred, respectively, should be verified. So even though a doctor violated duty of care to patients, he or she will not bear the responsibility to indemnify damages unless it is not verified. If a doctor's negligence in medical practices is assessed that obviously unfaithful medical practice far exceeds the limit of admission of a patient, it will not go against people's general perception of justice or law and order to constitute a medical malpractice itself as an illegal action that will require liabiliy for damage. However, when the limit of admission is set too low, a patient's benefit and expectation of proper medical treatment can be violated. In contrast, if the limit of admission is set high, it can leave too little room for doctors' discretion for treatments due to a bigger risk of indemnification for damages. Thus, a reasonable balance that can satisfy both benefit and expectation of patients and doctors' right to treatment is needed.