• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.163-194
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• 2017

Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

• The Korean Journal of Food And Nutrition
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• v.21 no.4
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• pp.562-571
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• 2008

The principal objective of this study was to assess dietitian's awareness and performance with regard to food suppliers' selection guidelines and purchase guidelines for the receipt of safe food materials. A questionnaire was administered to 203 dietitians working at an elementary school in Gyeonggi North province, and 190 responses were ultimately returned. Excluding responses with incomplete answers and significant missing data, 161 responses(79.3%) were ultimately utilized for data analysis. We determined that meat/poulty and seafood were purchased mainly by manufacturer's branch(59.8% and 78.3%), and processed food and kimchi were generally purchased by producer's cooperatives(47.7% and 44.9%). 78.3% of the contracts were made via informal purchasing and the frequency of contracts was less than 3 times per year(53.4%). Market studies were conducted individually(54.7%), and by group(47.2%). Dietitian and parents volunteered(50.3%) or dietitians, and school and foodservice staffs(45.3%) participated - together in receiving and inspection. School contracted with $4{\sim}5$(39.1%) and $6{\sim}8$ food suppliers(29.8%). Dietitians(42.3%) or school councils(40.2%) evaluated food suppliers once per semester(60.2%). The majority of dietitians(96.3%) conducted sanitary education for food suppliers once per semester (68.3%). All 13 guidelines which were usually used to evaluate food suppliers were thought to be important(more than 4) based on a 5 scale(1: never important, 5: very important). Among them, 'sanitary storage status of food products(4.85)', 'have a chill car(4.83)' and 'proper control of refrigerator, freezer and storage room(4.81)' were the most crucial guidelines. As dietitians evaluated food supplier's-observances of 13 guidelines, 'have a chill car(4.89)', 'hold medical examination of employees(4.89)' and 'hold liability insurance for handling product(4.80)' were fulfilled relatively well. The guidelines for conducting education for their employees(4.45) and keeping their establishment and equipment sanitary(4.79) were important, but were not observed well(3.39 and 3.37). Additionally, the difference between the importance and the observance score of the 'HACCP certificate' were fairly significant(4.44 and 3.54). Dietitians tended to report that purchasing management related to the removal of foodborne illness factors(4.71), return confirmation(4.50) and purchase specification(4.32) were important. The difference between importance and performance was highest in the process of changing food suppliers when the contracts were violated more than three times. Dietitian's age, education work experience and employment type had no observable effects on how important they considered purchase management to be, but their work experience significantly affected performance in terms of the removal of foodborne illness factors(p<0.05). As supplier management is the most critical factor, it is clearly desirable to educate suppliers at specialized training centers and to supervise suppliers in accordance with the established sanitary guidelines.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.103-141
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• 2017

The (Korean) Medical Services Act revised in 2009 introduces the accreditation of specialty hospital. When a hospital meets prescribed standards, passes a board review, and is accredited as a specialty hospital by the Minister of Health and Welfare, then it may use 'specialty hospital' in its name and certification mark of specialty hospital. The problem is that the (Korean) Fair Trade Commission and the (Korean) Ministry of Health and Welfare, both of which have authorities to regulate advertising in general and in health care service in turn, announced the guidelines to prohibit internet (portal) service providers to provide keyword search ads service using key-words such as 'specialty' or 'specialized in' for those who are not accredited by the Minister of Health and Welfare. In this article, whether these guidelines can be justified by the current regime and whether the current specialty hospital policy is agreeable would be examined. To do this, the legal nature of accreditation of specialty hospital, the limit of advertisement regulation, the law of keyword search ads, and the liability of internet service providers also would be analyzed.

• Journal of the Korean Society of Marine Environment & Safety
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• v.28 no.4
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• pp.567-576
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• 2022

Seafarers are exposed to various unpredictable maritime risks due to the spatial specificity of the working environment of the sea; thus, sufficient compensation for injured crewmembers is needed. However, Korea does not provide such compensation. Therefore, this study attempted to examine the Maritime Labor Act and the Industrial Accident Insurance Act of Germany, an advanced European social insurance country, and derive implications compared to Korea. First, we investigated how compensations are managed by a public institution in Germany and by shipowners in Korea. Second, regarding the contents of accident compensation, Germany does not only provide continuous treatment and care through various support systems, but also operates various programs to enable a return to ship work. In contrast, Korea has a temporary compensation system that allows shipowners to avoid liability for accident compensation, which is disadvantageous to shipwrecked seafarers. Finally, in Germany, workers' compensation insurance is public, judged considering the origin of work, whereas in Korea, it is determined by shipowners or insurance companies. Therefore, it is necessary to establish a public institution in charge of crew accident compensation to ensure proper compensation for crewmembers in Korea and to improve the Seafarers Act or system to provide compensation for additional medical care, disability pension, and rehabilitation benefits.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.87-130
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• 2015

In a case in which National Health Insurance Corporation (NHIC) pays medical care expenses to a victim of a traffic accident resulting in injury or death and asks the assailant for compensation of its share in the medical care expenses, as the precedent treats the subrogation of a claim set by National Health Insurance Act the same as that set by Industrial Accident Compensation Insurance Act, it draws the range of its compensation from the range of deduction, according to the principle of deduction after offsetting and acknowledges the compensation of all medical care expenses borne by the NHIC, within the amount of compensation claimed by the victim. However, both the National Health Insurance Act and the Industrial Accident Compensation Insurance Act are laws that regulate social insurance, but medical care expenses in the National Health Insurance Act have a character of 'an underinsurance that fixes the ratio of indemnification,' while insurance benefit on the Industrial Accident Compensation Insurance Act has a character of full insurance, or focuses on helping the insured that suffered an industrial accident lead a life, approximate to that in the past, regardless of the amount of damages according to its character of social insurance. Therefore, there is no reason to treat the subrogation of a claim on the National Health Insurance Act the same as that on the Industrial Accident Compensation Insurance Act. Since the insured loses the right of claim acquired by the insurer by subrogation in return for receiving a receipt, there is no benefit from receiving insurance in the range. Thus, in a suit in which the insured seeks compensation for damages from the assailant, there is no room for the application of the legal principle of offset of profits and losses, and the range of subrogation of a claim or the amount of deduction from compensation should be decided by the contract between the persons directly involved or a related law. Therefore, it is not reasonable that the precedent draws the range of the NHIC's compensation from the principle of deduction after offsetting. To interpret Clause 1, Article 58 of the National Health Insurance Act that sets the range of the NHIC's compensation uniformly and systematically in combination with Clause 2 of the same article that sets the range of exemption, if the compensation is made first, it is reasonable to fix the range of the NHIC's compensation by multiplying the medical care expenses paid by the ratio of the assailant's liability. This is contrasted with the range of the Korea Labor Welfare Corporation's compensation which covers the total amount of the claim of the insured within the insurance benefit paid in the interpretation of Clauses 1 and 2, Article 87 of the Industrial Accident Compensation Insurance Act. In the meantime, there are doubts about why the profit should be deducted from the amount of compensation claimed, though it is enough for the principle of deduction after offsetting that the precedent took as the premise in judging the range of the NHIC's compensation to deduct the profit made by the victim from the amount of damages, so as to achieve the goal of not attributing profit more than the amount of damage to a victim; whether it is reasonable to attribute all the profit made by the victim to the assailant, while the damages suffered by the victim are distributed fairly; and whether there is concrete validity in actual cases. Therefore, the legal principle of the precedent concerning the range of the NHIC's compensation and the legal principle of the precedent following the principle of deduction after offsetting should be reconsidered.