• 의료법학
• /
• 제14권2호
• /
• pp.143-172
• /
• 2013

In order to achieve the purpose of treatment for patients by a doctor, the instruction explanation obligation, which means that he should give patients the description in more details to prepare for postoperative sequelae or complications, is common with the advice explanation obligation as a doctor should ex-plain some information to patients. Since the advice explanation obligation is the benefit and protection of the law for self determination right, but the instruction explanation obligation is one for the integrity of body and life, one can be distinct from the other. Judgments giving the instruction on the concept of instruction explanation obligation, specific methods of implementation and a range of compensation for damage are recently being made by courts at all levels including the Supreme Court. It is the time to systematize them. The contents which have been mainly discussed so far include the essence of above mentioned instruction explanation obligation. However, when the tendency of practice is considered, the efforts are required to admit the organic relevance between instruction explanation obligation and advice explanation obligation and to explain the relationship without any contradiction. For whereabouts of li-ability of proof, patients theoretically demonstrate the failure to implement it. However, when the theoretical consistency is maintained, it is likely to fail the intent to recognize the instruction explanation obligation and it may ask patients to prove something impossible to be proven. Thus, these things should be considered. Moreover, as the instruction explanation obligation is associated with medicine instruction obligation of a pharmacist and the coverage is being extended, it is the time to require the systematic study on the theoretical limit.

• 한국병원경영학회지
• /
• 제27권1호
• /
• pp.11-19
• /
• 2022

Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision. Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA). Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination. Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

• 의료법학
• /
• 제15권2호
• /
• pp.227-251
• /
• 2014

In current law, the premium medical treatment system gives patients the right of choice between normal medical treatment service and premium medical treatment service. Only the doctors having a career more than a certain period of time fixed in the law are eligible for providing the premium medical treatment service. So, the premium medical treatment system is highly related to the patients' right to know and the right of self-determination. The system is also relevant to the so-called 'economic explanation' notion because patients should pay additional fee when they want to use this system. Meanwhile, the situation as follows is problematic as to this system. Although a patient applied for using the premium medical treatment system and the patient also chose his or her own doctor specifically, another doctor who was not selected as premium doctor could make a medical accident. Then, is the another doctor liable for damages because the accident was a medical malpractice or a breach of medical contract? In this study, we are going to examine the problems related with the premium medical treatment system. First, we examine the current law related to the system. Second, we look into the economic explanation duty and its application to the premium medical treatment system. Finally, we examine a real judgment case about a medical practice against the premium medical treatment system and we propose our solution to this case.

• 의료법학
• /
• 제24권4호
• /
• pp.37-63
• /
• 2023

의료소송에서 의사의 환자에 대한 '설명'이 문제되는 경우는 다양하다. 진단의 초기부터 시작하여 수술 등의 치료과정, 치료를 위해 입원이 필요한 경우, 입원 중과 퇴원 시, 그리고 퇴원 후에 이르기까지 의학적인 설명과 지도가 의사에게 요구된다. 나아가 의료행위로 인하여 발생하게 될 경제적 비용에 대하여도 의사 혹은 의료기관의 고지가 요청되기도 한다. 우리나라 사법부는 이와 같은 의사의 설명에 대하여 진료의 단계 및 의료법 등 관계법령을 고려하여 의료행위에 대한 동의를 구하기 위한 설명과 환자의 요양방법 지도와 관련된 진료상 설명을 구분하여 법리를 전개해 오고 있다. 또한 헌법재판소는 경제적 비용에 관한 설명과 연계된 비급여 비용 고지 제도에 관하여 최근 판단하기도 하였다. 그런데 의사의 설명이 불충분하였다는 것만을 이유로 의사에게 책임을 추궁을 하는 것은 임상현실의 실제 상황과 부합하지 않는 측면이 존재하고, 오히려 의권의 위축을 초래하는 반사적인 불이익이 있을 수 있다. 따라서 의사의 설명은 환자의 자기결정권 보장과 의권 보호라는 양측면에서 살펴보아야 할 필요가 있다.

• Journal of Chest Surgery
• /
• 제54권1호
• /
• pp.65-67
• /
• 2021

A fistula between the right pulmonary artery and the left atrium is a very rare congenital anomaly, for which there is no definitive embryogenetic explanation. Patients present with cyanosis or clubbing, and the treatment strategy is to close the fistula, which can be done by an open surgical technique or by percutaneous intervention. Although rare, this condition should be considered in the differential diagnosis when evaluating a patient with central cyanosis.

• 인지과학
• /
• 제23권2호
• /
• pp.185-204
• /
• 2012

촉진질문을 제공해서 무엇을 설명해야 하는지 알려주거나 자기설명을 하게 지시하면 기억과 이해가 향상되는지, 그리고 자기설명 지시와 촉진질문 제공의 효과가 학습자의 인지욕구와 상호작용하는지 알아보기 위해 3요인 실험을 실시하였다. 촉진질문과 자기설명 지시의 효과는 과제와 학습자의 인지욕구 수준에 따라 다르게 나타났다. 기억검사에서는 인지욕구가 낮은 학습자에게서 자기설명 지시와 질문 제공이 기억 수행을 향상시켰다. 인지욕구가 높은 학습자에게는 촉진질문이나 자기 설명지시는 기억에 별 도움이 되지 않았다. 오히려 촉진질문에서 언급하지 않았던 항목에 대한 기억은 저하시키는 경향을 보여주었다. 그러나 이해검사에서는 인지욕구가 높은 학습자의 이해 수행이 좋았다. 특히 인지욕구가 높은 학습자에게 촉진질문을 제공하고 자기설명을 하게 지시한 경우에는 이해 수행이 좋았으나, 인지욕구가 높은 학습자에게 촉진질문을 제공하지 않고 자기설명을 하게 한 경우에는 이해 수행이 나빴다. 이 연구의 결과는 자기설명 지시와 촉진문의 효과는 학습자의 인지욕구 수준에 따라 다를 수 있고, 인지욕구 수준이 낮은 경우 자기설명 지시와 촉진질문의 효과는 가산적일 수 있으며, 설명이 필요한 부분을 정확하게 찾아내는 것이 자기설명의 효과를 결정하는 중요한 요인일 수 있다는 것을 시사하는 것으로 해석되었다.

• 의료법학
• /
• 제14권2호
• /
• pp.217-260
• /
• 2013

In connection to the civil liability of the medical malpractice, plaintiff and courts are solving the medical disputes with theory of the liability based on tort law. because contract law does not enact the right of claim of solatium and a plaintiff's lawyer and courts hesitate to use contract law. Medical treatment of doctor is main debt in medical contract and its in-complete performance gives rise to the violations of human's life, body and health. Consequently a breach of medical contract leads to violations of person-al rights. These violations spring from liability of contract as well as tort and damages from them are recognized based on medical contract law. A duty of explanation of doctor is a independent and appendant debt to the treatment debt. However its breach provokes violations of human's life, body and health as well as a right self-determination. Therefore consolation money claim should be recognized. In case of the violation of patient's life, body and health, patient's family al-so can demand consolation money due to the violation of their's own mental pain. However in case of the violation of only patient's self-determination without informed concent, they can not demand it by reason of the violation of patient's self-determination. But by reason of the violation of patient's life, body and health that were recognized by proximate causal relation between violation of duty of explanation and abd execution, they can do.

• 한국지능시스템학회논문지
• /
• 제19권2호
• /
• pp.218-223
• /
• 2009

이 논문은 개별화된 오답노트 모형 개발에 관한 문제를 고찰한다. 여기에서 사용된 방법은 집단지성을 이용하여 오답노트해설을 추가하고, 오답분석을 통하여 유사한 패턴의 오답자 해설노트를 참조한다. 이 논문의 주된 결과는 정답에 대한 해설이 아닌 오답에 이르는 틀린 과정을 찾고 오답을 정리하는 것이다. 제안된 방법으로 기존 오답노트 시스템의 개선된 해결책을 찾을 수 있다.

• Archives of Plastic Surgery
• /
• 제36권3호
• /
• pp.262-268
• /
• 2009

Purpose: Recently medical dispute about plastic surgery is increasing rapidly as result of growing surgery itself due to high interest in appearance and advertisement of plastic surgery. So we want to find a way to prevent similar medical accident by making better solution of plastic surgery through case analysis of medical dispute. Method: 161 cases about plastic surgery asked for aid at Korea Consumer Agency and 41 cases judged at the court was surveyed and gender, location and kind of hospital, goal and kind of operation, making operation agreement or not, kind of damage, result of process, result of lawsuit was studied from 2004.1.1. to 2006.12.31. Result: Medical doctor have to explain about symptoms of disease, method of treatment, possibility of complication, prognosis to patients before therapy so they can make decision if they take operation by doctor or not. On this survey, among the patients who underwent re - operation or had complication, 88.1%(96 from 109 cases) of them didn't get enough explanation about possibility of complication before surgery They brought lawsuit insisting they would not undergo operation if they got enough explanation about possibility of complication and result of operation before surgery. Conclusion: It is advisable that doctor must observe the duty of explanation before surgery and respect the right to decide of patient, make operation agreement and put down concrete progress note and store the pre and post operative photo to avoid medical accident. It is also needed to have guideline of therapy, Code of ethics, organization which deals with medical dispute, reconsideration of law to control that.

• 보건행정학회지
• /
• 제22권3호
• /
• pp.315-346
• /
• 2012

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.