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Current Status of Informed Consent Form for Acupotomy in Korean Medicine Hospitals and Development of a Standard Informed Consent Form Using Delphi Method (한방병원의 침도 시술 동의서의 현황 조사와 델파이 기법을 활용한 표준 시술 동의서 개발)

  • Jihun Kim;Bonhyuk Goo;Hyongjun Kim;Kyoungsuk Seo;Myungjin Oh;Myungseok Ryu;Sang-Hoon Yoon;Kwang Ho Lee;Hyun-Jong Lee;Jungtae Leem;Hyungsun Jun;Jeong Ihn Sook;Sung Woon Choi;Tae Wook Lee;Yeonhak Kim;Yoona Oh;Kunhyung Kim;Gi Young Yang;Eunseok Kim
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.182-201
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    • 2024
  • Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine. Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert. Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed. Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.

Analysis of the Spatial Dose Rates during Dental Panoramic Radiography (치과 파노라마 촬영에서 공간선량률 분석)

  • Ko, Jong-Kyung;Park, Myeong-Hwan;Kim, Yongmin
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.509-516
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    • 2016
  • A dental panoramic radiography which usually uses low level X-rays is subject to the Nuclear Safety Act when it is installed for the purpose of education. This paper measures radiation dose and spatial dose rate by usage and thereby aims to verify the effectiveness of radiation safety equipment and provide basic information for radiation safety of radiation workers and students. After glass dosimeter (GD-352M) is attached to direct exposure area, the teeth, and indirect exposure area, the eye lens and the thyroid, on the dental radiography head phantom, these exposure areas are measured. Then, after dividing the horizontal into a $45^{\circ}$, it is separated into seven directions which all includes 30, 60, 90, 120 cm distance. The paper shows that the spatial dose rate is the highest at 30 cm and declines as the distance increases. At 30 cm, the spatial dose rate around the starting area of rotation is $3,840{\mu}Sv/h$, which is four times higher than the lowest level $778{\mu}Sv/h$. Furthermore, the spatial dose rate was $408{\mu}Sv/h$ on average at the distance of 60 cm where radiation workers can be located. From a conservative point of view, It is possible to avoid needless exposure to radiation for the purpose of education. However, in case that an unintended exposure to radiation happens within a radiation controlled area, it is still necessary to educate radiation safety. But according to the current Medical Service Act, in medical institutions, even if they are not installed, the equipment such as interlock are obliged by the Nuclear Safety Law, considering that the spatial dose rate of the educational dental panoramic radiography room is low. It seems to be excessive regulation.

A Basic Study to Establish a Framework Act on Landscape Architecture (조경 기본법 제정을 위한 기초 연구)

  • Shin, Ick-Soon;Koo, Bon-Hak;Byeon, Jae-Sang
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.6
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    • pp.86-97
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    • 2011
  • This study analyzed the necessity of the tentatively-named "Framework Act on Landscape Architecture" as an umbrella law in the field of landscape architecture regarding legal, industrial, and academic aspects and is intended to provide basic data to suggest the optimal legal system and legislative proceedings to control it. This study can be summarized as follows: First, a form of framework act on landscape architecture is appropriate for a compromise between ideal type and political framework. Some content is suitable for proclamatory character including present and future issue related to the landscape architecture fields. Second, legislative proceedings are more reasonable as motions coming from assembly proposals rather than government. Motions by assembly proposal recommend the following procedure: submission of a legislative bill by an assemblyperson, passing of a permanent commission, review by government, leading approval by emphasis on correspondence with the principle to carry out government affairs, proclamation. Third, a frame based on content and form can be made up of a total of 7 chapters 34 articles. The function must include the following: the suggestion of direction for government policy, the systematization of the institution and what it includes, the control of government administration, a public service system regarding public relations for landscape architecture and so on. The results of this study will form a social consensus about the necessity of a framework act regarding landscape architecture fields and contribute to informing the importance of landscape architecture as related to other industrial fields.

Study on the effect of small and medium-sized businesses being selected as suitable business types, on the franchise industry (중소기업적합업종선정이 프랜차이즈산업에 미치는 영향에 관한 연구)

  • Kang, Chang-Dong;Shin, Geon-Chel;Jang, Jae Nam
    • Journal of Distribution Research
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    • v.17 no.5
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    • pp.1-23
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    • 2012
  • The conflict between major corporations and small and medium-sized businesses is being aggravated, the trickle down effect is not working properly, and, as the controversy surrounding the effectiveness of the business limiting system continues to swirl, the plan proposed to protect the business domain of small and medium-sized businesses, resolve polarization between these businesses and large corporations, and protect small family run stores is the suitable business type designation system for small and medium-sized businesses. The current status of carrying out this system of selecting suitable business types among small and medium-sized businesses involves receiving applications for 234 items among the suitable business types and items from small and medium-sized businesses in manufacturing, and then selecting the items of the consultative group by analyzing and investigating the actual conditions. Suitable business type designation in the service industry will involve designation with priority on business types that are experiencing social conflict. Three major classifications of the service industry, related to the livelihood of small and medium-sized businesses, will be first designated, and subsequently this will be expanded sequentially. However, there is the concern that when designated as a suitable business type or item, this will hinder the growth motive for small to medium-sized businesses, and designation all cause decrease in consumer welfare. Also it is highly likely that it will operate as a prior regulation, cause side-effects by limiting competition systematically, and also be in violation against the main regulations of the FTA system. Moreover, it is pointed out that the system does not sufficiently reflect reverse discrimination factor against large corporations. Because conflict between small to medium sized businesses and large corporations results from the expansion of corporations to the service industry, which is unrelated to their key industry, it is necessary to introduce an advanced contract method like a master franchise or local franchise system and to develop local small to medium sized businesses through a franchise system to protect these businesses and dealers. However, this method may have an effect that contributes to stronger competitiveness of small to medium sized franchise businesses by advancing their competitiveness and operational methods a step further, but also has many negative aspects. First, as revealed by the Ministry of Knowledge Economy, the franchise industry is contributing to the strengthening of competitiveness through the economy of scale by organizing existing individual proprietors and increasing the success rate of new businesses. It is also revealed to be a response measure by the government to stabilize the economy of ordinary people and is emphasized as a 'useful way' to revitalize the service industry and improve the competitiveness of individual proprietors, and has been involved in contributions to creating jobs and expanding the domestic market by providing various services to consumers. From this viewpoint, franchises fit the purpose of the suitable business type system and is not something that is against it. Second, designation as a suitable business type may decrease investment for overseas expansion, R&D, and food safety, as well negatively affect the expansion of overseas corporations that have entered the domestic market, due to the contraction and low morale of large domestic franchise corporations that have competitiveness internationally. Also because domestic franchise businesses are hard pressed to secure competitiveness with multinational overseas franchise corporations that are operating in Korea, the system may cause difficulty for domestic franchise businesses in securing international competitiveness and also may result in reverse discrimination against these overseas franchise corporations. Third, the designation of suitable business type and item can limit the opportunity of selection for consumers who have up to now used those products and can cause a negative effect that reduces consumer welfare. Also, because there is the possibility that the range of consumer selection may be reduced when a few small to medium size businesses monopolize the market, by causing reverse discrimination between these businesses, the role of determining the utility of products must be left ot the consumer not the government. Lastly, it is desirable that this is carried out with the supplementation of deficient parts in the future, because fair trade is already secured with the enforcement of the franchise trade law and the best trade standard of the Fair Trade Commission. Overlapping regulations by the suitable business type designation is an excessive restriction in the franchise industry. Now, it is necessary to establish in the domestic franchise industry an environment where a global franchise corporation, which spreads Korean culture around the world, is capable of growing, and the active support by the government is needed. Therefore, systems that do not consider the process or background of the growth of franchise businesses and harm these businesses for the sole reason of them being large corporations must be removed. The inhibition of growth to franchise enterprises may decrease the sales of franchise stores, in some cases even bankrupt them, as well as cause other problems. Therefore the suitable business type system should not hinder large corporations, and as both small dealers and small to medium size businesses both aim at improving competitiveness and combined growth, large corporations, small dealers and small to medium sized businesses, based on their mutual cooperation, should not include franchise corporations that continue business relations with them in this system.

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