• 제목/요약/키워드: Withholding

검색결과 85건 처리시간 0.025초

연명치료 중단의 입법화 방안에 관한 연구 - 성년후견제도의 도입과 관련하여 - (A Study on the Method of Legislation on Withholding or Withdrawing of LST -In relation to the introduction of adult guardianship-)

  • 이은영
    • 의료법학
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    • 제10권2호
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    • pp.203-249
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    • 2009
  • It is the so-called Shinchon Severance Hospital Case brought to an end by the decision of the Supreme Court that opened the real discourse of withholding or withdrawing of LST (Life-Sustaining Treatment) in the legal profession as well as medical profession in Korea. Everyone has sympathy with the validity and necessity of legal regulation on withdrawing-including withholding-of LST save the requirements & procedure of withdrawing of LST. In this situation, the legislative bill of amendment to the Korean Civil Law introducing of adult guardianship was pre-announced by the Ministry of Justice on September 18th 2009. The adult guardianship is a guardianship system that supports an mentally handicapped adult to deal with his affairs by support of a guardian. The object of adult guardianship includes affairs of body or well-being as well as property of adult wards. In particular, affairs of medical matters are of importance in the duty and authority of adult guardians. So, the introduction of adult guardianship is of much importance de lege lata as well as de lege ferena in the discussion of withdrawing of LST as a medical treatment. Since the legislation on withdrawing of LST intents to protect the right of death with dignity on the basis of patients' autonomy, the ratio legis of withdrawing of LST is variant from that of adult guardianship. In this context, it seems reasonable to legislate the withdrawing of LST separately from the adultguardianship. In the meantime, the adult guardianship of the legislative bill of amendment to the Korean Civil Law is related to the withdrawing of LST, since the main purpose of adult guardianship is to protect patients' quality of lives and to regulate guardianship contracts based on patients' autonomy. In that context, it seems reasonable to incorporate the legislation of withdrawing of LST into the adult guardianship system. In the latter case, it is not easy to adopt the withdrawing of LST into the legislative bill of the Korean Civil Law for the bill is pre-announced already as previously stated. However, the legislation of withdrawing of LST is not inferior to the legislation of adult guardianship as a matter of urgency. Moreover, it is likely that the legislative bill of Amendment to the Korean Civil Law generates discrepancies in interpretation of the requirements & procedure of withdrawing of LST as the amended German Civil Law did. In short, it is desirable for the legislator to revise the legislative bill despite delay.

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한국 변호사들의 연명치료중단에 대한 태도 (Attitude of Korean Lawyers toward Withdrawal of Life Sustaining Treatment)

  • 이경남;김분한;이훈희
    • Journal of Hospice and Palliative Care
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    • 제13권2호
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    • pp.81-88
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    • 2010
  • 목적: 본 연구는 연명치료중단에 대한 한국변호사들의 태도유형을 구분하고, 각 유형별 특성과 유형별 차이점을 파악하는 주관성 연구를 위해 실시되었다. 방법: 본 연구 설계는 Q 방법론을 이용하였다. 본 연구의 대상자는 32~69세의 변호사 24명을 대상으로 하였다. 연명치료중단에 대한 태도 유형을 확인하기 위한 Q 표본은 이들 중 5인을 대상으로 한 심층면담, 문헌고찰, TV토론을 통해 확보하여 34문항의 진술문을 구성하였다. 대상자에게 연구의 목적과 방법을 설명하여 동의를 구한 후 인구사회학적 특성을 파악하기 위한 질문지를 작성하였고, 9점 Q 표본 분포도상에 강제 분포하도록 하였다. 결과: 수집된 자료는 QUANL PC 프로그램으로 처리하여 최종적으로 유형을 구분하였다. 그 결과 5가지 유형이 구분되었으며, 제1유형은 연명치료중단에 대한 확고한 신념이 있는 '연명치료중단 선택형', 제2유형은 비용이 얼마나 소요되든지 생명연장술을 시행하여야 한다는 '생명연장술 추구형', 제3유형은 연명치료중단이나 생명연장술이나 모두 인간의 권리에 해당하며, 이런 권리를 충분히 행사하기 위해 제도적 장치를 요구하는 '제도요구형', 제4유형은 연명치료중단에 동의를 하지만, 본인은 연명치료중단을 선택하지 않을 것이라는 모순된 태도를 보이는 '자기모순형', 제5유형은 생명은 하나님만이 판단할 수 있다고 하고, 인간에게는 죽음을 선택할 권리가 없다는 '인명재천형'으로 분석되었다. 결론: 연명치료중단에 대한 한국 변호사들의 태도는, 제1유형 '연명치료중단 선택형', 제2유형 '생명연장술 추구형', 제3유형 '제도요구형', 제4유형 '자기모순형', 제5유형 '인명재천형'으로 나타났다.

신용카드 상담사례를 통해 본 소비자문제의 유형과 개선 방안 (Consumer Complaints and Settlements on Credit Cards)

  • 김경자
    • 가정과삶의질연구
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    • 제19권1호
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    • pp.77-93
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    • 2001
  • This paper examines consumer problems and issues of credit card use. The cases of credit card problems were from a civil consumer organization called Green Consumers Network in Korea. This paper focused on over five concerns, including credit card issuing, lost or stolen card settlements, vendor fee charging to customer, withholding payment in case of unsatisfactory purchases, and abusive debt collecting practices. Some solutions for the consumer problems were suggested.

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연명(延命)치료적 인공기계호흡요법의 보류(保留)/중지(中止)를 전후한, 법의학적 및 윤리적 문제들과 그 대처방안 (The Medico-Legal and Ethical Problems of Withholding / Withdrawing of Futile Life-Sustaining Mechanical Respirator treatment)

  • 김건열
    • Tuberculosis and Respiratory Diseases
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    • 제58권3호
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    • pp.213-229
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    • 2005
  • The first and the longest criminal indictment case of Korean medico-legal battle, so called BORAMAE Hospital Incident, was finally on its end by Korean Supreme Court's decision on June 24, 2004, after 7 years long legal dispute via Seoul District Court and Seoul Superior Appeal Court's decision. Boramae Hospital case was the first Korean legal case of Withdrawing Life-sustaining treatment of mechanical respirator on 58 years old Extradural Hematoma victim who was on Respirator under Coma after multi-organ failure postoperatively(APACHE II score: 34-39). Two physicians who have involved patient's care and had helped to make discharge the Near-death patient to home after repeated demand of patient's wife, due to economic reason, were sentenced as homicidal crime. This review article will discuss the following items with the review of US cases, Quinlan(1976), Nancy Cruzan(1990), Barber (1983), Helen Wanglie(1990), Baby K (1994) and Baby L cases, along with Official Statement of ATS and other Academic dignitaries of US and World.: [1] Details of Boramae Hospital incident, medical facts description and legal language of homicidal crime sentence. [2] The medical dispute about the legal misinterpretation of patient's clinical status, regarding the severity of the victim with multi-organs failure on Respirator under coma with least chance of recovery, less than 10% probability. [3] Case study of US, of similar situation. [4] Introduction of ATS official Statement on Withdrawing/ Withholding Life sustaining treatment. [5] Patient Autonomy as basic principle. [6] The procedural formality in Medical practise for keeping the legitimacy. [7] The definition of Medical Futility and its dispute. [8] Dying in Dignity and PAS(Physician Assisted Suicide)/and/or Euthanasia [9] The Korean version of "Dying in Dignity", based on the Supreme Court's decision of Boramae Hospital incident (2004.6.24.) [10] Summary and Author's Note for future prospects.

디지털 음악시장에서 음원사용료 징수 개정안의 고찰-2013년 징수개정안을 중심으로 (Pricing Policy of Music Service in Digital Music Market-focused on the Regulations for the Digital Music Service)

  • 정지영
    • 디지털융복합연구
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    • 제13권4호
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    • pp.341-348
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    • 2015
  • 디지털 음악시장이 급속히 성장함에 따라 법률적 제도의 측면에서 창작의 주체인 저작권자들의 권익이 논쟁의 중심이 되고 있다. 전 세계 음악시장에서 이미 디지털 음악 매출이 음반매출을 추월하고 있으며 이러한 디지털 음악시장의 높은 상승세는 이전의 다운로드 방식에서 실시간 재생 서비스의 형태로 급속히 바뀌어 가고 있다. 이러한 추세는 국내 음악산업에서도 동일하며 이로 인해 음원 사용료 징수와 창작자들에 대한 이익분배는 큰 이슈가 되고 있다. 2013년 문체부에서는 음원 사용료 징수 규정을 발표하였는데 음원에 대하여 기존의 정액제가 아닌 종량제로 바뀌어 사용자가 이용횟수에 따라 요금을 지불하는 방식이 되었다. 그러나 종량제의 시행에도 불구하고 저작권자에게 돌아가는 이익은 여전히 낮고 소비자에게는 서비스 요금 인상을 가져오는 문제점을 가지고 있다. 그러므로 창작자들의 창작의식 고취와 소비자들의 만족도를 아울러 높일 수 있는 제도개선과 올바른 인식의 변화가 요구되어진다.

간호사 자신과 간호사 가족의 연명의료 결정과 관련요인 (Life-Sustaining Treatment Choices and Related Factors Involving Hospital Nurses)

  • 최유남;송영숙
    • 한국보건간호학회지
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    • 제32권2호
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    • pp.167-180
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    • 2018
  • Purpose: The aim of this study was to identify the life-sustaining treatment choices and related factors among general hospital nurses. Data were collected from June 16 to June 29, 2015. The participants were 244 nurses from five general hospitals in D city. Methods: The data were analyzed using the SPSS 18.0 program, descriptive statistics, paired t-test and one-way ANOVA. Results: Significant differences were observed in the level of life-sustaining treatment choices for nurses to themselves and to their families except for pain control. More nurses declined life-sustaining treatment choices, but suggested their families receive it. The related factors of special life-sustaining treatment choices for nurses themselves and their families according to their general characteristics were age, marital status, education and religion. Conclusion: This study suggests that the related factors need to be considered in the education of nurses' or public health providers' Life-sustaining treatment choices.

국내산 파티클보드에 대한 나무못의 직경과 천공여척이 나무못 유지력에 미치는 영향 (The Effect of Diameter and Prehole Clearance for Wooden Dowel on the Withdrawal Loads of Domestic Particleboard)

  • 김범준;차재경
    • 한국가구학회지
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    • 제28권1호
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    • pp.53-59
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    • 2017
  • Wooden dowels are commonly used to join the particleboard members together in many types of structures, But little information is available concerning their holding properties in domestic particleboard. This study was performed to determine the withdrawal loads and strengths on the effect of diameter of dowel and hole clearance. The test block was manufactured from 15 mm thick domestic particleboard. The dowel was manufactured 6, 8 and 10 mm diameters from korean castanea, korean pine and tuliptree. Research reported here indicates that withdrawal loads increase, but withdrawal strengths decrease, as the dowel diameter increases. This study also indicates that dowel withholding load and strength for particleboard less decrease than those for domestic wood as a hole clearance decreases.

키아리기형 (Chiari Malformation)

  • 한정훈
    • 보험의학회지
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    • 제27권1호
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    • pp.37-38
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    • 2008
  • The concept of Chiari malformations emerged toward the end of $19^{th}$ century from Chiari's initial descriptions of "alterations in the cerebellum resulting from cerebral hydrocephalus." In 1891, Hans Chiari(1851-1916) suggested cerebellar ectopia in which he classified Type I as "elongation of the tonsils and medial parts of the inferior lobes of the cerebellum into cone-shaped projections, which accompany the medulla oblongata into the spinal canal. The incidence of Chiari malformation has been found to be between 0.56% and 0.77% on MR imaging studies, as well as 0.62% in brain dissection studies. the definition of the adult Chiari malformation has varied with the evolution of neurodiagnositic capabilities and knowledge of physiopathology. This disorder can be associated with significant symptomatology, risk of secondary injury due to trauma, and the risk of progression and damage of the spinal cord due to associated Syringomyelia. Syringomyelia is found in 50 to 70% of Chiari I malformation. It is the clinical judgment of the physicians evaluating this disorder that is of the importance to avoid the therapeutic extremes of pursuing unnecessary surgery or withholding necessary treatment from patients.

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Deciding not to Operate in Head Injuries and Legal Considerations

  • Choi, Il;Lee, Kyeong-Seok;Shim, Jai-Joon;Choi, Weon-Rim
    • Journal of Korean Neurosurgical Society
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    • 제42권2호
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    • pp.135-140
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    • 2007
  • It is not the best way to treat a hopeless patient with life-sustaining medical devices until the heart beats stop. Advanced medical technology may prolong the life for a significant period without recovery from the disease. However, it would give an unbearable economic burden to the family and the society. In 2006, we decided not to operate 9 patients with traumatic intracranial hematomas. We examined those patients with special references to possible legal and ethical problems. It is reasonable to withhold a treatment after documentation that the family never wants any life sustaining treatment when the treatment does not guarantee the meaningful life.

영유아 급성 설사의 영양 공급: 탈수 치료 후 연령별 식이요법을 중심으로 (Nutritional Support for Acute Diarrhea in Children: Focused on Age-appropriate Diet Therapy after Rehydration)

  • 추미애;최병호
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제12권sup1호
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    • pp.53-61
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    • 2009
  • The mainstay in the management of mild to moderately dehydrated children is fast rehydration by using hypotonic ORS (oral rehydration solution) and complete resumption of normal diet, including lactose-containing formula after 4 hours rehydration. Since the majority of young children with uncomplicated acute diarrhea will tolerate large amounts of undiluted non-human milk, withholding food and milk from children during diarrhea is not recommended anymore, regarding time to resolution and diarrhea control. In addition, routine dilution of milk and routine use of lactose-free formula are not necessary after fast ORS therapy. Breastfed infants and children fed with solid foods may safely continue receiving their usual diets during diarrhea instead of gradual reintroduction of feeding. However, young infants or children with severe diarrhea or malnutrition should be carefully treated under supervision if fed with lactose containing, non-human milk exclusively.