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Neurotechnologies and civil law issues (뇌신경과학 연구 및 기술에 대한 민사법적 대응)

  • SooJeong Kim
    • The Korean Society of Law and Medicine
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    • v.24 no.2
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    • pp.147-196
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    • 2023
  • Advances in brain science have made it possible to stimulate the brain to treat brain disorder or to connect directly between the neuron activity and an external devices. Non-invasive neurotechnologies already exist, but invasive neurotechnologies can provide more precise stimulation or measure brainwaves more precisely. Nowadays deep brain stimulation (DBS) is recognized as an accepted treatment for Parkinson's disease and essential tremor. In addition DBS has shown a certain positive effect in patients with Alzheimer's disease and depression. Brain-computer interfaces (BCI) are in the clinical stage but help patients in vegetative state can communicate or support rehabilitation for nerve-damaged people. The issue is that the people who need these invasive neurotechnologies are those whose capacity to consent is impaired or who are unable to communicate due to disease or nerve damage, while DBS and BCI operations are highly invasive and require informed consent of patients. Especially in areas where neurotechnology is still in clinical trials, the risks are greater and the benefits are uncertain, so more explanation should be provided to let patients make an informed decision. If the patient is under guardianship, the guardian is able to substitute for the patient's consent, if necessary with the authorization of court. If the patient is not under guardianship and the patient's capacity to consent is impaired or he is unable to express the consent, korean healthcare institution tend to rely on the patient's near relative guardian(de facto guardian) to give consent. But the concept of a de facto guardian is not provided by our civil law system. In the long run, it would be more appropriate to provide that a patient's spouse or next of kin may be authorized to give consent for the patient, if he or she is neither under guardianship nor appointed enduring power of attorney. If the patient was not properly informed of the risks involved in the neurosurgery, he or she may be entitled to compensation of intangible damages. If there is a causal relation between the malpractice and the side effects, the patient may also be able to recover damages for those side effects. In addition, both BCI and DBS involve the implantation of electrodes or microchips in the brain, which are controlled by an external devices. Since implantable medical devices are subject to product liability laws, the patient may be able to sue the manufacturer for damages if the defect caused the adverse effects. Recently, Korea's medical device regulation mandated liability insurance system for implantable medical devices to strengthen consumer protection.

Haewon-sangsaeng Thought for the Future of Humanity and World (인간과 세계의 미래에 관한 해원상생사상 연구)

  • Bae, Kyu-han
    • Journal of the Daesoon Academy of Sciences
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    • v.30
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    • pp.1-57
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    • 2018
  • There are three purposes to this study: first, to understand comprehensively the meaning of Haewon-sangsaeng (Resolution of Grievances for Mutual Beneficence) Thought, which can be taken as representative thought regarding peace in Korean new religions. Next, Haewon-sangsaeng Thought and the works for Haewon (resolving grievances) will be examined as principles and practical mechanisms for building the paradise of the Later World and understanding the structure of this system of thought. Lastly, logical inferences will be made regarding the future of humanity and the world through the ideological characteristics implied by Haewon-sangsaeng Thought. Haewon-sangsaeng Thought contains the complicated concepts of Haewon and Sangsaeng. Haewon is the resolution of the enmity and grievances that have accumulated in the realms of humanity and deities. Sangsaeng indicates the action of mutually benefiting one another or a state wherein people live in prosperity and peace. In Daesoon Jinrihoe, the concept of Haewon-sangsaeng is expressed explicitly and has broad applications. It can be expanded for the global peace and the harmony of all humanity. As the result of an integrated analysis of previous studies, it can be stated that Haewon-sangsaeng has values and meanings in terms of principles, laws, ethics, and ideology all of which are commonly connected to Injon (Human Nobility), Sangsaeng, peace, harmony, the Later World, and paradise. This indicates that its valuable for the future of humanity and world is deeper and wider than its mere etymological meaning. The common factor among paired ideas such as human nobility and Sangsaeng, peace and harmony, and Later World and paradise is the realization of humanity's greatest wish. This is the reason why the value and meaning of Haewon-sangsaeng can be expanded globally. The works of Haewon were a religious act of Kang Jeungsan who resolved the grievances of the Former World which was under the rule of mutual conflict and built a Later World that will operate according to mutual beneficence. Therefore, the principle of Haewon-sangsaeng has a motivative power, through the Reordering Works of the Universe, which can transform the future of humanity and the world. In this study, it can be inferred that as Haewon-sangsaeng 'fulfills human desires' and forms a 'harmonious relations of Sangsaeng' between humans and world, humans will be transformed into Injon (Human Nobility) while the world turns into a paradise, and the future turns into period of peace. Therefore, Haewon-sangsaeng Thought works as a principle that changes society, the world, and the universe. The social actualization of Haewon-sangsaeng is tantamount to bringing the future of Injon, paradise, and peace into objective reality. Previous studies on Haewon-sangsaeng Thought had been carried out under difficult circumstances by a small number of scholars. For all the above reasons, I anticipate that there will be more and more studies made on the topic of Haewon-sangsaeng Thought, which seeks the realization of Haewon (the Resolution of Grievances), Sangsaeng (Mutual Beneficence), human nobility, paradise, and peace. I hope it will emerge as a main subject in global religious thought.

Conclusion of Conventions on Compensation for Damage Caused by Aircraft in Flight to Third Parties (항공운항 시 제3자 피해 배상 관련 협약 채택 -그 혁신적 내용과 배경 고찰-)

  • Park, Won-Hwa
    • The Korean Journal of Air & Space Law and Policy
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    • v.24 no.1
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    • pp.35-58
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    • 2009
  • A treaty that governs the compensation on damage caused by aircraft to the third parties on surface was first adopted in Rome in 1933, but without support from the international aviation community it was replaced by another convention adopted again in Rome in 1952. Despite the increase of the compensation amount and some improvements to the old version, the Rome Convention 1952 with 49 State parties as of today is not considered universally accepted. Neither is the Montreal Protocol 1978 amending the Rome Convention 1952, with only 12 State parties excluding major aviation powers like USA, Japan, UK, and Germany. Consequently, it is mostly the local laws that apply to the compensation case of surface damage caused by the aircraft, contrary to the intention of those countries and people who involved themselves in the drafting of the early conventions on surface damage. The terrorist attacks 9/11 proved that even the strongest power in the world like the USA cannot with ease bear all the damages done to the third parties by the terrorist acts involving aircraft. Accordingly as a matter of urgency, the International Civil Aviation Organization(ICAO) picked up the matter and have it considered among member States for a few years through its Legal Committee before proposing for adoption as a new treaty in the Diplomatic Conference held in Montreal, Canada 20 April to 2 May 2009. Accordingly, two treaties based on the drafts of the Legal Committee were adopted in Montreal by consensus, one on the compensation for general risk damage caused by aircraft, the other one on compensation for damage from acts of unlawful interference involving aircraft. Both Conventions improved the old Convention/Protocol in many aspects. Deleting 'surface' in defining the damage to the third parties in the title and contents of the Conventions is the first improvement because the third party damage is not necessarily limited to surface on the soil and sea of the Earth. Thus Mid-air collision is now the new scope of application. Increasing compensation limit in big gallop is another improvement, so is the inclusion of the mental injury accompanied by bodily injury as the damage to be compensated. In fact, jurisprudence in recent years for cases of passengers in aircraft accident holds aircraft operators to be liable to such mental injuries. However, "Terror Convention" involving unlawful interference of aircraft has some unique provisions of innovation and others. While establishing the International Civil Aviation Compensation Fund to supplement, when necessary, the damages that exceed the limit to be covered by aircraft operators through insurance taking is an innovation, leaving the fate of the Convention to a State Party, implying in fact the USA, is harming its universality. Furthermore, taking into account the fact that the damage incurred by the terrorist acts, where ever it takes place targeting whichever sector or industry, are the domain of the State responsibility, imposing the burden of compensation resulting from terrorist acts in the air industry on the aircraft operators and passengers/shippers is a source of serious concern for the prospect of the Convention. This is more so when the risks of terrorist acts normally aimed at a few countries because of current international political situation are spread out to many innocent countries without quid pro quo.

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Collision of New and Old Control Ideologies, Witnessed through the Moving of Jeong-regun (Tomb of Queen Sindeok) and Repair of Gwangtong-gyo (정릉(貞陵) 이장과 광통교(廣通橋) 개수를 통해 본 조선 초기 지배 이데올로기의 대립)

  • Nam, Hohyun
    • Korean Journal of Heritage: History & Science
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    • v.53 no.4
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    • pp.234-249
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    • 2020
  • The dispute involving the construction of the Tomb of Queen Sindeok (hereinafter "Jeongreung"), King Taejo's wife in Seoul, and the moving of that tomb, represents the most clearly demonstrated case for the collision of new and old ideologies between political powers in the early period of Joseon. Jeongreung, the tomb of Queen Sindeok from the Kang Clan, was built inside the capital fortress, but in 1409, King Taejong forced the tomb to be moved outside the capital, and the stone relics remaining at the original location were used to build the stone bridge, Gwangtong-gyo. In an unofficial story, King Taejong moved the tomb outside the capital and used the stone items there to make the Cheonggyecheon Gwang-gyo so that the people would step upon the area in order to curse Lady Kang. In the final year of King Taejo, Lady Kang and King Taejong were in a politically conflictual relationship, but they were close to being political partners until King Taejo became the king. Sillok records pertaining to the establishment of Jeongreung or Gwangtong-gyo in fact state things more plainly, indicating that the moving of Jeongreung was a result of following the sangeon (a written statement to the king) of Uijeongbu (the highest administrative agency in Joseon), which stated that having the tomb of a king or queen in the capital was inappropriate, and since it was close to the official quarter of envoys, it had to be moved. The assertion that it was aimed at degrading Jeongreung in order to repair Gwangtong-gyo thus does not reflect the factual relationship. This article presents the possibility that the use of stone items from Jeongreung to repair Gwangtong-gyo reflected an emerging need for efficient material procurement that accompanied a drastic increase in demand for materials required in civil works both in- and outside the capital. The cause for constructing Jeongreung within the capital and the cause of moving the tomb outside the capital would therefore be attributable to the heterogeneity of the ideological backgrounds of King Taejo and King Taejong. King Taejo was the ruler of the Confucius state, as he reigned through the Yeokseong Revolution, but he constructed the tomb and Hongcheon-sa, the temple in the capital for his wife Queen Sindeok. In this respect, it is considered that, with the power of Buddhism, there was an attempt to rally supporters and gather the force needed to establish the authority of Queen Sindeok. Yi Seong-gye, who was raised in the Dorugachi clan of Yuan, lived as a military man in the border area, and so he would not have had a high level of understanding in Confucian scholarship. Rather, he was a man of the old system with its 'Buddhist" tendency. On the other hand, King Taejong Yi Bang-won was an elite Confucian student who passed the national examination at the end of the Goryeo era, and he is also known to have held a profound understanding of Neo-Confucianism. To state it differently, it would be reasonable to say that the understanding of symbolic implications for the capital would be more profound in a Confucian state. Since the national system that was ruled by laws had been established following the Three-Kingdom era, the principle of burial outside of the capital that would have seen a grave constructed on the outskirts of the capital was not upheld, without exception. Jeongreung was built inside the capital due to the strong individual desire of King Taejo, but since he was a Confucian scholar prior to becoming king, it would not have been accepted as desirable. After taking the throne, King Taejong took the initiative to begin overhauling the capital in order to reflect his intent to clearly realize Confucian ideology emphasizing 'Yechi' ("ruling with good manners") with the scenic view of the Capital's Hanyang river. It would be reasonable to conclude accordingly that the moving of Jeongreung was undertaken in the context of such a historic background.

An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.1 s.21
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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