• Title/Summary/Keyword: Nature of Medicine

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Evolution of Healthcare Service Disparities: A Case Study of Primary Care Services in Korea, 1995-2021 (보건의료 서비스의 공간적 불균등 분포 변이에 대한 연구: 1995년부터 2021년까지 초기진료기관을 대상으로)

  • Hyun Kim;Yena Song
    • Journal of the Economic Geographical Society of Korea
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    • v.26 no.3
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    • pp.289-309
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    • 2023
  • While South Korea's universal healthcare system has garnered attention in public health, the issue of inequality in healthcare service provision among different age groups has incessantly become a significant concern. The focus of this concern is primarily on essential healthcare services, encompassing fundamental aspects of healthcare such as internal medicine, family medicine, and pediatric and adolescent care. This inequality is not limited to differences among age groups (both junior and senior demographics) but also extends to potential disparities in healthcare services based on geographic location, particularly in urban and rural contexts. This paper aims to investigate disparities in primary healthcare service resources in South Korea's evolving economic landscape between 1995 and 2021. We utilize a set of inequality indices with a spatial perspective through geographic cluster analysis. The findings reveal that concerns about inequality have been amplified during various economic events, including the IMF crisis in 1999, the global financial crisis in 2008, and the COVID-19 pandemic in 2020. These years are identified as significant phases that have contributed to manifesting spatial disparities in primary healthcare provisions, with a particular emphasis on the senior-aged population rather than junior or all population groups. Our findings underscore the pressing need to address the unequal distribution of essential healthcare resources as part of preparedness for potential economic impacts, requiring a comprehensive consideration of the interconnected nature of demographic and spatial dimensions in healthcare services.

Invasive Brain Stimulation and Legal Regulation: with a special focus on Deep Brain Stimulation (침습적 뇌자극기술과 법적 규제 - 뇌심부자극술(Deep Brain Stimulation)을 중심으로 -)

  • Choi, Min-Young
    • The Korean Society of Law and Medicine
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    • v.23 no.2
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    • pp.119-139
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    • 2022
  • Brain stimulation technology that administers electrical and magnetic stimulation to a brain has shown a significant level of possibility for treating a wide range of various neurological and psychiatric disorders. Depending on its nature, the technology is defined either as invasive or non-invasive, and deep brain stimulation (DBS) is one of the most well-known invasive brain stimulation technologies. Currently categorized as grade 4 medical device in accordance with Guideline On Medical Devices And Their Grades, a Notification of Ministry of Food and Drug Safety (MFDS), the DBS has been used as a stable treatment for several diseases. At the same time, the DBS technology has recently achieved substantial advancement, encouraging active discussions for its use from various perspectives. On the contrary, debates over legal regulation related to the use of DBS has relatively been smaller in numbers. In this context, this article aims to 1) introduce the DBS technology and its safety in setting out the tone; 2) touch upon major legal issues that would potentially rise from its use for four different purposes of treatment, clinical study, areas of non-standard treatment where no other methods are available, and enhancement; and finally 3) highlight disputes concerning common emerging issues observed in the aforementioned four purposes from the viewpoint of legal responsibility and liability of using the DBS, which are benefit-risk assessment, physicians' duty of information, patients' capacity to consent, control for device, and insurance coverage.

Specialty Hospital and Keyword Searching Ads Regulation (전문병원과 키워드검색광고 규제)

  • Lee, Dongjin
    • 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.

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A Review on the Improvement of the Meaning and Composition Requirements of Interference with Fire Protection Activities - Focusing on Interference with 119 EMS Activities - (소방활동방해죄의 의미와 구성요건 개선에 관한 검토 -119구급활동 방해를 중심으로-)

  • Young Pyo Hong
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.105-124
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    • 2023
  • Modern society is facing an unstable environment due to unexpected accidents and hazardous situations. For example, incidents such as the collapse of the Bundang Bridge and the crushing accident in Itaewon could serve as examples. In addition to these, critical emergencies like sudden cardiac arrests and strokes frequently occur, requiring swift actions and smooth transfers to specialized medical institutions for effective responses. In response to these risks, the country has been establishing various systems to protect the lives and safety of its citizens. Among these, the 119 First Aid Activities plays a crucial role within the emergency medical system. Its goal is to promptly respond to critical emergency situations involving severe trauma patients or patients with serious illnesses, minimizing damage and safeguarding lives by swiftly transferring them to emergency medical institutions for specialized treatment. The core activity related to this is emergency rescue operations. In particular, the 119 First Aid system serves as a crucial institution responsible for the hospital transportation of emergency patients. However, rescue personnel still encounter cases of interference with their activities during their duties. Despite efforts from the police, these interference cases persist, and they share similarities with the crime of obstructing official duties. Interference with emergency activities exhibits a comparable nature to instances such as physical assaults and equipment damage against emergency medical practitioners working within the emergency medical system. Therefore, a comprehensive understanding and improvement efforts regarding the issues of interference that arise during the process of emergency medical activities, including the 119 First Aid system, are necessary. The solution to these problems is to establish and improve the conditions for obstruction of first aid activities, focusing on the "Framework Act on Firefighting" and the "Act on 119 Rescue and Emergency."

Survey of Knowledge on Hypertension among the Parents of Elementary School Students (초등학생 학부모의 고혈압 관련 지식에 관한 조사)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.29-38
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    • 2005
  • Objectives: Hypertension is the most important risk factors for the cerebrovascular diseases, and also for coronary heart diseases, it is therefore very important that the people have a knowledge on nature of hypertension and it's high risk in order to prevent and detect the hypertension as early as possible. Methods: This study was done to find out the knowledge on hypertension of 434 parents of elementary school students from Kimjae city, Jonbuk province, they were parents in grade 4, 5 and 6 attending two elementary schools. The survey took 10 days from November 20 to November 30, 2003. Results: first, The highest correct answer(94.5%) was "obesity is risk factors for hypertension", followed by "hypertension is closely related with hereditary factors(91.0%) and "high sodium intake is associated with high blood pressure"(85.7%). The lowest correct answer(77.4%) was the classification of blood pressure level between normal and high. Second, Rate of blood pressure measurement for fathers was 53.7% and 54.8% in mothers. Awareness of own blood pressure by fathers was 84.1 %, while 91.1% by mothers. Third, According to blood pressure level reported by parents, fathers with normal blood pressure was 59.2%, high normal blood pressure was 12.2%, while hypertension was 28.6%. It revealed that prevalence of hypertension of fathers was higher than mother (normal: 74.5%, high normal: 7.7%, hypertension: 18.2%). Conclusions: From the results of this study, it is important to strengthen the health education about hypertension for community people and also school students.

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Future Medical Screening: A Challenge to the Insurance Industry (보험업계(保險業界)의 과제(課題))

  • Yoon, Byong-Hak;Kraus, H.K.
    • The Journal of the Korean life insurance medical association
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    • v.12
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    • pp.50-55
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    • 1993
  • After a short historical resume, screening is discussed on the basis of the current philosophy of Life insurance compaines in leading countries. This is followed by considerations with regard to the future in areas of major bearing on Life insurance screening which have emerged as important within the last decade. HIV-antibody testing is dealt with from the screening point of view followed by aspects regarding the applicability of tumour marker use in Life insurance medicine. Last but not least genetic testing will be addressed, taking into account prospects for the future, as well as the resulting responsibility in medical and underwriting terms. The major considerations and suggested guidelines can be summarized as follows: 1) Screening in Life insurance is a prerequisite for underwriting and is a well-functioning selection instrument. 2) Screening technologies are medically well defined and have to follow general clinical rules, also in the future. 3) Screening parameters should follow the patterns of diseases according to age and risk groups. 4) Screening parameters for prognostic use are legitimate as long as they are considered in conjuction with clinical medical observations and rules. 5) Screening technologies of a sensitive nature require very special rules for handling in the sense of "consequential ethies". 6) Screening parameters like HIV-antibody testing require ongoing scientific feedback in their new testing dimensions. 7) Screening in the form of genetic testing is as yet not used in Life insurance; its potential future role in Life insurfance medicine must, however, be discussed responsibly and in time. 8) Screening enables the insurance industry to rule out possible antiselection and provide for equal knowledge on the part of the insurance applicant and the insurer about impairements which shorten life expectancy. 9) Screening, informed consent, counselling and confidentiality must go hand in hand both now and to an even greater extent in the future.

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An analytical method of soap biodegradability with fatty acid p-BPB derivatives (지방산의 p-BPB 유도체에 의한 비누 생분해도 분석 방법)

  • Oh, Se-Woong;Lee, Ja-Kyoung;Chung, Yong;Chang, Sug-Youn;Kim, Yeo-Kyung
    • Analytical Science and Technology
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    • v.6 no.1
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    • pp.9-19
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    • 1993
  • Fatty acid salts derived from soap can be transferred into a typical derivative with p-bromophenacyl bromide using crown ether, a catalizer by the solid-liquid phase transfer reaction in nonpolar, aprotic solvents and separated by the reverse phase high performance liquid Chromatography (RP-HPLC) and determined using UV detector. The minimal limit of detection was defined at approximately 10~50ng in accordance with the chain length. The derivatization reaction in the presence of EDTA can be applied mot only to the calcium salts but also to the other various metal salts. The recoveries of fatty acid derivatizations in the absence and presence of the midium containing the yeast extract were obtained $95.4{\pm}1.2$, and $85.2{\pm}2.4%$ respectively. The analytical method would be applicable to determine the biodegradation of fatty acid salts in nature as well as in artificial condition such as shaker flask-medium method.

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A Study about the Legal Nature of Negotiations between NHIS and Pharmaceutical Company (국민건강보험공단과 제약사 간 의약품 관련 협상 행위의 법적 성격에 관한 고찰)

  • DUCKGYU JANG
    • The Korean Society of Law and Medicine
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    • v.23 no.4
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    • pp.3-28
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    • 2022
  • Recently, the targets and clauses of negotiation between 'National Health Insurance Service (NHIS)' and Pharmaceutical companies has been expanded. Due to newly adopted 'Quality management clause', 'Compulsory supply maintenance clause' and 'Penalty for breach of contract clause', not only 'Ministry of Health and Wellfare (MOHW)'s 'drug listing' and 'Price cap' announcement, but also 'negotiation between NHIS and pharmaceutical companies' can be a legal sanction to the suppliers. Once secretary of MOHW order NHIS to negotiate with pharmaceutical company, NHIS notify this order to the company and enter into the negotiation. 'The order' exists in the public domain between the government (MOHW) and public institutions (NHIS) and does not constrain the legal rights of companies (Therefore companies cannot pile a lawsuit about the order). However, 'the notice' or 'negotiation' is an act which has a counterpart, can be a target of administrative litigation if the company get some disadvantages from the talks. Negotiations can be divided into four types according to "the target (whether it is listed on the insurance benefit list)" and "the purpose (whether the target is price or conditional)." In particular, negotiations on listed drugs, whose goal is to set unfavorable conditions for companies, can be illegal if there is no price. So we need to consider compensation for the company as an incentive to negotiate.

Non Face-to-Face Treatment and Not-informed Medication to Persons with Mental Disorders (정신질환자에 대한 비대면진료 및 비고지투약 -치료적 대화의 복원을 위한 모색적 고찰-)

  • Jung, Sangmin
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.149-192
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    • 2024
  • People with mental illness are generally either unaware of their illness or unwilling to voluntarily seek treatment, which makes treatment difficult and the pain mainly passed on to their families. Accordingly, non-face-to-face treatment, in which the patient is diagnosed by interviews with the family and unannounced medication, in which medication is secretly administered through the family, can be performed, and this has been considered a necessary evil. Even considering realistic aspects such as the special nature of mental health care and families' suffer, not-informed treatment without consent violates not only medical laws, but also human rights of mentally ill patients. Above all, if the patient finds out about this late, the trust between the patient, family, and doctor is completely broken, and a treatment is absolutely refused. Japan's Chiba decision, which presents exceptional conditions for allowance might be a solution. However, it would not be a right solution, considering that it could lead to long-term unannounced medication and completely cut off treatment through therapeutic dialogue. Ultimately, it need to approach this problem and seek alternatives through restoration of therapeutic dialogue.

Study on "Four Tantras", the Prime Textbook of Tibetan Medicine (티벳의학에 대한 연구 - "사부의전(四部醫典).근본의전(根本醫典)"을 중심으로)

  • Chang, Eun-Young;Yun, Chang-Yul
    • Journal of Korean Medical classics
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    • v.11 no.1
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    • pp.416-512
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    • 1998
  • The following conclusions are obtained from the studies on the chapters concerning phisiology, pathology, daily conduct, materia medica, pulse, and urinalysis from , of the "Four Tantras". 1. The theoretical basis forming the Tibetan Medicine is the substance of phlegm, bile, and wind each of which is divided into five kinds. These phisiological substances can be transformed into pathological factors when certain environment is formed. 2. In embryology, the semen of the father and menstral blood of mother is considered the most important condition in conception, and the Five factors are regarded as important. There is a detailed explanation of development of the fetus while it stays in the womb of mother during 38weeks, such as the formation of the viscera, channels, sense organs, etc. 3. There is metaphor which compares the human body with the king's palace. With the development of human anatomy, there is the detailed anatomical picture of anterior and posterior aspects of human body. And also there is the measurement of physiological constitution and the three fluids. 4. In division of the channels, they concerned the now of the blood and distribution of the nerve fibers, and each channel is connected with one another. The division of the cannel is namely embryonic channel, channel of existence, channel of connection, and the course of life principle. 5. The seven bodily constituents and three factors of phlegm, bile, and wind are important in sustaining the life of human body as well as growth and maturization, and when their equilibrium is broken, the human body is degnerated, and finally death comes. 6. The signs of death is divided into distant sign, remote sign, certain sign. and uncertain sign, and is used as a clue in diagnosis of the disease. Especially there is a mention about the mechanism of the dreams, and different dreams according to the condition of the patient. 7. In pathology, there is the cause of the disease, the environmental factors which can induce disease, the path by which disease come into the human body, the characteristics of the disease, and the kinds of disease. 8. There is a mention about the conduct, and it is divided into the daily conduct, the mental attitude, and the side-effects which can occur when one puts up with the physiological actions of the body. 9. The daily diet is divided into food and beverage. The food is divided again into grain, meat, fat, boiled food, and spiced food, and the beverage into milk, water, and wine. 10. The pulsation should be taken in lift hand to diagnose heart, small intestine, stomach, spleen, kidney, reproductive organ, and in right hand jungs, large intestine, liver, gall bladder, kidney, and bladder. In the healthy person, the pulse moves 5times in one perspiration, and the type of pulse is constant while the pulse moves 100times. But unhealthy person's pulse is different from this. The urinalysis is the unique part of Tibetan Medicine, and is important in examination of the disease. One should decide which of the three factors are dominant by the obervation of the color, amount of the steam and how long it lasts, odour, foam, and the shape of the swirl in three different states when the urine is hot, warm, and cold. One can determine the life of the patient and which viscera is the cause of the disease by the pulse, and whether the nature of the disease is hot or cold by the urinalysis. 11. The materia medica contains gemstones, minerals, plateau medication, and meat products.

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