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Acceptance, Modification and Rejection of Paternalism in Korean Medical Law (한국 의료법에서 후견주의 이념의 수용, 변형 그리고 거부 - 치료중단에 대한 법원 판결을 중심으로 -)

  • Kim, Na-Kyoung;Harmon, Shawn H.E.
    • Development and Reproduction
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    • v.14 no.2
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    • pp.143-154
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    • 2010
  • This article analyzes two leading Korean cases which led to opposite conclusions: the Boramae Hospital Case (Korean Supreme Court 2002 Do 995) and the Shinchon Severance Hospital Case (Korean Supreme Court 2009 Da 17471). In doing so, it pays particular attention to the acceptance, modification, and rejection of paternalism, specifically 'physician paternalism' and 'familial paternalism', both of which have long and strongly influenced the Korean medical environment. In Boramae Hospital, the Court emphasized the obligation of the physician in terms of the life of the patient (eg: protecting and preserving the life and welfare of the patient). Its position seemed to be based on the traditional physician paternalism which presupposes the ability of physicians to identify right and wrong choices according to natural laws. However, the Court saw itself as the final arbiter of who identifies and determines the real world content and consequences of that natural law. In short, the Court elevated itself to the supreme guardian of the patient, and held that its decision cannot be overruled by that of the patient's family. So without specifically referring to the importance of the family and the role of familial decisions, both long-observed traditions in medical decision-making in Korea, the Court shifted away from familial paternalism. In Shinchon Severance Hospital, the Court explained the meaning of the patient's powers of self-rulemore concretely, explaining its scope and substance in greater detail. The Court held that one can exercise the right of self-rule, even over issues such as death, in the form of 'previous medical directions'. However, this case does not represent a wholesale acceptance of medical autonomy (ie: it does not accept self-rule unconditionally). Rather, the Court accepted the importance of the opinions and decision of physicians and of the Hospital Ethics Commission, and the Court still retained to itself the authority to review and make alterations to 'material' decision. The Court did not overlook the importance of the decision of the patient's family, but it also did not relinquish its status as supreme guardian, emphasizing the 'objective' nature of a decision from the court.

Analysis on the actual state and plan for improvement for vocational courses are operated consignment in General high school (일반고등학교 직업과정 위탁 운영의 실태 분석 및 개선 방안)

  • Yoon, Kyoung-Suk;Yi, Sang-Bong
    • 대한공업교육학회지
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    • v.36 no.2
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    • pp.131-150
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    • 2011
  • The purpose of this study vocational courses in general high schools in each city in order to operate efficiently. Provinces operating status and the general high school vocational courses through the regular high school vocational courses siltae analysis to identify operational problems, and that is to derive ways to improve. Operating in the desired direction, the typical high school vocational courses ilbango select students that meet the purpose of operating as one that students admit you need the correct promotion and career guidance and vocational courses ilbango teachers of vocational courses is operating correctly recognize the purpose and students with career guidance and vocational courses so that you can operate effectively at: Provincial Office-wide need to conduct a systematic study. Vocational courses also target students ilbango sosokgyo (wonjeokgyo) to be completed in the course stated in the plan for the school and the need to practice, and professional students ilbango by configuring a separate class is most preferable to operate. If the person is prime target, with each region run by creating a class needs to definitely consider. Entrusted to the agency's key performance improvements in order to improve the employment rate in the direction of promotional materials for the students selected to take advantage of college enrollment than the employment data for the students and their parents ilbango vocational courses for the purpose and intent is necessary to provide accurate information In addition, the employment rate is relatively low industrial (information) to install the school department employment, and employment representatives (industry-academia co-coordinator), and by placing career paths and industries to ensure the needs of industry, including working conditions and students who wish adjusting to the role, and industrial college (2 years), industrial (information) through the school's agreement to the aggressive promotional schemes seonchwieop hujinhak. Getting the need to encourage. Vocational courses ilbango in the new and the abolition, rather than the case of some popular course when you are away from work and there, so if the course-changing industry, new or repealed to reflect the demands of social work and careful review of how to connect carefully to decide by. Commissioned a systematic quality management in education, in terms of industry (information) schools and public vocational training institutions or private vocational school is better than school. However, 16 cities across the country. Also only five of the major cities around the school has industry information. Ilbango vocational courses at the expected continued demand. Degrees, the operation in terms of comparative advantage in many ways the school's new industry information is necessary to consider.

The Role of Open Innovation for SME's R&D Success (중소기업 R&D 성공에 있어서 개방형 혁신의 효과에 관한 연구)

  • Yoo, In-Jin;Seo, Bong-Goon;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.24 no.3
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    • pp.89-117
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    • 2018
  • The Korean companies are intensifying competition with not only domestic companies but also foreign companies in globalization. In this environment, it is essential activities not only for large companies but also Small and Medium Enterprises (SMEs) to get and develop the core competency. Particularly, SMEs that are inferior to resources of various aspects, such as financial resources etc., can make innovation through effective R&D investment. And then, SMEs can occupy a competency and can be survive at the environment. Conventionally, the method of "self-development" by using only the internal resources of the company has been dominant. Recently, however, R&D method through cooperation, also called "Open Innovation", is emerging. Especially SMEs are relatively short of available internal resources. Therefore, it is necessary to utilize technology and resources through cooperation with external companies(such as joint development or contract development etc.) rather than self-development R&D. In this context, we confirmed the effect of SMEs' factors on sales in Korea. Specifically, the factors that SMEs hold are classified as 'Technical characteristic', 'Company competency', and 'R&D activity' and analyzed how they influence the sales achieved as a result of R&D. The analysis was based on a two-year statistical survey conducted by the Korean government. In addition, we confirmed the influence of the factors on the sales according to the R&D method(Self-Development vs. Open Innovation), and also observed the influence change in 29 industrial categories. The results of the study are summarized as follows: First, regression analysis shows that twelve factors of SMEs have a significant effect on sales. Specifically, 15 factors included in the analysis, 12 factors excluding 3 factors were found to have significant influence. In the technical characteristic, 'imitation period' and 'product life cycle' of the technology were confirmed. In the company competency, 'R&D led person', 'researcher number', 'intellectual property registration status', 'number of R&D attempts', and 'ratio of success to trial' were confirmed. The R&D activity was found to have a significant impact on all included factors. Second, the influence of factors on the R&D method was confirmed, and the change was confirmed in four factors. In addition, these factors were found that have different effects on sales according to the R&D method. Specifically, 'researcher number', 'number of R&D attempts', 'performance compensation system', and 'R&D investment' were found to have significant moderate effects. In other words, the moderating effect of open innovation was confirmed for four factors. Third, on the industrial classification, it is confirmed that different factors have a significant influence on each industrial classification. At this point, it was confirmed that at least one factor, up to nine factors had a significant effect on the sales according to the industrial classification. Furthermore, different moderate effects have been confirmed in the industrial classification and R&D method. In the moderate effect, up to eight significant moderate effects were confirmed according to the industrial classification. In particular, 'R&D investment' and 'performance compensation system' were confirmed to be the most common moderating effect by each 12 times and 11 times in all industrial classification. This study provides the following suggestions: First, it is necessary for SMEs to determine the R&D method in consideration of the characteristics of the technology to be R&D as well as the enterprise competency and the R&D activity. In addition, there is a need to identify and concentrate on the factors that increase sales in R&D decisions, which are mainly affected by the industry classification to which the company belongs. Second, governments that support SMEs' R&D need to provide guidelines that are fit to their situation. It is necessary to differentiate the support for the company considering various factors such as technology and R&D purpose for their effective budget execution. Finally, based on the results of this study, we urge the need to reconsider the effectiveness of existing SME support policies.

A Study on Reorganization of System of Assistant Police Officer (치안보조인력 제도의 개편에 관한 연구)

  • Kim, Moon-Kwi
    • Korean Security Journal
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    • no.62
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    • pp.255-276
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    • 2020
  • The mandatory police system, which plays a pivotal role in securing security and securing social safety as a security assistant, is expected to face difficulties in supplying the mandatory police manpower and securing absolute police manpower in the future according to the Ministry of Defense's abolition of the conversion service system. In this situation, this study intends to provide a concrete plan to replace the mandatory police officers as security assistants, recruiting contractors from civilians who are not military service resources or regular police officers, and using them for security assistance. More ultimately, this study goes beyond securing obligatory police to reduce or abolish mandatory police, which has been dealt with in previous studies. It aims to present the rescue and operation directions so that the police can provide quality public security services. In order to achieve the purpose of this study, this study 1) analyzes the current situation of police personnel, derives the necessity and justification of securing the police personnel or increasing the number of police personnel due to changes in security demand and security environment, and 2) After discussing the necessity and direction of reorganization, 3) deriving policy implications through analysis of foreign cases operating similar systems to derive specific plans for the introduction of security contractors for private contract workers in Korea. This study reviewed the specific operation plan and legal and institutional maintenance plan of private contract workers. In order to achieve these research objectives, this study 1) analyzes the current status of the police manpower and derives the necessity and justification of securing an absolute police manpower or increasing the manpower of the police in response to changes in security demand and security environment, and the current security aid system. 2) After discussing the necessity and orientation of reorganization of exinsting system of assistant police officer, 3) derive policy implications through analysis of foreign cases utilizing security aids similar to Korea, and 4) The specific operation plan and legal and institutional maintenance plan were presented. including security aids for private contract workers in Korea, from recruitment procedures to activities.

Effect of Adenovirus-p53 to Non-Small Cell Lung Cancer Cell Lines (Adenovirus-p53이 비소세포폐암세포 성장에 미치는 영향에 관한 연구)

  • 박종호;이춘택;김주현
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1134-1146
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    • 1998
  • Background: The tumor suppressor gene p53 is one of the most frequently altered genes in human tumors, including those of the lung. There is now a compelling evidence that wild-type p53 can negatively influence cell growth by causing G1 arrest or by inducing apoptosis. The possibilities of using p53 for gene therapy are also gathering much interest. Material and Method: Our approach towards understanding p53 function would be to study the biological consequences of overexpression of wild-type p53 in normal and tumor cells by using adenovirus vectors capable of giving high levels of the p53 gene product in cells. We have used this vector containing wild-type p53 to infect tumor cells with different p53 status (null, mutant, or wild-type) to confirm that expression of p53 in null or mutant cell lines becomes possible by Adenovirus-p53 transduction, to examine the effects of high levels of p53 expression on the growth properties of tumor cells, to evaluate the role of apoptosis in p53-mediated biological effects, and to examine the effect of Adenovirus-p53 on the tumorigenicities of the lung cancer cell lines in vitro. Result: The results of our study showed that cells expressing endogenous mutant p53 and those devoid of p53 expression altogether were significantly more sensitive to Adenovirus-p53-mediated cytotoxicity compared to tumor cells expressing endogenous wild-type p53 and that overexpression of wild-type p53 induced programmed cell death. Also we knew that Adenovirus-p53 significantly reduced tumor colony formation of human non-small cell lung cancer cell lines, and decreased the growth of pre-formed colonies in vitro. Conclusion: These results suggest that adenovirus is an efficient vector for mediating transfer and expression of tumor suppressor genes in human non-small cell lung cancer cells and that the tumor cells null for p53 or expressing mutant p53 readily undergo apoptosis by Adenovirus-p53.

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The Role of Radiotherapy in Patients with Brain Metastasis (고형암의 뇌전이시 방사선치료 효과)

  • Lee Soon Nam;Choo Mi-Soon;Lee Kyung-Ja;Nam Eunmi
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.281-286
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    • 1999
  • Purpose : Brain metastases are the most frequent metastatic neurologic complication of systemic cancer. Even if the prognosis of brain metastases is grave, with available treatments, most patients experience effective palliation of neurologic symptoms and meaningful extension of life. We evaluated the clinical features and prognostic factors of the patients who were diagnosed as solid tumors with brain metastasis and received radiotherapy for brain metastases. Materials and Methods: Between January 1987 and January 1998, 71 patients with brain metastases from solid malignancy were included. We reviewed neurologic symptoms and signs of patients and evaluated improvememt of neurologic symptoms and signs. Survival durations after brain metastasis were ana lysed according to several factors such as age, performance status, primary malignancies, the pre-sence of brain metastasis at initial diagnosis of primary tumor, multiplicity of brain metastass, the presence of metastases other than brain, and treatment method. Results: Frequent symptoms associated with brain metastasis were headache (47.9$\%$), motor weakness (40.8$\%$), nausea and vomiting (19.7$\%$) and mental change (19.7%). Palliation of these symptoms was accomplished in 64.9$\%$ of cases. The overall median survival time was 16 weeks and 1- and 2-year survival rates were 15.0$\%$ and 5.1$\%$ respectively. Patients without extracranial metastases (n=27) had longer median survival than patients with extracranial metastases (33 weeks vs 10 weeks, p=0.0018). In patients with single brain metastasis (n=37), the median survival time was longer in patients treated with surgery plus radiotherapy than in patients treated with radiotherapy alone (40 weeks vs 16 weeks, p=0.0438). Conclusion: Patients who has brain metastases only constitute a prognostically favorable group and they may be benefited from radiotherapy and surgery if indicated.

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A Study on the Strategies of Growth in Small & Medium Construction Firms (강원지방 중소건설업의 성장전략에 관한 연구)

  • Kim, Beom-Jin;Cho, Chang-Jin
    • Korean Business Review
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    • v.19 no.1
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    • pp.53-80
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    • 2006
  • This research has been accomplished to build up the growth strategies of Kangwon district's small & medium-sized construction firms. For this purpose, we made an investigation of the present situation and status for existing regional small & medium construction firms by analyzing data. Based on the results from this study, the following growth strategies are suggested to gain their competitive advantages. Firstly, most of all, the role of the top manager is the most important factor since most of the top manager for the small & medium-sized construction firms coincide with the owner the firms. Secondly, the specialization strategy is to establish. Above all they concentrate their business capacities on core business. Then, this growth strategy should be based on the selective escalation of functions in order to maintain an appropriate level of construction works. Thirdly, the specialized skills and skilled workers are ensured for competitive advantages. For human resource development, they should train workers to be multi-functioned on the assumption the they could stay at firm until they wish to retire. Finally, the government must also spare no effort to encourage the small & medium-sized construction firms to build up it's competitive power and cultivate it's spontaneous generation power though the reformation of system related whit the small and medium construction industry.

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Therapeutic Compliance for Calcium Supplements and Its Related Factors in Rural Osteoporotic Women (일부 농촌지역 여성 골다공증 환자의 칼슘보조제 치료순응도와 결정요인)

  • Chun, Byung-Yeol;Kam, Sin;Lee, Young-Ja;Lee, Sang-Won;Lee, Kyung-Eun;Lee, Young-Seok;Kim, Bong-Kee
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.111-132
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    • 2001
  • This study was conducted to examine the therapeutic compliance and its related factors in rural women with osteoporosis. A questionnaire survey was performed from April to May in 2000 for 140 osteoporotic patients who were diagnosed from April to June in 1999 through community health program. The study employed the health belief model for predicting and explaining sick role behavior. The analysis techniques employed included contingency table analysis and path analysis using LISREL. The major results of this study were as follows: Of the subjects, 12.1% were continuously complaint, 53.6% were intermittently compliant, and 34.3% were non- compliant to calcium supplement therapy. As the result of path analysis, the therapeutic compliance was significantly higher(${\mid}T{\mid}$ >2.0) as patients had higher perceived severity of disease, lower perceived barriers of treatment, and when patients thought their disease status as severe. As the patients had higher educational level, more experience of mass media contact or health education about osteoporosis, and when family had more concern for patient treatment, they had higher perceived susceptibility of complication(bone fracture)${\mid}T{\mid}$ >2.0). The patients had higher perceived severity(${\mid}T{\mid}$ >2.0) as they had more educational level, more advice for treatment from their doctors, and when family had more concern for their treatment. As the patients had more advice for treatment from their doctors and when family had more concern for their treatment, they had higher perceived benefit of treatment and lower perceived barriers to treatment(${\mid}T{\mid}$ >2.0). In order to improve the therapeutic compliance in rural osteoporotic women, it would be necessary that the patient should recognize their disease severity properly. And the perceived barriers should be removed through supportive environments for osteoporosis treatment such as doctor 's more advice and family 's more concern for treatment. In addition, effective and continuous management system for osteoporotic patients should be established.

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Surgical Treatment for T4 Non-small Cell Lung Cancer Invading Mediastinal Structures (종격동 구조물을 침범한 T4 비소세포폐암의 수술적 치료)

  • 황은구;이해원;정진행;박종호;조재일;심영목;백희종
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.349-355
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    • 2004
  • Non-small cell lung cancer (NSCLC) with invasion of mediastinal structures is classified as stage IIIB, and has been considered surgically unresectable However, in a selected group of these patients, better results after surgical resection compared to non-surgical group have been reported. The aim of this study is to evaluate the role of surgical resection in treatment of mediastinal T4 NSCLC. Material and Method: Among 1067 patients who underwent surgical intervention for non-small cell lung cancer from Aug 1987 to Dec 2001 in Korea cancer center hospital, 82 patients had an invasion of T4 mediastinal structures (7.7%). Resection was possible in 63patients (63/82 resectability 76.8%). Their medical records in Data Base were reviewed, and they were followed up completely until Jun 2002. Surgical results and prognostic factors of NSCLC invading mediastinal structures were evaluated retrospectively. Result Lung cancer was resected completely in 52 patients (63.4%, 52/82). Lung resection was lobectomy (or more) in 14, pneumonectomy in 49. The mediastinal structures invaded by primary tumor were great vessel (61.9%), heart (19%), vagus nerve (9.5%), esophagus (7.9%), and vertebral body (7.9%). Nodal status was N0 in 11, N1 in 24, and N2 in 28 (44.4%). Neoadjuvant therapy was done in 6 (9.5%, 5 chemotherapy, 1 radiotherapy), and adjuvant therapy was added in 44 (69.8%, 15 chemotherapy, 29 radiotherapy) in resection group (n=63). Complication was occurred in 23 (31.7%), and operative mortality was 9.5% in resection group. Median and 5 year overall survival including operative mortality was 18.1 months and 21.7% in resection group (n=63), 6.2months and 0% in exploration only group (n=19, p=.001), 39 months and 32.9% in N2 (-) resection group (n=35), and 8.8 months and 8.6% in N2 (+) resection group (n=28, p=.007). The difference of overall survival by mediastinal structure was not significant. Conclusion: The operative risk of NSCLC invading mediastinal structures was high but acceptable, and long-term result of resection was favorable in selected group. Aggressive resection is recommended in well selected pateints with good performace and especially N2 (-) NSCLC with mediastinal invasion.

Task Analysis of Paramedics of Korea Based on DACUM Method (DACUM 기법에 의한 1급 응급구조사의 직무분석)

  • Bae, Ki-Sook;Koh, Bong-Yeun;Lee, Jung-Eun;Lee, In-Mo;Choi, Keun-Myoung;Kim, Soo-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.5-23
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    • 2011
  • Objective : This study grasps specific task on paramedics who plays a great role in the emergency scene, thereby eliciting definition of job called paramedics and analyzing occupation by DACUM method. Thus, the aim is to suggest working-level guidelines on the task of paramedics. Methods : It targeted paramedics who are working at hospitals, fire stations, and industries in Seoul and Gyeonggi area from Oct. 11, 2010 to Nov. 30. A total of 608 copies of questionnaire were analyzed by DACUM method. A research tool on occupational analysis consisted of 8 pieces for duty, 43 pieces for task, and 149 pieces for task elements. In order to survey performance frequency, importance, and difficulty by element, each task was developed by this research team, and each task was analyzed and finally elicited through workshop of DACUM method. Results : The occupational definition of paramedics, which was defined through this DACUM, was elicited as 'professional job of performing emergency medical care on the scene, during transferring, or within medical institution in order to maintain life and prevent wound deterioration, targeting a person who is put in emergency situation.' Task element, whose performance frequency was indicated to be the highest, was in order of checking mental status($2.76{\pm}0.497$), checking vital signs($2.70{\pm}0.578$), and airway/c-spine immobilization($2.69{\pm}.546$). Especially, defibrillation stood at $2.23{\pm}.655$ points. Task element, whose performance frequency was low, was in order of caring sexual abuse victims($1.32{\pm}0.563$), performing cricothyrotomy($1.36{\pm}0.618$), and caring cardiac arrest victims($1.40{\pm}0.636$). Importance of task was in order of airway/c-spine immobilization ($2.88{\pm}0.338$), maintenance of respiration($2.88{\pm}0.351$), caring cardiac arrest victims($2.87{\pm}0.349$), and performing CPR($2.87{\pm}0.361$). Task element, whose importance is low, was indicated to be in order of enema($2.29{\pm}0.736$), urinary catheterization($2.35{\pm}0.664$), and nasogastric intubation($2.35{\pm}0.667$). Task element, whose difficulty was shown to be the highest, was indicated to be in order of caring cardiac arrest victims during pregnancy ($2.60{\pm}0.559$), caring cardiovascular injury($2.59{\pm}0.546$), and labor management($2.53{\pm}0.533$). Conclusion : Based on the results of this study, the job performance work table(Dacom chart) of paramedics is suggested to be used, thereby being applied to development in education and curriculum of paramedics. It is necessary to evaluate usefulness of the job performance work table by estimating effect of education for paramedics based on the job performance work table of paramedics.