• Title/Summary/Keyword: duty of care

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Standards of Due Diligence and Separation of Responsibilities in the Division of Labor in Medicine (분업적 의료행위에 있어서 주의의무위반 판단기준과 그 제한규칙들)

  • Choi, Hojin
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.41-72
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    • 2018
  • In the division of labor (or teamwork) in medicine, the responsibility of medical and nursing staff should be separated or distributed to justify negligent criminal offenses. The present work refers to the standards by which the due diligence and responsibility of the individual persons are to be determined and delimited. In this context, it has been proven that objective theory as a measure of due diligence is appropriate. From a moral point of view, when assessing due diligence, it makes sense to impose greater individual or higher performance demands on the perpetrator, but law and order require that due diligence should result from socially relevant human behavior. To give objective measure of negligence and to provide the highest level of personal responsibility, so that man can not be burdened too much responsibility and it is accordingly with an equality theorem. Afterwards some points are presented, which should be considered in a concrete fact in the determination of the medical negligence. Medical action has specific characteristics such as professionalism, discretionary and exclusive, unbalance of information. These characteristics distinguish medical actions from general negligence. The general level of knowledge, the urgency, working condition and working environment of the medical facility, duration of the professional practice, assessment of the medical activity are crucial in this context. As a standard of delineation of due diligence, I have used the permitted risk and the principle of trust. In the horizontal division of labor, the principle of trust applies. The principle of trust applies in principle in cases of division of labor interaction, when doctors in the same hospital exercise their own specific occupational field or everyone works in another hospital. However, this is not true for every case. In the vertical division of labor, the principle of trust does not apply and the senior physician can not trust the assistant doctors. In this case, the principle of trust is converted into a duty of supervision for assistant doctors by the senior physician. This supervision requirement could be used as a random check.

Role-based User Access Control with Working Status for u-Healthcare System (u-Healthcare 시스템을 위한 RBAC-WS)

  • Lee, Bong-Hwan;Cho, Hyun-Sug
    • The KIPS Transactions:PartC
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    • v.17C no.2
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    • pp.173-180
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    • 2010
  • Information technology is being applied to the development of ubiquitous healthcare system, which provides both efficient patient care and convenient treatment regardless of patient's location. However, the increasing number of users and medical information give rise to the problem of user management and the infringement of privacy. In order to address this problem we propose a user access scheme based on the RBAC (Role Based Access Control) model. The preceding trust management model for Grid security, FAS(Federation Agent Server), was analyzed and extended to provide supplementary functions for role-based access control in u-Healthcare system. The RBAC model provides efficient user management and access control, but very vulnerable in case when one with valid role tries to leak confidential inner medical information. In order to resolve this problem, a RBAC-WS (Work Status with RBAC) model has been additionally developed which allows only qualified staffs to access the system while on duty. Th proposed RBAC and RBAC-WS model have been merged together and applied to the PACS (Picture Archiving and Communication System).

A Study of Perception and Practice on Family Nursing of Clinical Nurse (임상간호사의 가족간호에 대한 인식 및 수행정도에 관한 연구)

  • Oh, Moon-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.439-455
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    • 1998
  • This is the descriptive investigation study intended to provide basic informations to develop concrete method of nurse arbitration which can improve the quality of nursing care on family by investigating and analyzing the perception and practice on family nursing of clinical nurse. 332 nurses working in 4 university hospitals in Seoul have been the object and the collection of data have been conducted by visiting cooperated by the department of nursing in university hospital from April 4th through April 17th 1998. The measuring instrument of the perception and the practice on family nursing which was written by the researcher was used based on the family nursing arbitration by recently amending Calgary Family Arbitration of the Model of Wright & Leahey. Cronbach's a value of this instrument was .9288 in the perception and .9168 in the practice the collected data have been analyzed by frequency percentage, averaged value. t-test, F-test(ANOVA), Duncan's Multiple Range, Pearson's Correlation Coefficient, and the results are as the follows: 1. The perception on patient's family nursing of clinical nurse showed comparatively high by 3.22 in average(maximum 3.52, minimum 2.82) on the basis of 4 point but the practice showed low by average 2.47(maximum 3.02, minimum 2.11), By providing the patients and their family with "The information about the health problem of the which is the role of giving explanation and information about the disease. the nurse presents the method of their helping patient and in case that the family lack of knowledge about the health problem and crisis of the patient which is the role of education about the method of solving the crisis and change. the nurse educates about the necessity and method of taking care of the crisis and the changes. The third question that the relation of recognizing the difficuly of family and cooperating with them in supporting the patient for mutual function is to be formed showed high in the degree of perception and practice of the necessity. 2. General characteristics of perception about patient's family nursing of the object showed no significant difference except the concerns about the family usually(F=5.472. p<.001) and general characteristics which showed significant difference in the degree of practice were educational background (F=3.177, p<.05), clinical experience (F=2.462, p<.05) and position(F=7.029. p<.001), and attention about patient's family(F=10.603, p<.001), 3. The relation between perception and practice about the nursing on patient's family showed pure correlation but the degree was very low(r=.188, p<.05). The above results showed that the clinical nurses has been high understanding about the necessity of patient's family nursing but the degree of practice has been very low due to the lack of education about the family nursing, having no ways of nurse arbitration for practical duty and lack of political administrative support. Therefore concrete and systematic family situation and arbitration method to be applied clinically are required to be developed and also the education about patient's family nursing and the development of the course for clinical practice are required and political and administrative support for clinical practice about patient's family nursing is required as well.

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Physician's Responsibilities in Medical Dispute (의료분쟁(醫療紛爭)에 있어서 의사(醫師)의 주의의무(注意義務))

  • Lee, Joon-Sang;Choi, Baik-Hi
    • Journal of Preventive Medicine and Public Health
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    • v.15 no.1
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    • pp.17-31
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    • 1982
  • A physician assumes toward his patient the obligation to use such reasonable care and skill as is commonly possessed and exercised by physicians in the same general line of practice in the same or similar localities and to use his best judgment at the times. Medical disputes between physicians and patients are, ever more increased in these days as human body, happens to cause a variety of changes in body unlike the function of machine. Such increased trends of medical disputes became a problem in common across the word under the influence of affluent living standard, high consciousness of life value and right by today's people. The aim of this dissertation is oriented to forming a physician's responsibilities in medicalcare accidents arising between physicians and patients. A general physician, for example, has not been negligent merely because, a specialist might have treated the patient with greater skill and knowledge. However, the fact that a physician may have acted to the best of his ability will not avoid legal problems for damages resulting from substandard treatment, that is the degree of care and skill which is to be expected of the ordinary practitioner in his field of practice. The duty of a physician who is, or holds himself out to be, a specialist is greater in the field of his specialty than one who is a general physician. A patient's consent to routine medical procedures is implied from the fact that patient comes to the physician with a medical problem and voluntarily submits to the procedures. For the more serious medical procedures and for major operations, however, it is preferable for the physician to have the patient's consent in writing, to facilitate proof of the consent in the event of a dispute or litigation. Suppose that mistakes on the part of physicians are likely to be blamed in all cases of malpractice. Then it will create a sort of shrinkage in activities of medical treatment. There should be some limitation on excessive application of 'The thing speaks for itself' on mistakes by physicians and availablity of cause and effect. It is a matter of complicity as well as a matter of importance to draw a definite boundary on responsibilities of physician. A series of further research on this particular aspect is strongly urged.

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A Study on the Socialization Theory of Social Welfare Institutions -From the Point of View of the Community Welfare in Japan- (사회복지시설의 사회화론에 관한 일고찰 -일본 지역복지의 관점에서-)

  • Lee, Byoung-Rock
    • Korean Journal of Social Welfare
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    • v.56 no.1
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    • pp.181-201
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    • 2004
  • It has been said that there were many problems in a social welfare institution. Community welfare in Japan is being presented as an alternative solving these problems and underlying theories are deinstitutionalization, normalization, and community care. Recently, in Korea, these alternatives are connected with the logic that social welfare institutions are useless. But if we think the inborn duty of the social welfare institution, we can know the logic problem of these theories. Also, 'the socialization theory of social welfare institutions' has been presented as a solving method. But studies in Korea are having a partiality only to opening to community and are researched separately from community welfare. Under these problem perceptions, this study examined the construction contents of the community welfare in Japan, the relation of community welfare and social welfare institutions, the relation of the community welfare and the socialization theory of social welfare institutions, and the concept and content of the socialization theory of social welfare institutions. This study investigated the discussions in Japan, for studies in Korea are generally based on those of Japan and the domestic community welfare policy has been influenced immensely by Japan. The result of this study is as follows. Firstly, not the social welfare institution in a category of community welfare is excluded, but is prescribed as an essential post, a premise condition, and a composition post of the community welfare. Secondly, the socialization theory of social welfare institutions is also discussed in a category of the community welfare and in the side of community welfare development. Thirdly, the socialization theory of social welfare institutions is presented in the side of not only opening to community, but also a basic practice theory of the social welfare institution reformation including that.

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A Study of the "erlaubtes Risiko" in Aviation (항공 운항에서의 허용된 위험 법리에 대한 연구)

  • Ham, Se-Hoon
    • The Korean Journal of Air & Space Law and Policy
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    • v.25 no.2
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    • pp.201-230
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    • 2010
  • With starting the industry of automobiles, railroads and mining, the legal principle of "erlaubtes Risiko" that began as a means of maintaining the revitalized world for the cause of social utility has interpreted as a system of negligence theory in the precedent while it has gained academic recognition. Yet in aircraft operation, which is one area of high technology, CAT which can be the cause of some accidents or events or thunderstorm with turbulence is an abnormal meteorological phenomenon with frequent change that cannot be monitored perfectly just as some patient with unstable condition and that cannot be ascertained about not only the possibility of its happening but also the degree of how big the accident is. Yet the use of jet current which has the possibility of CAT can be an act of high social utility where we not only drastically cut down on time fuel also guarantee the arrival and departure on schedule when landing in airports that have thunderstorm which does not appear as fatal risk. Although we could take some measures where we can predict and avoid the potential risk, easing the regular duty of care is necessary by applying the legal principles of permitted risk concerning the incidents and accidents caused by operating in areas with the risk of turbulence or CAT with the low probability by the reason of social utility.

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Review of 2021 Major Medical Decisions (2021년 주요 의료판결 분석)

  • Park, Taeshin;Yoo, Hyunjung;Lee, Jeongmin;Cho, Woosun;Jeong, Heyseung
    • The Korean Society of Law and Medicine
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    • v.23 no.2
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    • pp.171-209
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    • 2022
  • There were also many medical-related rulings in 2021, among which the rulings reviewed in this paper are as follows. The first relates to a case in which the medical record, which is the primary judgment data regarding the presence or absence of medical negligence, has been modified. The court judged whether there was negligence on the basis of the first written medical record without considering the contents of the medical record that was later modified. Next, the ruling on the case of asking for liability for damages for prescription of anti-obesity drugs recognized negligence related to prescription, but denied liability for property damage by denying a causal relationship, and recognized only alimony for violation of the duty of explanation. The a full-bench ruling on the scope of subrogation of the National Health Insurance Corporation, which subrogates the claims for compensation for medical expenses against the perpetrator of the patient, changed the existing precedent that had taken the 'deduction method after offsetting negligence' and judged it as 'the method of offsetting negligence after deduction'. In addition, in the ruling on whether or not there was negligence, the court was not bound by the medical record appraisal result. Lastly, in relation to the National Health Insurance Service's disposition of reimbursement for medical care benefit costs, we reviewed the ruling that discretion should be exercised even when a non-medical person makes a refund to a medical institution opened by a non-medical person. And we also reviewed the ruling that the scope of reimbursement for medical institutions jointly using facilities and manpower specifically should be determined.

A Study on the Childbirth Experience in Primiparas (출산경험에 대한 연구)

  • Kim, Hyun-Kyung
    • Women's Health Nursing
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    • v.1 no.1
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    • pp.81-96
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    • 1995
  • This study was intended to provide women who are supposed to experience childbirth with effective nursing care exploring the childbirth experience. The purpose of this paper is to give an answer to the question of what the childbirth experience is, and phenomenological method has been used for that purpose. 17 primiparous mothers right after delivery in one university hospital of J city were served as subjects for this research. Data were collected June to October, 1993 through in depth interview with subjects using unstructured and open questions about the childbirth experience. Van Kaam's phenomenological analysis method was used for the analysis of the data. The results of the study are summarized as follows : The contents of the experience which primiparous mothers had undergone through childbirth were pain, fear, worry, relief, lightness, thankfulness, unsatisfactory, unreality, holiness for a new life, identifying the meaning of life, becoming a mother. 1. Experience before delivery Mothers experienced pain, fear, worry, unsatisfactory, relief, and thankfulness before delivery. Subjects' descriptions about the pain appeared to be various ; unbearable pain, bearable pain, anticipated pain. And their reactions were also various ours ; some endured pain, sought alternative method i.e., surgery, didn't want to reexperience it, or accepted it as women's fate. Subjects experienced fear for anticipated pain, suffering pain, and possible delayed delivery progress and were worried about delivery progress and baby wellbeing. Also, Subjects were unsatisfied with professionals' unfaithful attitude, their spouses' absence, and the ignorance of their pain. But subjects became relieved at the accustomed surroundings, good progress of delivery, support of family, care of professionals and support of other family. And they expressed their thanks to the professionals and family members for doing their best and also to their mothers who gave birth to them. 2. Experience after delivery Subjects experienced lightness, thankfulness, unsatisfactory, worry, unreality, holiness for a new life, identifying the meaning of life, becoming a mother after delivery. Mothers experienced lightness from the fact that it is over, and freshness right after delivery. They were thankful that they delivered vaginally and had an easy delivery. Subjects who delivered female baby were unsatisfied and some were worried about rearing the baby. By confessing, "I have no specific feeling, I am very confused, It is unrealistic, I feel strange", they expressed the unrealistic aspect of childbirth experience. Subjects felt holiness for a new life for novelty and birth of life. They identified the meaning of life from the fact that they felt worthy, fulfilled their duty, had their own baby, accomplished an important affair. After they experienced what it is to be a mother, they realized with it is being a mother and had a rearing expectation for the baby. The results of the study will provide basic data for caring the childbearing women.

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Cases and Legal Issues For 119paramedics in Mental Emergency Situations (정신응급상황에서 119구급대원 대응사례와 법적쟁점)

  • Young Pyo Hong
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.87-115
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    • 2024
  • In Korea, exposure to stress has been accompanied by mental pain in the process of achieving many growth along with rapid development, various social problems, and the frequency of emergency hospitalization is increasing.. In the case of mentally ill patients, "unwanted hospitalization" is a problem, and police and 119 paramedics try to suppress the body of mentally ill patients, and many problems are exposed This is because the constituent requirements of the provisions of emergency hospitalization under the Mental Health and Welfare Act do not reflect reality, and each institution has a different position on one mentally ill person, and emergency hospitalization does not proceed smoothly or leads to friction between related organizations, and the safety of the mentally ill or others is not secured. Emergency hospitalization is defined as "a person who finds a person who is presumed to be mentally ill and is at high risk of harming his or her health or safety or others," and if the situation is so urgent that he or she cannot afford time to go through the hospitalization procedure to decide on his or her own hospitalization, he or she can request emergency hospitalization with the consent of a doctor and a police officer. In this case, 119 paramedics are escorted to a psychiatric institution. This provision of emergency hospitalization poses many problems in the process of transferring to psychiatric institutions. If a police officer or 119 paramedics in charge of practice use "physical force" during the emergency hospitalization process, side effects will inevitably occur, and professional negligence can be a problem. Specifically, when exercising physical force, the minimum necessary physical restraint based on laws and regulations and proportional principles is required, and the lack of the duty of care of 119 paramedics or police officers under the laws and regulations will eventually be resolved by applying other laws and regulations. Accordingly, it will be an opportunity for mentally ill patients to be transferred to psychiatric institutions in a safe environment by changing the subject of emergency hospitalization provisions under the Mental Health Welfare Act, defining and prescribing the use of physical protection guards as the enforcement regulations of the Mental Health Act, setting the duty of care for 119 paramedics and police officers, and creating an environment for transportation so that mentally ill patients can be treated safely.

A Study on Activation device of 119 Emergency Care (119구급대의 활성화 방안에 관한 연구)

  • Koh, Jae-Moon;Kim, Gyoung-Wan;Chung, Yong-Tai
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.1
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    • pp.27-40
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    • 2007
  • Even now, 119 rescue services have dissatisfactory aspects in operation, system and equipments as discussed above, It is the most urgent subject to systemize rescue services so that they can be suitable for our status, for we will make 21C welfare state come true before long. So, this author suggest that the followings have to be raised to activate 119 rescue service. 1) Bring up experts and offer high-quality rescue service 2) Prepare more up-to-date equipments 3) Operate transfer joint organizations 4) Promote the ability to meet with a press at the time of rescue service activities 5) Adjust regulations related to rescue services 6) Make up for a countermeasure to traffic accidents of ambulances 7) Adjust regulations making it mandatory to establish heliport at the target on hospitals more than a defined scale 8) Install more rescue service teams 9) Educate and train officials belonging to briefing rooms, where the officials with long experiences are arranged 10) Minimize the time for rescue team to reach fields 11) Establish legal protection system for rescue the team Nowadays, our country operates the department of fire fighting and rescue services without great difficulty, even though the circumstances are bad - insufficient members and the inferior circumstances. All of the fire fighting officials are given heavy duties in bad circumstances, and so are the team of rescue service. The rescue service team, taking charge of some emergency medical system, do a fire fighting inspection as a non-duty service, though they are scanty of sleep due to prevention and protection services of the fire fighting service team. But, they can not engage in rescue services completely and have to deal with miscellaneous duties. So they can not offer professional emergency medical services. But now, almost every fire fighting organization, belonging to National Emergency Management Agency, are separating rescue services, which shows a lot of good results. People recognize rescue services to get better and better gradually and the demands for this rescue services increase. So, this is the best time when rescue service teams should offer qualitative services rather than quantitative services. The people will recognize this rescue service team to be an organization sacrificing and serving for them. However well institutes and operation systems should be established, the rescue service team can not come true their aim without strong wills that they will serve and sacrifice themselves for people from their hearts. In addition, it is essential for the officials in charge of policies about emergency medical services to have a concernment on and practice the policy without failure.

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