The first legislation for terminal health-care decision was California's Natural Death Act (NDA) of 1976 that permitted any adult person to execute a directive directing the withholding or withdrawal of life-sustaining procedures. Advance directive legislation has subsequently progressed on a state-by-state basis. By 1992, all 50 states, as well as the District of Columbia, had passed legislation to legalize some form of advance directive. This state legislation, however, has resulted in an often fragmented, incomplete, and sometimes inconsistent set of rules. Statutes enacted within a state often conflict and conflicts between statutes of different states are common. In an increasingly mobile society where an advance health-care directive given in one state must frequently be implemented in another, there is a need for greater uniformity. In 1993, the Uniform Law Commissioners approved the Uniform Health-Care Decisions Act (UHCDA) in order to bring order to the existing chaos. Unfortunately, the Commissioners waited too long to act. By the time the UHCDA was approved, nearly all states had passed legislation governing advance directives. Consequently, the UHCDA has achieved only a limited success, picking up but one or two enactments a year. The UHCDA is currently in effect in around 10 states: Alabama, Alaska, California, Delaware, Hawaii, Kansas, Maine, Mississippi, New Mexico, Tennessee, Wyoming. In these states the previous laws related to the subjects have been all repealed. The overall objective of the UHCDA is to encourage the making and enforcement of advance health care directives including living will or individual instruction, power of health-care attorney and to provide a means for making health care decisions for those who have failed to plan. The U. S. House of Representatives in 1991 enacted the Patient Self-Determination Act (PSDA). The Act stipulates that all hospitals receiving Medicaid or Medicare reimbursement must ascertain whether patients have or wish to have advance directives. The Patient Self- Determination Act does not create or legalize advance directives; rather it validates their existence in each of the states. Now in America, terminal health-care decision or advance directive for health care is common and universal system. The problem, however, is how to let more people use these good tools to make their lives more beautiful and honorable.
Journal of Korean Society of Occupational and Environmental Hygiene
/
v.32
no.4
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pp.302-324
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2022
Objectives: The objective of this study is to investigate exposure to occupational carcinogens in the nationwide electronics industries and to establish a strategy for control of occupational carcinogens in South Korea. Methods: We evaluated occupational carcinogens as defined by International Agency for Research on Cancer (IARC) using a nationwide work environment measurement database on the electronics industry in South Korea measured between 2013 and 2017 in accordance with the Occupational Safety and Health Act. Results: The number of occupational carcinogens found in the electronics industry in South Korea were: 20 for IARC Group 1, 14 for Group 2A, and 30 for Group 2B. The occupational carcinogens (Group 1) most frequently exposed were strong-inorganic-acid mists containing sulfuric acid (sulfuric acid), welding fumes, mineral oils (untreated or mildly treated), nickel compounds, silica dust, crystalline substances in the form of quartz or cristobalite, formaldehyde, arsenic and inorganic arsenic compounds, chromium (VI) compounds, trichloroethylene, cadmium and cadmium compounds, vinyl chloride, ethylene oxide, wood dust, beryllium and beryllium compounds, 1,3 butadiene, benzene, and others. Among them, the carcinogens (Group 1) exceeding the acceptable standard were trichloroethylene, formaldehyde, and ethylene oxide. The working environment measurement system as regulated by Occupational Safety and Health Act is not properly assessed and managed for occupational carcinogens in South Korea. A component analysis for all materials used should be set up to practically reduce occupational carcinogens. A ban on the use of occupational carcinogens and the development of alternative materials are needed. The occupational carcinogens below the acceptable standards should be carefully examined and a new standard for exposure needs to be established. Conclusions: The Occupational Safety and Health Act should be improved to identify and monitor occupational carcinogens at work sites. A strategy for occupational safety and health systems should be provided to give direction to workers' needs and right to know.
The legal relationship between patient and physician is legally equal relationship. But, in times past, patients be compelled to sign an unequal contract, substantially. Because of the imbalance between supply and demand in the health care market. Today, the law of supply and demand in the health care market is running well. And as the cognition of citizens' rights grows, the relationship between patient and physician can also get a lot of changes. Patients have the right to know the information about medical care, and to decide whether or not to get treatment including invasions against their own bodies. In other words, Doctors have an obligation to explain to their patients. If doctors did not provide patients sufficient explanation or information, it violates the right of patients. This is a tort, or a breach of contract. To improve the remedy for violation of patient's right, patient is able to be protected by status as consumer. If patient is a kind of consumer in terms of medical consumption, he/she as consumer can enjoy supplementally the consumer's right. The patient as a consumer can exercise now a consumer's right as a constitutional right. In addition, with respect to consumer's rights, Framework Act on Consumers was enacted. This Act is based on constitutional provisions of Article 124 and the Act can be seen as a law that embodies consumer right because the provision of the constitutional law delegates specific contents. In the health care field, patients need to win recognition the statue of the consumer to hold the sovereignty of the consumer. In particular, if patients are consumers, they may be able to make good use of the quickly and efficiently collective dispute resolution and association lawsuit to rescue their damage, the Alternative Dispute Resolution(ADR) of Framework Act on Consumers.
National Health Insurance Act has been enforced all over the People as part of the effort to assure the minimum constitutional human worth and dignity in the aspect of the right to pursue health for preventing misfortune that comes to death without even a chance to be received treatment for illness or injury. Meanwhile auto insurance is compulsory in certain parts in order to promote benefits of everyday life and the rapid recovery of the damage caused by traffic accident when one have negligently driven a car which has become the necessities in daily life. Any injured driver in a traffic accident can be treated by National Health Insurance without getting an auto insurance in various circumstances, but Article 3 paragraph 2 of Traffic Accident Act don't allow exception of criminal punishment when he has driven a car without license, drunken, or tresspassing the centerline, etc. When the injury occured by his own certain negligence is judged to 'when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident' of National Health Insurance Act, insurance benefits can be restricted. Such a restriction could harm the right to pursue happiness and health of People by depriving the poor, who cannot afford to pay, of chances to get treatment. Here we will see benefit restriction by 'gross negligence' of National Health Insurance Act Article 48 paragraph 1, which has largest portion of such restriction. It is desirable to delete 'gross negligence' clause from above paragraph and to interpret 'when' clause restrictively for diminishing confusion of interpreting and guaranteeing the right of health.
There were many books on infectious disease prevention act, and still remained 5 books including Ganuibyeokonbang. Epidemics were seriously ill and widely contagious, so it was important to prevent them. Therefore, they wrote various preventive measures from epidemics on those books. They emphasized medication, and used not only compound prescriptions but also singular ones. They wrote 5 compound prescriptions including Sohaphyangwon and many singular ones on Ganuibyeokonbang, and they used folk medicine such as red-beans준 for practical use on that book. On Sinchanbyeokonbang, they emphasized Hyangsosan and presented many prescriptions to specialize in epidemics. Heojun presented various prescriptions for Dangdokyeok on Byeokyeoksinbang, and he excluded incantation methods to cope with epidemics medically. Since Ganuibyeokonbang they had tried to improve personal hygiene such as boiling clothes of patients.
2021, the Supreme Court recognized the foundation of the quasi-indecent act by force by the concept of 'alcohol blackout' although there were multiple situations that it was hard to judge insanity of the victims was evident in the cases with drunken victims. This means the consideration of insanity state due to temporary false memory rather than the total loss of mental capacity from the existing concept of insanity. However, the interpretation of insanity in the criminal law has to be strict and its application could be difficult. In particular, the comparison precedent which is very similar to the subject one was determined not to be the same with the state of the insanity or inability to resist during the sexual relation though the victim had the symptoms of alcohol blackout, denying the quasi-indecent act by force. This argument is determined to be logical remarkably, and insanity and quasi-indecent act by force should be discussed considering the medical review on the alcohol blackout of the victims sufficiently when determining the individual precedents. In addition, the most important point in the sexual crimes is the consent, and there may be possibility of negligence in case that uncertain consent is determined as the consent to continue the following act. Also, in case of uncertain consent or suspicious, universal determination not to follow the act should be able to realized. Therefore, strong evidence is required for criminality, determining that the victim is the state not to be able to do the normal judgment and the minimum willful negligence is existed that the accused uses this. In the subject ruling, the act of the accused has to be clearly punished, however, it is determined to be unreasonable for the punishment with the quasi-indecent act by force under the interpretation of the current regulations.
Kim, Yee Hyung;Yoo, Kwang Ha;Yoo, Jee-Hong;Kim, Tae-Eun;Kim, Deog Kyeom;Park, Yong Bum;Rhee, Chin Kook;Kim, Tae-Hyung;Kim, Young Sam;Yoon, Hyoung Kyu;Um, Soo-Jung;Park, I-Nae;Ryu, Yon Ju;Jung, Jae-Woo;Hwang, Yong Il;Lee, Heung Bum;Lim, Sung-Chul;Jung, Sung Soo;Kim, Eun-Kyung;Kim, Woo Jin;Lee, Sung-Soon;Lee, Jaechun;Kim, Ki Uk;Kim, Hyun Kuk;Kim, Sang Ha;Park, Joo Hun;Shin, Kyeong Cheol;Choe, Kang Hyeon;Yum, Ho-Kee
Tuberculosis and Respiratory Diseases
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v.80
no.2
/
pp.169-178
/
2017
Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). Results: The study enrolled 144 patients (mean age, $56.7{\pm}16.7years$). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from $16.6{\pm}4.6$ to $20.0{\pm}3.9$ (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.
ChatGPT has the potential to revolutionize occupational medicine by providing a powerful tool for analyzing data, improving communication, and increasing efficiency. It can help identify patterns and trends in workplace health and safety, act as a virtual assistant for workers, employers, and occupational health professionals, and automate certain tasks. However, caution is required due to ethical concerns, the need to maintain confidentiality, and the risk of inconsistent or inaccurate results. ChatGPT cannot replace the crucial role of the occupational health professional in the medical surveillance of workers and the analysis of data on workers' health.
A combination of information technology and medical care has given rise to a new type of medicine, i.e., telemedicine. Broadly defined, telemedicine is the transfer of electronic medical data from one location to another. Both at home and abroad, telemedicine has come to success in establishing appropriate equipment and solutions for such non-conventional medicine. Sooner or later, telemedicine is believed to find itself as one of the universal treatments. In order to facilitate the full-fledged development of telemedicine, a number of legal and institutional problems have to be settled. In Korea, the Medical Act was amended to include such provisions as telemedicine, electronic medical records, electronic prescriptions, etc. and the Act came into force on March 31, 2002. Telemedicine is in common with the conventional medicine in that a physician treats a patient. However, telemedicine is basically differentiated in the followings: - The offer and acceptance of treatment and medication are usually made on-line; - Telemedicine is inherently dangerous because a physician cannot meet face-to-face with a patient; and - Joint and several liability is borne by all the physicians involved in a telemedical consultation. As a result, telemedicine is vulnerable in nature to medical malpractice. Accordingly, there must be some new theories and arguments in the formation of contract and torts. The discussion on the civil liability covers the above-mentioned issues, and would give an insight or guidelines in the concerted operation of provisions with respect to telemedicine. This study delves into the civil liability of physicians involved in telemedical consultations and treatments based upon the conventional malpractice theory.
When we are totalizing the lawsrelated to the medical, as the Laboratory medical testing is a kind of the medical act, it is the regulation that the medical technologist can analyze the specimen using in vitro diagnostic devices and diagnosticdrugs under the guidance of doctor or dentist from a corresponding medical institution and can report through verification and interpretation. However, in real medical fields, 'the guidance of doctor' is seriously in-sufficient or even the person who is not the medical technologist is executing. Furthermore the cases that produce inspection results with devices or reagents which are not validated nor approved have been frequently occurred. The result of Laboratory medical testing derived from this procedure can become the important information for the disease control of a country, and also can be decisive to the definite diagnosis and the prognostic monitoring about the patient disease. In spite of its significant medical act to be applicable to an unique proof with the related expert appraisal result in the medical mal-practice lawsuit, our reality in which the quality control is not properly working due by the costs and the labor shortage related to the Laboratory medical testing is quietly in bad condition. Even from now, the government should recognize the significance of the Laboratory medical testing and must achieve more strict administrative management as well as the law maintenance.
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