• Korean Medical Education Review
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• v.24 no.2
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• pp.93-102
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• 2022

We use the concept of the "doctor's role" as a guideline for developing medical education programs for medical students, residents, and doctors. Therefore, we should regularly reflect on the times and social needs to develop a clear sense of that role. The objective of the present study was to understand the knowledge structure related to doctor's job competencies in Korea. We analyzed research trends related to doctor's job competencies in Korea Citation Index journals using text network analysis through an integrative approach focusing on identifying social issues. We finally selected 1,354 research papers related to doctor's job competencies from 2011 to 2020, and we analyzed 2,627 words through data pre-processing with the NetMiner ver. 4.2 program (Cyram Inc., Seongnam, Korea). We conducted keyword centrality analysis, topic modeling, frequency analysis, and linear regression analysis using NetMiner ver. 4.2 (Cyram Inc.) and IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA). As a result of the study, words such as "family," "revision," and "rejection" appeared frequently. In topic modeling, we extracted five potential topics: "topic 1: Life and death in medical situations," "topic 2: Medical practice under the Medical Act," "topic 3: Medical malpractice and litigation," "topic 4: Medical professionalism," and "topic 5: Competency development education for medical students." Although there were no statistically significant changes in the research trends for each topic over time, it is nonetheless known that social changes could affect the demand for doctor's job competencies.

• Journal of the Korea Safety Management & Science
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• v.12 no.2
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• pp.35-40
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• 2010

This study collected 217 cases of court ruling statements for the cases over which administrative litigations were made regarding the acknowledgment of cerebral and cardiovascular diseases arising out of duty against Korea Labor Welfare Corporation and analyzed the factors of occurrence of cerebral hemorrhage and infarction and the Court cases of cancelation and dismissal of the litigation. As a result, due to seasonal factors, cerebral hemorrhage occurred more in the winter while cerebral infarction, in spring. The incidences for each age group were the higest in people in their 40s for cerebral hemorrhage while in those in their 50s for cerebral infarction, it turned that the incidence inside the places of business was the highest. The average days from application for care and family benefits until the confirmation of the case was 31 months on average for 34 canceled cases while 23 months for 183 dismissed ones, and the average number of months working until the occurrence of accident was 80.8 months for the 34 canceled cases while 77.6 for the 183 dismissed ones. This study has a significance in that it analyzed leading cases of confirmed administrative litigations in some cases applied for diseases due to occupational cases after the occurrence of cerebral and cardiovascular diseases but not approved, through which it is expected to be used as the basic data to reduce time and economic loss generated by the litigations to judge the acknowledgment of diseases due to occupational cases.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.3-36
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• 2023

The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.

• Health Policy and Management
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• v.31 no.3
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• pp.280-291
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• 2021

Background: Based on the fact that the Korea Medical Dispute Mediation and Arbitration Agency is a public institution established by social demands for medical disputes, this study reviews the publicness of public organization and discusses its policy implications. Methods: Through Moore's strategic triangle, which consists of legitimacy and support, public value and operational capacity, the process of creating public value is examined. For the analysis, case studies were conducted using related literature data from 2012, when the agency was established, to the present. Results: As a result of the analysis, first, the related law examined in the operational capability has been revised dozens of times, but the revised law has its own contradictions and limitations. The human resource system is also being improved, but there is a problem with the fairness and reliability of the arbitration process, especially due to the limitations of the appraiser system. Second, in terms of legitimacy and support, a regional gap occurred despite efforts to improve accessibility through the expansion of the organization. And the arbitration agency failed to reconcile conflicts caused by stakeholders' perception of each other as a trade-off relationship. Third, the public value result shows that, despite many explicit (statistical) achievements, citizens' use of the past dispute resolution means (litigation) has not decreased. Likewise, the perception of value makers (citizens) is important for creating public value as an invisible result, but it has not yet been formally investigated, so the performance can not be recognized. Conclusion: While the organization's efforts for continuous change and improvement are encouraging, it is not perceived as a better means of resolving disputes and improving quality of services. Therefore, it is necessary to reconsider the institutional design centered on value creators.

• Quality Improvement in Health Care
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• v.29 no.2
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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.

• The Korean Society of Law and Medicine
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• v.20 no.1
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• pp.83-107
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• 2019

In order to resolve a dispute over a medical accident, the court is in the process of appraising the medical records for medical professionals to report their medical expertise or judgments using that knowledge. The consequences of expert opinion about a medical accident are only one of the methods of evidence as a reference. Therefore, in principle, the court should not be bound to the results, but the court, which is not a medical expert, can not completely rule out medical expert opinion as to whether there is medical malpractice and causality. Therefore, it can not be denied that the proportion of expert opinion of medical records in the dispute about medical accidents is high and it has an important influence on the judgement of the court. In this paper, we examine the significance and function of expert opinion of the medical accident, examine the appraising procedure of the medical records in the court and the appraising procedure of the medical accidents of the Korean medical dispute mediation arbitrator do. In addition, I would like to examine what kind of attitude is being taken in response to expert opinion of medical records in Korea to court, to examine the implications of the case of Japan as a foreign system, and to suggest improvement points in the expert opinion procedure of medical record filing in Korea. In particular, I would like to suggest improvements on issues such as the fairness of the expert opinion of medical records and the delays in litigation due to delays in the process of expert opinion.

• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.181-207
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• 2008

With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.

• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.85-113
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• 2009

In this paper, the Judgment 2007DA76290 of the Korean Supreme Court was analysed in two points of the legal theory and litigation. The judgment arouses some issues of medical malpractice liability. They includes the concept of the complications and permanent lesion and the difference between them, some problems in a judge's applying the requirements for the physician's tort liability to the medical malpractice situations, the theory of obligation de moyens related with the burden of proof of the negligent conduct for a physician's liability for misperformance of contract, the influence of a patient's physical conditions on the physician's liability, the breach of duty to disclose in selecting the safer one of the treatment methods bringing about the complications or leaving the permanent lesion and so on. In the situations of the case referred to above, the plaintiff should have tried to establish that a reasonable physician in the specific situation of the case would have substituted the safer method of treatment for the method in the case. If the plaintiff had succeeded in establishing it, he or she could have recovered even the physical harm resulting from the permanent lesion brought about by the complications of the specific treatment in the case. The plaintiff failed to do so and recovered only the emotional distress which the patient suffered owing to the physician's breach of the duty to disclose. Therefore the legal malpractice of the counsel might be found in this case.

• Journal of the Korea Society of Computer and Information
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• v.19 no.4
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• pp.139-147
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• 2014

Medical disputes the problem that occurs essentially among the rapidly increasing of the demand for health care and the attention of the public health. The subject of dispute is mostly criminal penalties and civil redress due to a physician's medical malpractice, resolved by agreement was prioritized. They trying to solve through the litigation and exercise the skills. But, the lack of clear standards and related legislation make difficult to solve the problem. for this, "The Act of Medical Malpractice Damage's Relief and Mediation for Medical Dispute Resolution" (Medical Disputes Adjustment Act) was enacted in April 7, 2011 and performed in Apr. 8, 2012. To solve the problem autonomously between the parties. It is the legislative intent such as mediation or arbitration to solve the conflict between the parties. But there are some problems that examined from the perspective of constitutional review with the criminal and civil problems. Therefore, this paper will find out the legal issues about Medical Dispute Adjustment Act and the constitutional and civil issues. And want to expect to be prepared the more stable and efficient solution of medical disputes.

• Journal of Environmental Health Sciences
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• v.19 no.2
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• pp.88-99
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• 1993

There has been investments by firms to protect workers' health and to improve their health status. Most of the investments are made on the ground of legal requirement. However many argue that the amount of investments made falls short of the legally required level. One of the reasons why firms are not active in undertaking required investments is that they are not certain whether such investment is economically beneficial to them or not. Using CBA (Cost-Benefit Analysis), this study investigates whether firms' investments on workers' health are economically justifiable or not. All kinds of expected costs and benefits are itemized and calculated, and costs are compared with benefits. The result shows that if firms fully undertake the legally required investments, total expected costs amount to W453.2 billion and expected benefits accruing to reductions from medical care costs, workers compensation costs, litigation costs in case of legal suit, work days lost, and etc. comes up to W2,086.8 billion. In other words, economic benefits from firms' investment on industrial health far outweighs their costs. As the economy grows, the probability of having various occupational disease increases. It is well conceivable from this study outcome that, the higher the probability, the greater the social loss would be, and the greater the benefits from proper investments on workers' health.