Journal of the Korea Society of Computer and Information
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v.19
no.4
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pp.139-147
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2014
Medical disputes the problem that occurs essentially among the rapidly increasing of the demand for health care and the attention of the public health. The subject of dispute is mostly criminal penalties and civil redress due to a physician's medical malpractice, resolved by agreement was prioritized. They trying to solve through the litigation and exercise the skills. But, the lack of clear standards and related legislation make difficult to solve the problem. for this, "The Act of Medical Malpractice Damage's Relief and Mediation for Medical Dispute Resolution" (Medical Disputes Adjustment Act) was enacted in April 7, 2011 and performed in Apr. 8, 2012. To solve the problem autonomously between the parties. It is the legislative intent such as mediation or arbitration to solve the conflict between the parties. But there are some problems that examined from the perspective of constitutional review with the criminal and civil problems. Therefore, this paper will find out the legal issues about Medical Dispute Adjustment Act and the constitutional and civil issues. And want to expect to be prepared the more stable and efficient solution of medical disputes.
This study aims to explore the possible ways to establish the effective medical supports for the sexual violence victims(svv). Using the data collected from 83 male and female doctors who are interested or involved in providing medical services for the victims, the doctors' attitudes toward the victims, medical services provided, and their needs for the possible medical supports were investigated. For comparison, 3 different groups of doctors were presented. The doctors who had treated svv(type1) seemed to have a difficulty in receiving the fee for the treatment of svv, and to have higher needs for the spermatic(fluid) test as well as the diverse supports for the testimony in courts. The doctors who had no experience of treatment, but were supposed to treat svv(type2) seemed to have negative attitudes toward the victims, and expect more difficulties in treating svv. The doctors of type2 had lower needs for the support for the specialized medical services and assessment of the sexual assault, but higher needs for the testimony supports. The doctors who had no experience of treatment, and were not supposed to treat svv(type3) appeared to have less negative attitudes toward the victims, but more knowledge of law and the community organizations for svv. The type3 doctors seemed to have higher needs for the supports for the specialized medical services, assessment for the sexual assault, and testimony in the courts. Based on the findings, the intervention strategies to create a new effective medical support system for the sexual violence victims were suggested.
The purpose of this study is to check the extent to which "instruction of physician or dentist" defined in the Medical Service Technologists, etc. Act is applied in relation to radiography examination procedures for radiological technologists. In addition, it is intended to present basic data on the requirement to revise the Medical Service Technologists, etc. Act in the radiological technologist's duty area and scope of work, The subjects of this study were radiological technologists with license, and the response data were collected after sending the questionnaire link written on the online questionnaire form. The final number of respondents were 1,018, and the response rate was 6.8%. Most of the negative responses were "I have never received 'instruction' for radiologic examination by a physician or dentist, including a radiologist in a medical environment." There were a high perception that "the professionalism in radiation examination on radiological technologists are higher than that of a physician or dentist." They answered that the current continuing education has a great impact on maintaining and continuing professionalism and learning new knowledge in the radiology field. In addition, the radiological technologists provide a very high level of education in areas related to radiography procedure ethics such as patient care, patient safety, and patient privacy protection, as well as specialized fields such as radiation-related examination methods, radiography examination dose, and patient exposure dose. Radiological technologists replied that they were receiving it consistently. In conclusion, in the current medical environment, the 'instruction' of a physician or dentist cannot be seen as being realistically performed. The phrase 'instruction' of a physician or dentist as defined in the Medical Service Technologists, etc. Act is considered inappropriate in respect of the fact that the state recognizes the qualifications of the medical service technologist through a license. It is thought that revision to a new term suitable for the current medical environment is necessary.
Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.
The presentation of this paper was triggered by the spread of MERS in Korea in the year 2015. The analysis of the present acts related with MERS is necessary in order to cope efficiently with any probable spread of such infectious diseases as MERS in future. The acts that should be analyzed in this paper include 'Medical Service Act' and 'Infectious Disease Control And Prevention Act' (hereafter, IDCAPA). At first the classification of the infectious diseases in IDCAPA should be referred to. The Act does not properly classify them because the scope of concept of each group of the infectious diseases overlaps each other. This overlap should be removed. The present system in IDCAPA is not proper for the efficient notification and reporting of the infectious disease patients. This is so in some viewpoints including the persons obligated to make the notification and reporting, the persons to whom they should notify and report such patients, and the process of notification and reporting. The efficient approach to the information related with the infectious disease is necessary for the rapid prevention of its spread. Cohort isolation and quarantine of the infectious patients and exposed contacts are the strongest and most efficient steps for the prevention of spread of the infectious diseases. One of the great problems related with such steps would be the conflict of powers or attributions, the likelihood of which is inevitable under the present system of IDCAPA. The IDCAPA distributed the power or attribution to take the steps to the three governments including the central government, the metropolitan government and the primary local government. The power should be concentrated in the central government, which could afford financially to compensate for the huge amount of damages caused likely by the steps. The power to take the steps would be actually just a useless thing for its holder without such financial capacity. The remedy for the victims by the fault of spreader should be approached to in the sense of national wealth. The general principle of tort law could not supply the victims with the sufficient remedy because the damages would be likely too huge for the wealth of such spreader to cope with. In future another parliamentary inspection could reveal another problems in the administration by the government of the MERS event in the year 2015. Any problem caused by defect in the legal system of the control and prevention of the infectious diseases should be taken into consideration when the legal system would be reformed in future.
Recently, the antitrust tribunal of Seoul High Court revoked the disposition of Korea Fair Trade Commission(hereafter 'KFTC'). While KFTC determined that the restriction of Korea Pediatrician Association violated article 26 of the Monopoly Regulation and Fair Trade Act(Korean antitrust law), Seoul High court viewed that KFTC failed to prove the compulsory measures and the restraint of competition required in article 26. The 'restriction' of article 26 should be interpreted as 'excessive restriction'. Since entrepeneurs' organization is allowed to limit its member's activities, KFTC could regulate entrepeneurs' organization on a very exceptional basis. In addition, though entrepeneurs' organization did not use compulsory measures to enforce its resolution, its 'excessive restriction' could fit into the notion of 'restriction' of article 26. Under the current medical care system, the price of medical care is decided by Korean government. Therefore the restriction of Korea Pediatrician Association is not likely to have effect on the price. However, the resolution of Korea Pediatrician Association was aimed to decrease the supply of medical care. Therefore the resolution is capable of having effect on the competition. In this sense, though KFTC failed to submit direct evidence to support the decrease of quantity, there could be possibility of restraint of competition. The Seoul High Court's decision has important implications. The leading case on restraint of competition(Supreme Court 2002Du8628, Posco case) was delivered in 2007. However the remaining issue such as the standard and scope of restraint of competition is not clear. Through reappeal case of this decision, Supreme Court has to decide the line between competition and its restraint.
On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.
The conception of 'earth(土)' belonging to the five evolutive phases(五行) is cognized that it is not partial to any side differing from other four phases and it can control other four phases so, it is the first gate to enter the process of changes. In the five organs(五臟), the spleen come under the earth phases and it have been very importantly considered for past to now in oriental medical history, for example by Li Dongyuan(李東垣). In this study, the results are summarized as the followings. 1. The term of the acquired constitution(後天) made by So-ong(邵雍), a scholar in the north so-dynasty, is used in the study of the book of changes(易經). And he said "The inborn constitution(先天) is the law of the nature itself and, the acquired constitution(後天) is the law of making the changes with the nature." In the myung-dynasty Li jungjae(李仲梓) made extract from this remarks 10 define that the spleen is the basis of the acquired constitution. So it considered that the the idea of changes(易) had an effect on the oriental medicine. 2. The one element of five phases, earth is the center of the changes and it composes the power of life with the sangsu(生數)-1, 2, 3, 4, and the sungsu(成數)-6, 7, 8, 9. In this process, the earth is the basis of the changes of the five phases. At the same time the spleen carry out the important physiological role in the humanbody controlling the other four organs. 3. In the change of the universe, the repetitionary movement of Yin(陰) and yang(陽) is the action of earth and it means illimitable division. In the course of this division all things change to new phases for example, the food changes 10 the ki(氣) through the action of spleen and stomach. So the organ of spleen and stomach is the space that the action of change occur. 4. Consequently the conception of bi(脾) is close to the pancreas that the spleen. And the duodenum is close to the conception of stomach because the space is the site of mito(未土). 5. The action of yin and yang in the ancient taegukdo(太極圖) is close 10 the connection of N-pole and S-pole. In the humanbody the two power is compared to the action of spleen and kidney, that means expansion and contraction. Also it means the inborn constitution and the acquired constitution so, it applyed to the all things in the universe.
The study conducted a survey on the perception level for radiological technologists with 321 nurses and auxiliary nurses working at university hospitals in Busan in order to supply preliminary data to enhance the status as well as professional images of radiological technologists. The result shows the perception level of $3.02{\pm}0.42$ with the highest score for the professional image and the lowest score for the business image. By question, 'they are professional' gets the highest score while 'they understand problems of patients well' gets the lowest. Among respondents, those who are well aware of education courses as well as leading organization of examination and who answer as a health care provider or a medical technician under the medical law show a high level of perception while those who answer as technician show a low perception level. Those who agree with radiologists as a career and consider their status as high in medical institutions have a high level of perception. In order to improve the perception level, individuals as well as associations' promotion and strategies are required to fix the title and enhance the negative images through active interests and kind attitudes toward patients. Also, efforts to escape from previous images limited to technical colleges, to vitalize academic conference and remedial education, and to frame the law of professional radiological technologists system are asked to heighten the qualification and status of radiological technologists. More than that, advertising and monitoring via mass media are needed to develop the image as professional career men as well.
Hospice and palliative care in Taiwan has been growing continuously. The 2015 Quality of Death index, as rated by the Economist Intelligence Unit, ranked Taiwan first among Asian countries and sixth in the world. In this review article, we highlight three particular areas that might have contributed to this success; the laws and regulations, spiritual care and research network. Finally, we discuss the future challenges and prospects for Taiwanese encounters. A systemic review was conducted with the keywords "hospice palliative care Taiwan" using PubMed. The passing of the "Natural Death Act" in 2000 set the example and established a landmark for patient autonomy in Asia; it guarantees the patient's right to request that medical staff do not resuscitate (DNR) them and to reject other futile medical treatments at the end of their life, thus reflecting the importance of palliative care from the policy perspective. In 2015, Taiwan passed another pioneering law entitled the "Patient Autonomy Act". This law states that a patient may decline medical treatment according to his/her own will. Taiwanese indigenous spiritual care was launched in 2000. It requires a Buddhist Chaplain to successfully complete a training program consisting of lectures, as well as bedside practicum before applying Buddhist practices to end-of-life care. The Japan-Korea-Taiwan research network was established for the purpose of enabling collaborative research for the East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) cohort. With consensus from the government and society to make it a priority, hospice and palliative medicine in Taiwan has been growing steadily.
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