This article analyzes legal meaning and definition of medical practice examining Korean Supreme Court cases. Until now, there is no right answer about the meaning of medical practice and it is also hard to define of it. Moreover, not only Acts and regulations containing medical practice but also many cases ruling a person who practice medicine, the concept of medical practice involves various meanings. So, it has caused confusion. In order to solve this problem, this article divides the medical practice's meaning into range and nature within prohibition article of the Medical Act about unlicensed personnel who practice medicine. After providing a explanation of the meaning of medical practice according to amendment of the Act, this article disputes the meanings of the several cases following the amendment. And then analyzing non-medical person's unlicensed medical practice and medical person's unlicensed medical practice. In order to provide more accurate legal concept of medical practice when Korean government amends the Medical Act or making policies in this field, this classifying analysis approach should be needed. Looking at the result, in general, Korean Supreme Court has interpreted unlicensed prohibition clause of the Medical Act widely; not only non-medical person's unlicensed medical practice but also medical person's unlicensed medical practice. Therefore, this article suggests that the prohibition clause needs to be careful applying to non-medical practice. Because, in fact, even though there are some necessity of non-medical practice, there are no qualificatory or license system of non-medical practitioner in the Medical Acts or regulations forbidding whole non-medical practices. Furthermore, the Supreme Court has decided medical person's unlicensed medical practice too narrowly, thus it does not keep up with rapid change of medical development and people's demands these days. Regarding this subject, in order to take advantage of medical practitioners effectively and cope with increasing people's medical demands, this article proposes that medical person's unlicensed medical practice only to be prohibited in case of endangering our public health.
This article analyses the concept of medicine in the legal context. It is not easy to define the concept of medicine because medical practice has various dimensions and the situation in which the practice is performed has a broad variety. The duty of medical law is to build the boundary of protection in that the nature of medicine would not be distorted by the factors of social systems like industry or governmental authorities. Without understanding the various dimensions - especially the dimension of Humanities and Sociology - of the medicine it is not possible to draw the limit on the performance of medicine appropriately. Concerning the medical practice (especially in the context of the regulation of medical licence), the enacted law (Medical Act) defines the concept just for form's sake and it finally depends on the interpretation of the legal enforcement authorities. Moreover, between the judgments of the courts there exists no coherent principles for the regulation and the interpretation of the Medical Act depends often on the riskiness, the abstract concept, which finally leads the interpretation to depend on the subject of the practice. On the contrary, the development and scientific movement of the technology tends to tighten the range of the medical professionals of medical practice and the perspectives of the medicine. Medical act is actually oriented at the patient's understanding of him- or herself. The above-mentioned tendency of the interpretation and the legal policy could lead the medicine away from its nature.
Nowadays, it is surely the quack which stands as one of the most controversial, problematic. the quack has been a consistent target of contested public protection strategies in the past few centuries in many countries. Recently, complementary and alternative medicine (CAM) is increasingly utilized and accepted by patients and providers throughout the health care system in the world, most accounts attribute this growing acceptability to the shortcomings of conventional medicine, the appeal of CAM's core beliefs, and the growing body of research indicating that CAM actually works. However, the governments of western countries have called for measures to ensure that the public are protected from incompetent and dangerous practitioners. Common to these controversies has been a suggestion to ban, exclude or limit the medical practice of those deemed to be damaging rather than improving the health of individuals as a measure of public protection. This article describes the experiences of western counties' health care system which is moving in a more pluralistic direction. By examining the ways in which regulatory efforts in the countries have come to address what is invariably described as a growing interest in CAM, this study show how the problem of CAM/quackery today is increasingly located in an ethical field of practitioner competency, qualifications, conduct, responsibility and personal professional development, regardless of the form of therapy in question. Many countries developed a series of measures and strategies to contain the acceptance of CAM groups, such as insisting on scientific evidence of safety and efficacy, resisting integration of CAM with conventional medicine and opposing government support for research and education. In a sense, those countries' movements serve to protect not only patients, but the dominant position of medicine and its allied professions, and to maintain existing jurisdictional boundaries within the healthcare system. The popular support for CAM will require that health professional stakeholders continue to address the challenges this poses, and at the same time protect their position at healthcare system. To cope with the quack, professional body, public sector and health authorities should consider the safety of consumers of healthcare and responding to the demands of the community for CAM therapies as well as the claims of the established healthcare professions. Finally, some implications for future health care were suggested.
In November 2007, the Korean Constiutional Court held that a joint penal provision in which the individual employer is punished when his or her employee is determined to have committed a crime was unconstitutional, because the joint penal provision had no contents for the culpability of an individual employer and thus violated the constitutionally protected principle of culpability. After the Korean Constitutional Court's judgment, since December 2008 the Ministry of Justice began to change the old joint penal provision into the new revised joint penal provision. On January 2010, the old joint penal provisions of 110 laws were revised. The new revised joint penal provision adds only an additional sentence: "If a juristic person, an entity or an individual perform due care and supervision over its employee for the prevention of such a crime, it will be exempted from the punishment". But an presumption of negligence clause that is added in the new revised joint penal provision is still vacuum in concerned with supervision responsibility. Probably the new form of penal provision, that is understood to be a kind of the presumption of negligence, could let the burden of proof be changed from the public prosecutor to the accused, in other words employer-side. Especially, when joint penal provision is applied to hospital as administrative punishment, according to the hospital is a (juridical) foundation or not, the application of the joint penal provision is different and unfaithful. In my opinion, therefore, a corporation liability could be considered according to various liability of employee's business and the crime its employee committed because of an organizational failure of the corporation.
Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.
According to the development of medical technology, new medical treatments have been dramatically increased as an inevitable consequence, however, it is not easy for medical workers to learn the knowledge that is necessary for new medical treatments and their additions in the medical services. Therefore, it could not be helped increasing the guidelines for applying new medical treatments, and then, the problem would come out whether to attribute the medical negligence to the doctors who did not follow the guidelines when the patient became worse because of his non-compliance. Nevertheless, there is no document to review the problem mentioned above and also no definite precedents. Thus, the civil lawful character and obligation of guidelines on the lawsuit against the medical default have been examined in this studies. The medical negligence is defined as usual doctors violate the care obligation which is demanded for them to follow when they treat patients under the proper medical standard in those days. It is resonable to assume that the matter of guidelines is to decide the level of the care obligation, that means the care which is required of the rational doctors under same circumstances, and in general, the experts' testimonies should be needed in this case. In addition, the issue comes out whether the guidelines can be the standard of the judgement of the medical negligence. Finally, I suppose, the evaluation of the issue depends on who makes the guidelines, what materials are based on, and also depends on whether there is another guidelines in the same disease, what the purpose of guidelines is to save the medical costs or to realize the appropriate medical services, in addition, it depends on how often renew the guidelines, and how wide is the usage of guidelines.
Advance directive refers to a description of the treatment method a patient wants to be provided with in case where the person is unconscious or lacks an ability to decision making in a future period or a declaration of intention that delegates and appoints another person who makes a decision regarding a treatment method on behalf of the person. Advance directive is usually a document form, but oral statement is acceptable as well. Advance directive may have a variety of forms though, it basically consists of two basic forms. That is, one is a living will, and the other is a surrogate decision making. Though the importance of advance directive has been emphasized, and the necessity of adopting the system has been strongly argued for so far, the debates on criteria, method, and procedure alike have not yet reached an agreement. It is because even the concept of advance directive is more or less ambiguous, and each specific method has its own theoretical limitations and practical constraints. Thus the inquiries on advance directive raised in the study are summarized as the meaning, practicability, and philosophical foundation of the advance directive. Firstly, the theoretical limitations of Advance directive may be categorized into conceptual and moral limitations. In case of conceptual limitations, authors of advance directives may not be well aware, in advance, of the particular situation in which he or her will experience in the future, and patients may experience the change in his or her values and lack the understanding and information about the future situation due to the changes in treatment methods. In case of moral limitations, a patient has a limited moral autonomy right and self identity that have an impact on his or her preference. Secondly, in case of practical constraints for advance directive, there exist cultural features, low ratio of documentation, as patients themselves admit, and low predictability and stability of patient's own preference regarding life-sustaining care. And the problem of validity and accuracy in proxy's decision making is also raised. Those who administer a living will, especially, may have a difficulty in understanding the directive by a patient, so that the accuracy of execution cannot be secured. In the sense, it is needed to implement a legal device in order to solve such problems. In summary, it is urgently required to understand the limitations and explore desired alternatives to overcome the relevant problems in advance, which must contribute to successfully adopting and effectively operating the advance directive system in Korea.
In the presidential new-year address in January 2, 2009, the President declared that 17 kinds of new driving force of growth that could create high-added value be selected to step up job creation and an increase in national wealth. The Ministry of Strategy & Finance announced plans for the 17 kinds of new driving force of growth after the presidential address. Specifically, that ministry announced an ambitious plan to select health care service named 'Global Health Care' as one of the five service industries that could create high-added value in a move to provide jobs to approximately 7,000 people and produce pervasive economic effects coming up to a trillion and 10 billion won. To attain the goal, several action plans were mapped out to globalize domestic medical institutions, to rearrange the relevant law and system for the purposes of raising awareness of domestic medical institutions among foreign patients and improving their accessibility and post-satisfaction level, and to lure lots of foreign patients through financial assistance. At the same time, the government announced plans to lure severe patients such as those in want of surgery or organ transplant, cancer patients or patients with heart diseases to create high-added value on a long-term basis. Thus, the government announced that it planned to formulate such strategies and to enter an agreement with foreign governments to attract plenty of foreign patients. In fact, however, there are little full-scale evaluation of medical tourism though it's been a year since it was introduced, and there are few actual efforts to implement what the government announced, either. According to the results of the evaluation of medical tourism, domestic hospitals are said to undergo little significant changes after the introduction of medical tourism, which shows that they take a dim view of medical tourism instead of having expectations for that. The medical tourism industries in major Asian countries have been dynamized, and there are several factors of their success. First of all, they are successful in creating new market opportunities by incorporating related industries such as medicine, tourism and IT and in developing medical tourism products and differentiated marketing by taking advantage of their competitive edge. They have offered full-fledged assistance to this sector, and another reason is the improved international credibility of their medical service. If our country fails to pinpoint our problems in consideration of the cases of the Asian countries or to provide appropriate financial aid, our country is bound to lag behind them. Given this reality, how to assess medical tourism and what challenges this sector is confronted with are discussed.
This study is a paper reviewed legal status of medical personnel and issues of law on recently discovered medical records. As the increase of medical personnel who have gone through the administrative disposal in regards to the medical records, it is needed to examine the legal issue or dispute on the medical records under the current law. Medical records are the statement on patient's medical conditions made by the medical personnel. This records are used as important source for patient's further treatment. This becomes the communication route between the patients and the other medical personnel, and it provides the patients a right to find out their medical information. According to the Medical Service Act (Article 21), a medical personnel shall prepare respectively a record book of medical examination and treatment. And medical personnel shall make a signature. Furthermore, the medical personnel or the opener of the medical institutions must preserve the record book (including an electronic medical record). Meanwhile, the issues of a ban on false entry, additional record, revision or manipulation on the medical record have been recently on the rise. This paper briefly examined the major issues in regards to the medical records. It especially clarified the legal duty on medical records and its major-contentious-issues. At the same time, it pointed out the problems of the unreasonable over interpretation of the law. Furthermore, this suggested the guidelines for the further discussion and review.
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.
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