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Informed Consent and Refusal of Treatment in Emergency Medical Situation (응급의료에서의 설명·동의 원칙과 응급의료거부죄)

  • Lee, Jung-eun
    • The Korean Society of Law and Medicine
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    • v.23 no.1
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    • pp.37-80
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    • 2022
  • By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

The Types of Warm Temperate Forest and the Degraded Levels in the Island Area of the West and South Coast (서남해안 도서지역의 난온대 식생유형화 및 훼손등급)

  • Park, Seok-Gon;Sung, Chan-Yong;Kang, Hyun-Mi
    • Korean Journal of Environment and Ecology
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    • v.35 no.6
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    • pp.579-593
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    • 2021
  • In order to understand the types of vegetation in warm temperate-climate zones, vegetation was investigated in several island areas in Jeollanam-do (Jindo, Wando, Gangjin, Goheung, and Yeosu). The evaluation standard for degraded level of warm temperate forests were proposed based on the importance percentage (IP) in canopy layer of the evergreen broad-leaf forests and the number of arboreal evergreen broad-leaf species. Through these measurements, the restoration types and techniques for each degraded level were estimated, and it is intended to be used in establishing restoration plans for the southwest coast island area. The vegetation was analyzed using the two-way indicator species analysis (TWINSPAN) method using survey data of 307 plots. As a result, it was divided into 8 communities, and the appearance characteristics of evergreen broad-leaf species were identified in each community. Community I was located on the lower slope at an altitude of 86.6 m, and Neolitsea sericea and Castanopsis sieboldii were dominant. Communities II and III were the vegetation types that appear on the coast below an altitude of 10.5 to 22.5 m, and Machilus thunbergii, Cinnamomum japonicum, N. sericea, and C. sieboldii were dominant. Communities IV and V were vegetation types that appeared in the lower and middle slops between the altitudes of 71.9 to 153.4m, and C. sieboldii was dominant. In community VI, the N. sericea was dominant in the lower and middle slops at an altitude of 166.9 m. The last communities VII and VIII were the vegetation types that appeared on the middle slop at an altitude of 187.8 to 246.2 m. Also, Quercus acuta and Q. salicina were present. In summary, the evergreen broad-leaf forests dominated by M. thunbergii, C. japonicum, and N. sericea appeared mainly in the coastal areas of the lowlands. The community of C. sieboldii was distributed higher inland than this community. The communities that appeared mainly in the inland highlands at levels above these two communities were Q. acuta and Q. salicina. The degraded level was classified as 0 to V, according to the IP of arboreal evergreen broad-leaf species and the number of arboreal evergreen broad-leaf species. According to the degraded level, the restoration types (preservation, induction, improvement, creation) and the restoration techniques were determined.

A Study on the Characteristics of Ca(OH)2 According to the Calcination Conditions of Oyster Shells and Its Application for Exterior Water Paints (굴 패각의 소성 조건에 따른 소석회의 특성과 외부용 수성 도료 적용 연구)

  • Hwang, Dae Ju;Yu, Young Hwan;Han, Chang Soo;Lee, Jong Dae
    • Korean Chemical Engineering Research
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    • v.60 no.4
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    • pp.594-605
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    • 2022
  • CaO was prepared by calcining for oyster shells using a microwave kiln. It was analyzed to Ca(OH)2 synthed on hydration reaction from prepared CaO. The synthesized Ca(OH)2 was formulated as an external water paint. Oyster shells (325 mesh, 43 ㎛) were decarbonized for (a) 950 ℃/1 hr and (b) 1,150 ℃/1 hr to prepare CaO. In the calcination condition of (a), CaO was 56.7 wt%, and in the calcination condition of (b), CaO was 100 wt%. To compare CaO by calcination of oyster shells with that of limestone, limestone (25~30 mm) was decarbonized at 950 ℃/1 hr to prepare CaO, and as a result of the analysis(XRD), it was analyzed as CaO 100 wt%. CaO was prepared under the calcining conditions of oyster shells (b) 1,150 ℃/1 hr, and Ca(OH)2 was synthesized through hydration. Hydration conditions of the prepared CaO were (a) CaO : H2O(100 g : 200 g) and (b) CaO : H2O(100 g : 400 g). As a result of the hydration reaction, it was confirmed as low reactivity. 100 wt% of Ca(OH)2 was synthesized. In particular, Ca(OH)2 synthesized under the hydration condition of (a) was analyzed in a plate shape. An external water paint was formulated with Ca(OH)2 synthesized from oyster shells as the main component. When 15 items of the external water paint standard specification (KS M 6010) were analyzed, it was confirmed that all other criteria were satisfied except for freezing stability.

Comparison of the Efficacy of Disinfectants to Control Caseous Lymphadenitis in Korean Black Goat Farms (흑염소의 건락성 림프절염 제어를 위한 소독제 효능 비교)

  • Cho, Hyeunwoo;Kim, Yeona;Jang, Beomsoon;Kim, Chan-Lan;Park, Kun Taek
    • Journal of Food Hygiene and Safety
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    • v.37 no.5
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    • pp.317-322
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    • 2022
  • Corynebacterium pseudotuberculosis is the causative agent of caseous lymphadenitis (CLA), a chronic contagious disease in small ruminants. The prevalence of CLA has been reported to be >50% in Korean black goats. CLA is difficult to control due to a lack of efficient vaccines and treatment methods. Effective disinfection of the farm environment may be an alternative strategy for reducing the spread of C. pseudotuberculosis. The objective of this study was to evaluate the efficacy of commercial disinfectants against CLA. The six commercial disinfectants, largely composed of sodium dichloroisocyanurate, sodium hypochlorite, potassium monopersulfate triple salt, quaternary ammonium, citric acid, and copper sulfate, were tested against five different genotypes of C. pseudotuberculosis isolated from goat farms in Korea. Efficacy tests were performed in accordance with the disinfectant efficacy test guidelines recommended by the Animal and Plant Quarantine Agency of Korea with slight modifications. All disinfectants except for copper sulfate exhibited >99.99% killing efficacy under hard water conditions following 30 min of incubation, which is the recommended standard treatment time according to guidelines. The minimum bactericidal treatment time was evaluated by employing treatments for durations of 1, 5, and 15 min. The most effective compounds under hard water conditions were sodium dichloroisocyanurate, potassium monopersulfate triple salt, and sodium hypochlorite, exhibiting >99.99% killing efficacy after 1 min of treatment. In the aqueous solution forms, citric acid and the quaternary ammonium compound were the most effective, but required at least 5 min to kill >99.99% of the bacteria. The current study characterizes the killing efficacy of six commercial disinfectant active compounds against C. pseudotuberculosis. Thus, this study provides essential information regarding the efficacy of the disinfectants used to control CLA in goat farms.

A Study on the Policy Direction of Space Composition of the Future School in Old High School - Focused on The Judgment of Space Relocation for the Application of the High School Credit System - (노후고등학교의 미래학교 공간구성 정책방향에 관한 연구 - 고교학점제 적용을 위한 공간 재배치 판단을 중심으로 -)

  • Lee, Jae-Lim
    • The Journal of Sustainable Design and Educational Environment Research
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    • v.21 no.3
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    • pp.1-13
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    • 2022
  • This study is a case study to identify the spatial composition and structural problems of existing schools for spatial innovation as a future school that can operate a credit system for old high schools and establish a mid-to-long-term arrangement plan as a credit system operating school capable of various teaching and learning in the future. The study results are as follows: First, most of the problems of the old high schools entailed that there was very poor connectivity between buildings as most of them were arranged in a single, standard design-type unit building and distributed in multiple buildings. In addition, the floor plan of each building is suggested to be a structure in which student exchange and rest functions cannot be achieved during the break period due to the spatial composition of the classroom and hallway concepts. Second, in the direction of the high school space configuration for future school space innovation, the arrangement plan should be established by reflecting the collective arrangement in consideration of the shortening of the movement route and the expansion of subject areas due to the movement of students on the premise of the subject classroom system. Moreover, it is desirable to provide a square-type space for rest and exchange in the central area where communication and exchange are possible according to the moving class. Third, as the evaluation criteria for relocating old high schools, a space program is prepared based on the number of classes in the future, and legal analysis of school land use and land use efficiency analysis considering regional characteristics are conducted. Based on such analysis data, mid-to-long-term land use plans and space arrangement plans for the entire school space such as the school facility complex are established.

The verdict category and legal decision: Focused on the role of representation of 'innocent' (평결범주와 일반인의 법적판단: '무죄표상'의 역할을 중심으로)

  • Han, Yuhwa
    • Korean Journal of Forensic Psychology
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    • v.13 no.1
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    • pp.1-22
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    • 2022
  • This study tested the effect of the verdict category of lay-participation trial in Korea on the legal decision of layperson and the role of representation of 'innocent' in the process. Representation of 'innocent' refers to a psychological threshold for deciding someone's innocence (no fault or sin) in a general sense. The functions as a threshold for a legal decision of 'beyond a reasonable doubt (BRD)' and the individual threshold (IT), regarded as a standard for judgment of guilt established by law and an estimate of an individual's threshold, respectively, were compared. This study used a 2×2 complete factorial design in which the verdict category (guilty/innocent vs. guilty/not guilty) and the defendant's likelihood of guilt (low vs. high) were manipulated. Data from 137 lay-people who voluntarily participated in the online experiment was analyzed. The experiment's procedure was in the order of measuring 'representation of innocent' and the likelihood of guilt of an accused, presenting one of four trial vignettes, and obtaining legal decisions (verdict confidence and estimation of the likelihood of guilt for the defendant). As a result, it was found that the verdict category did not significantly affect the legal decision of layperson. However, the guilty verdict rate of the 'guilty/innocent' condition tended to be higher than those of the 'guilty/not guilty' condition. The layperson's representation of 'innocent' and the verdict category had an interaction effect on the difference between BRD and IT (threshold change) at the significance level of .1. In the 'guilty/innocent' condition, the threshold change varying with layperson's representation of 'innocent' was larger than in the 'guilty/not guilty' condition. In comparing the function of BRD and IT, IT significantly predicted the lay person's legal decision at the significance level of .1 by interacting with the likelihood of guilt for the defendant. Therefore, it could be said that IT was a better threshold estimator than BRD. The implication of this study is that it provided experimental evidence for the effect of the verdict category of lay-participation trial in Korea, which is a problem often raised among lawyers, and suggested logical reasoning and empirical grounds for the psychological mechanism of the possible effect.

A Study on Synthesis of Ca and Mg Compounds from Dolomite with Salt Additional React (MgCl2·6H2O) (염 첨가 반응(MgCl2·6H2O)을 이용하여 백운석으로부터 Ca 화합물과 Mg 화합물 합성에 관한 연구)

  • Hwang, Dae Ju;Yu, Young Hwan;Cho, Kye Hong;Lee, Jong Dae
    • Korean Chemical Engineering Research
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    • v.59 no.3
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    • pp.399-409
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    • 2021
  • In order to utilize dolomite as a calcium/magnesium compound material, it was prepared highly reactive calcined dolomite(CaO·MgO) using a microwave kiln (950 ℃, 60 min). The experiment was performed according to the standard of the hydration test (ASTM C 110) and hydration reactivity was analyzed as medium reactivity (max 74.1 ℃, 5 min). Experiments were performed with calcined dolomite and salt (MgCl2·6H2O) (a) 1:1, (b) 1:1.5, and (c) 1:2 wt% based on the hydration reaction of calcined dolomite. The result of X-ray diffraction analysis confirmed that MgO of calcined dolomite increased to Mg(OH)2 as the salt addition ratio increased. After the separating reaction, calcium was stirred at 80 ℃, 24 hr that produced CaCl2 of white crystal. XRD results, it was confirmed calcium chloride hydrate (CaCl2·(H2O)x) and CaO of calcined dolomite and salt additional reaction was separated into CaCl2. And it was synthesized with Ca(OH)2 99 wt% by NaOH adding reaction to the CaCl2 solution, and the synthesized Ca(OH)2 was manufactured CaO through the heat treatment process. In order to prepare calcium carbonate, CaCO3 was synthesized by adding Na2CO3 to CaCl2 solution, and the shape was analyzed in cubic form with a purity of 99 wt%.

The Discourse on Girls and the Comics in the 1970s Magazine, Schoolgirl - A Forced Model and the Invented Cheerfulness (1970년대 잡지 『여학생』의 소녀 담론과 만화 -강요된 모범과 만들어진 명랑)

  • Kim, So-Won
    • Journal of Popular Narrative
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    • v.27 no.3
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    • pp.13-51
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    • 2021
  • The aim of this essay is to illustrate Sunjung Manhwa in the 1970s which has been alienated in comics studies. This essay analyses the articles and the serial comics in Schoolgirl, the magazine in the 1970s, and examines the ideal representations of the girls at that time. Sunjung Manhwa is really different between the 1960s and 1970s. It cannot be explained on this gap just by analyzing Sunjung Manhwa in book form alone. Even though the censorship on comics was the element that has hampered the development of comics as a whole, the slumps of Sunjung Manhwa in the 1970s were very excessive compared to other comics genres. This article can gain the answers to the reason of the changes of Sunjung Manhwa by studying the magazines which was the main mass media aimed at girls with Sunjung Manhwa. While the articles in magazines show the editing direction and its characteristics, they reflect the values and ideologies at that time. The same is true for the comics in the magazines. Especially, the comics in the magazines was relatively free from the censorship. This essay examined how the articles and the comics in the girls' magazine in the 1970s represented the images of girls at the time by focusing on feature articles and comics in the magazine, Schoolgirl. This article explored Um, Hee-Ja's Blue Zone and Bang, Young-Jin's Mini March among a full-length serial comics in the magazine, Schoolgirl. Both Blue Zone and Mini March reveal the images of an ideal girl that has been emphasized by the articles in Schoolgirl. Blue Zone draws the appearances of an earnest and obedient daughter, and Mini March represents the figures of a cheerful and bright girl. Through this study, it can be recognized that the magazines in the 1970s highly appraised girls who are obedient to a given society and serve to a harmonious family as ideal ones, and it might be guessed that the ideal images of girls that was characterized ceaselessly by the magazines were the standard of the censorship on comics and its creativity and had also a huge impact on the contents and the expressions of a great deal of works. The 1970s was the times when its importance has been lost in the history of the comics studies by the censorship on the comics and the monopoly of "Hapdong(합동) publisher." The limits of expression in terms of censorship were awfully distinct, so its result was few of good works in quality, and there are still many blanks in the study on 1970s' comics. This study has a meaning which fills up a blank in the comics studies.

Narrative Structure and Ludonarrative Dissonance in the Video Game, "Red Dead Redemption 2" (<레드 데드 리뎀션 2>의 서사 형식과 서사 부조화)

  • Chun, Bum-Sue
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.5
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    • pp.59-72
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    • 2020
  • Video games have become a powerful tool to tell a complex story realistically thanks to modern technology. Rockstar Games' Red Dead Redemption 2 (2018), is a video game title that touts cinematic qualities such as superb acting by the voice actors and jaw-dropping cinematography as well as a rich narrative following the protagonist, Arthur Morgan's quest for redemption. Using Aristotle's Poetics and Robert Mckee's Aristotelian theory on storytelling, this study highlights Arthur's gradual change from a ruthless gunman to an altruistic hero, from which it derives the theme of redemption, and his super-objective to protect those he cares about. Then, it also explains a variety of possibilities in the narrative of the game determined by the opened-ended game mechanics, particularly the "honor" system, which reflects Arthur's moral choices on the narrative presentation with different sets of dialogue and endings. However, the study ultimately argues Red Dead Redemption 2 to be incohesive in its storytelling due to "ludonarrative dissonance," a concept coined by Clint Hocking, which indicates a conflict between the narrative and game mechanics of a video game. It's mainly because the game's various narrative choices bring changes to neither the theme nor Arthur's super-objective. Furthermore, the double-standard of evaluation in the "honor" system, and its numeric ranking system of honor also lend themselves to ludonarrative dissonance even further. After all, the study ultimately claims ludonarrative dissonance in Red Dead Redemption essentially disrupts the game's narrative unity, which is Aristotle's one of most emphasized upon traits of any story and signifies the game's instability as a storytelling medium.

Development of Diameter Distribution Change and Site Index in a Stand of Robinia pseudoacacia, a Major Honey Plant (꿀샘식물 아까시나무의 지위지수 도출 및 직경분포 변화)

  • Kim, Sora;Song, Jungeun;Park, Chunhee;Min, Suhui;Hong, Sunghee;Yun, Junhyuk;Son, Yeongmo
    • Journal of Korean Society of Forest Science
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    • v.111 no.2
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    • pp.311-318
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    • 2022
  • We conducted this study to derive the site index, which is a criterion for the planting of Robinia pseudoacacia, a honey plant, and to investigate the diameter distribution change by derived site index. We applied the Chapman-Richards equation model to estimate the site index of the Robinia pseudoacacia stand. The site index was distributed within the range of 16-22 when the base age was 30 years. The fitness index of the site index estimation model was low, but we judged that there was no problem in the application because the residual distribution of the equation had not shifted to one side. We used the Weibull diameter distribution function to determine the diameter distribution of the Robinia pseudoacacia stand by site index. We used the mean diameter and the dominant tree height as independent variables to present the diameter distribution, and our analysis procedure was to estimate and recover the parameters of the Weibull diameter distribution function. We used the mean diameter and the dominant tree height of the Robinia pseudoacacia stand to show distribution by diameter class, and the fitness index for dbh distribution estimation was about 80.5%. As a result of schematizing the diameter distribution by site indices as a 30-year-old, we found that the higher the site index, the more the curve of the diameter distribution moved to the right. This suggests that if the plantation were to be established in a high site index stand, considering the suitable trees on the site, the growth of Robinia pseudoacacia woul d become active, and not onl y the production of wood but al so the production of honey would increase. We therefore anticipate that the site index classification table and curve of this Robinia pseudoacacia stand will become the standard for decision making in the plantation and management of this tree.