• The Korean Journal of Emergency Medical Services
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• v.25 no.2
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• pp.169-186
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• 2021

Purpose: This study aimed to analyze the data from public information disclosure about pre-hospital advanced airway management and identify the problem by considering domestic laws and guidelines. Methods: Data were collected between 2017 and 2018 and analyzed using SPSS 25.0. Then, the problems of the analysis results based on the relevant laws and practical guidelines were reviewed. Results: The review of domestic laws and practice guidelines revealed that ambulance nurses can implement supraglottic airway device only under the following three conditions: ① smart advanced life support pilot project area, ② trained to insert I-Gel, and ③ member of a special ambulance. In total, 21,574 cases of advanced airway management (endotracheal intubation: 2,428, I-Gel: 18,502, LMA : 499, KING AIRWAY: 144) were reported. In many cases, advanced airway management was performed by ambulance nurses who did not meet the above conditions, which was in violation of laws and guidelines. In addition, the prognosis of intubated patients was not followed up. Conclusion: The Korea National Fire Agency must stop all unlicensed medical practice by untrained, uneducated, and uncertified nurses and demand quality control programs for intubated patients.

• The Journal of Korean Medical History
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• v.28 no.1
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• pp.121-133
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• 2015

Objectives : The purpose of this study is to suggest how to interpret the 'practice of Korean Medicine', differentiating it from 'medical practice'. Methods : I analyze the legislations and precedents regarding the practice of Korean Medicine. Results : The Korean Medicine and Pharmaceutics Promotion Act defines 'practice of Korean Medicine' and it clearly differentiates it from the definition of 'medical practice'. However, the scope of this definition is somewhat restricting and it can violate doctors of Korean Medicine's right to equality and their academic freedom. Thus, the application of this definition of the 'practice of Korean Medicine' should be limited to the field of research and development. Meanwhile, criteria of distinguishing 'practice of Korean Medicine' from 'medical practice', which used to make a sharp distinction between Medicine and Korean Medicine by rigorously applying their academic standards, are now focusing more on protecting and improving health of the people. Discussions & Conclusions : I suppose that the distinction between the 'practice of Korean Medicine' and 'medical practice' will be more focused on public health rather than the academic stance of those two medical fields. Meanwhile, in accordance with dualistic medical system, the mutual usage of medical equipment in the area of 'treatment' should be limited while it should be allowed in the area of 'diagnosis' if it satisfies requirements suggested by the Constitutional Court.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.337-361
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• 2010

In the case of Korea, both of modern medicine and oriental medicine are admitted as medical practices in the system. In other words, healthcare system is dualized. However, medical practice that corresponds to oriental medicine in Korea is substitution of medical practice in cases of foreign countries. For use of medical devices, it is provided only for doctors and medical technician relevant to use. Particularly, although oriental medicine is recognized as orthodox medicine in terms of the features of Korean medical system, superintendency of oriental doctors is not identical with that of doctors for use of medical devices and superintendency toward medical technicians. Recently, Cheongju District Court decided that superintendency of oriental doctor upon physical therapist is not acknowledged. It can be said that the judgement is opposed to the original verdict which judged that oriental doctors' employment and guidance of oriental doctors upon physical therapist is permissible. Hence this study aimed to review on domestic medical law system, which is dualized, roles of medical professionals, intent of the medical license system, provisions related to medical technician law and relevant precedents. Regulations on practices other than licensed practices by medical professionals are made because medical practices may affect on danger toward life and body of human and public health also. Therefore, the nation regulates medical professionals having licenses to perform medical practices within the range of the licenses. It is clearly prescribed that medical technicians may perform medical practices under instructions of doctors or dentists pursuant to the medical technician law. In addition, the court also judges that it is out of the license of oriental doctors if they use CT devices and limits the use of modern medical devices by oriental doctors. That is to say that it limits oriental doctors' employment of medical technicians and pursuant of oriental doctors on medical technicians as well.

• Journal of dental hygiene science
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• v.7 no.3
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• pp.113-119
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• 2007

This study attempts to find factors contributing to the use pattern of prosthetics by investigating the current condition of prosthetics for the aged of over 65 years old by place of practice. Among those of over 65 years old who live in Gangnam-gu, Seocho-gu, Seongbuk-gu, and Gwanak-gu of Seoul and use the apartment senior's center, those having prosthetics were selected as subjects of this study, and this study was conducted in forms of interview and record. Findings of this study are summarized as follows: First, in regard of the state of prosthetics and relevant symptoms in the mouth according to the place of prosthetics practice, there was significant difference in the questions except the medical benefit of prosthetics between unlicensed facilities and dental clinics and hospitals. Second, regarding difference in satisfaction according to the place of prosthetics practice, dental clinics and hospitals showed a higher level of aesthetic satisfaction than unlicensed facilities. For difference in satisfaction at pronunciation, chewing, pain, a sense of foreign body, and holding power, dental clinics and hospitals showed a higher level than unlicensed facilities, Third, after factor analysis on the perception factors of unlicensed treatment and dental treatment, unlicensed facilities showed the highest level of reliability, and then convenience, word of mouth, and modernity in order. Dental clinics and hospitals also showed the highest level of reliability, however, and then convenience, modernity, and word of mouth in order. Fourth, as a consequence of analyzing the factors to influence the use pattern of prosthetics, regarding residential pattern, there were higher possibilities to use dental clinics and hospitals when the subjects lived together with their children and in Gangnam, and the more were the number of pyeong for the residence, pocket money, medical expense, and property in their name, compared to unlicensed facilities. In conclusion, economic factors appear to be the most important factors in selecting facilities for denture prosthodontics. Therefore, it is important to ensure the denture prosthodontics for the elderly are reimbursable so that they can enjoy a healthier life.

• The Korean Society of Law and Medicine
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• v.24 no.1
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• pp.43-65
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• 2023

The healthcare industry is a digital healthcare that combines technology based on the 4th Industrial Revolution, dealing with information on individual health and medical care, and is a fusion of health care services and medical science and technology. It is questionable whether digital healthcare according to the paradigm change can be discussed by the concept of medical practice under the existing Medical Act. There is no clear definition of the concept of medical practice in the Medical Service Act, but the concept is established through precedents. In addition, under the Medical Service Act, the subject of medical practice is limited to medical personnel. However, digital healthcare sometimes diagnoses and treats diseases using digital technology by medical personnel. On the other hand, what is possible by non-medical personnel is digital healthcare. This is because digital healthcare is understood as a concept that includes health care such as exercise, eating habits, and weight control. For this reason, if the concept of medical practice under the "Medical Act" on digital healthcare is included, it is subject to criminal punishment for "unlicensed medical practice" prescribed in Article 27 of the "Medical Act". In the health and medical industry, digital transformation and convergence with information and communication technology are rapidly progressing. As a result, there is a need to newly define it as 'digitalized medical practice' or 'information and communication technology (ICT)-based medical practice' separately from existing medical practices. The concept of medical practice has variability, not a fixed and invariable concept. However, in response to this demand, it is not an infinite expansion of the concept of medical practice, but a request to reset its scope. Therefore, the concept of medical practice should be legislated by reflecting the demand of consumers for the medical service system.

• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.35-57
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• 2014

Recently, there has been fierce argument between oriental and western doctors in the medical field. The use of medical devices has particularly come to the fore lately. Appropriate medical devices are required to diagnose and treat patients' conditions or illnesses accurately. At issue recently in medical device sector are diagnostic instruments using radiation, magnetic resonance imaging, ultrasound, IPL(Intense Pulse Light), and instruments used for tonometry. Relating to this issue, Association of Korean Oriental Medicine and The Association of Korean Medicine are sharply opposed. It is predicted that more accusations of this kind will be seen in the future. As oriental medicine contends, ultrasonic imaging itself seems to cause no harm to humans and its use may have an advantage for national health. The use of western diagnostic equipment can expand the diagnostic range of oriental doctors. However, unless new legislation is made, it is against the law for oriental doctors to use this equipment. Both law and medical science require grounds and predictability on the correctness of a decision and all of its consequences. Additionally, oriental medicine's use of ultrasounds and other medical devices should be established by standards and grounds which make same the diagnosis with repetition. Therefore, the scope of oriental medicine can be expanded following a revision of the Oriental Medicine Promotion Act and it is estimated that the state of national health will be greatly improved by the mutual respect of both sides of the health profession.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.199-247
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• 2012

According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

• Research in Community and Public Health Nursing
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• v.8 no.1
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• pp.116-132
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• 1997

The purpose of the study is to find out how laws related to the nursing profession can be improved by analyzing the rules and regulations concerning nursing. Furthermore, to help settle legal matters in the process of doing nursing work. The data used for the study are the Health and Medical Act, the Maternal and Child Health Act, the School Health Act, the Special Act for Health and Medical Service in Rural Areas, the Industrial Health & Safety Act and the Notice on Nursing Professional Courses analyzed by age and content. The results of the study are as follows : First, basic nursing practice includes 'nursing care for recuperation and assistance in medical treatment and in special areas including the pre-vention of disease, maintenance of health, control of environment, and other therapeutic activities. It is suggested that the phrase 'assistance in medical treatment' should be eliminated as it limits the basic nursing practice to the assistance of the medical treatment. Second, Article 56 of the Health & Medical Act prescribes a special nurse but it does not prescribe a specific job. Accordingly, the new provison concerning the specific jobs of a special nurse should be added or a job guide should be inseated. Third, it is prescribed that those who have completed the training course after obtaining a license are qualified to be a midwife, a special nurse and a nurse practitioner working in special areas. However, school nurses, occupational health nurses and maternal and health workers are required to obtain a nurse license, but not to take an additional training course. Nurses working in special areas should be legally recognized as nurse specialists. The regulations to control various qualification standards consistently should be established. Fourth, the qualifications and types of nurses by area prescribed by Article 54 of the Health and Medical Act are not consistent with those of special nurses as recognized by affiliated organizations of the Korean Nurse Association and some hospitals. Accordingly, the qualifications and types of special nurses should be adjusted in consideration of special nurses. Fifth, as Article 16, Paragraph 2 of the Health and Medical Act does not prescribe the type and scope of first - aid treatment that nurses can provide, the first-aid treatment of nurses might be considered as an unlicensed practice. The specific regulations regarding these matters should be established. Sixth, the contents of the nursing record, which are prescribed by Article 21 of the Health and Medical Act as a duty, include 1) matters concerning body temperature, pulse, breath and blood pressure 2) matters concerning drug prescription 3) matters concerning input and output 4) matters concerning the treatment and nursing care (Article 17 of the Enforcement Regulations, Health and Medical Act). However, these matters are limited to basic nursing care and assistance in medical treatment. The new recording methods on nursing process are suggested to be adopted legally. Seventh, the prescription right entrusted to nurses which are prescribed by the School Health Act, the Special Act on Health and Medical Service for Rural Areas, and the Industrial Health and Safety Act are not consistent with the rights of nurses as prescribed by the Health and Medical Act. New regulations prescribing the partial right for medical treatment entrusted to nurses in consideration of the restraint of time and place in emergency situations should be established.

• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.111-138
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• 2021

'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

• KIPS Transactions on Computer and Communication Systems
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• v.10 no.1
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• pp.1-6
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• 2021

Recently, incidents such as proxy surgery (unlicensed medical practice) have been reported in the media that threaten the safety of patients. Alternatives such as the introduction of operating room surveillance camera devices to prevent proxy surgery are emerging, but there are practical difficulties in implementing them due to strong opposition from the medical community. However, the social credibility of doctors is falling as incidents such as proxy surgery occur frequently. In this paper, we propose a medical staff identification system combining Beacon and iris recognition. The system adds reliability by operating on the blockchain network. The system performs primary identification by performing user authentication through iris recognition and proves that the medical staff is in the operating room through beacons. It also ensures patient trust in the surgeon by receiving beacon signals in the background and performing iris authentication at random intervals to prevent medical staff from leaving the operating room after only performing initial certification.