• The Korean Society of Law and Medicine
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• v.22 no.2
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• pp.81-109
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• 2021

This paper review about the relationship between the prohibition against medical refusal and the principle of private autonomy in medical contracts. The obligation to this Prohibition in Medical Law does not restrict the liberty of contracting a medical contract. On the other hand, the prohibition limits the freedom to terminate medical contracts. Medical contracts can be terminated if the trust between doctors and patients is vanished. However certain restrictions should be placed on termination of the medical contract, because termination of the contract should not be detrimental to patients' health. According to the current medical law the medical contract is to be enforced in principle and can be revoked only with justifiable reason. At the Civil Code on Medical Contracts the freedom to terminate the medical contract is permitted, but this paper suggests the restrictions of the revocation under certain conditions. The Criminal Punishment Regulations against medical refusal should be removed. Refusal the provide medical service should be regulated by administrative sanctions under the National Health Insurance Act's obligation.

• Journal of Teachers' Pension
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• v.4
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• pp.127-173
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• 2019

현재 공적연금제도의 하나인 사학연금은 일반 민간 기업에서 퇴직시에 지급하는 퇴직금과 유사한 성격의 '퇴직수당' 급여를 지급하고 있다. 사립학교연금법에서 지급하고 있는 퇴직수당제도는 학교법인인 사용자가 지급할 의무가 있는 급여에 해당한다. 그러나 사립학교의 열악한 재정으로 인하여 학교법인이 지급하지 아니하고 이를 국가와 공단 및 대학의 일부가 이를 분담하여 지급하고 있다. 사학연금공단에서는 매년 236억원을 연금기금에서 지급하였으며, 동 금액은 기부금으로 손금산입되어 왔다. 그러나, 최근 들어 기부금의 손금 인정비율이 50%로 축소되어 실제 법인세를 납부하고 있다. 본 연구에서는 이러한 퇴직수당 공단부담금을 공단에서 부담하는 것이 타당한지 여부와 기부금으로 처리되는 것에 대한 타당성 여부 등에 대하여 세무회계적인 접근을 통해 법인세제개선을 위한 법 개정의 타당성을 살펴보고자 하였다. 본 연구는 퇴직수당 공단부담금이 기금회계에서 지급되어 기부금으로 보고 있는 기존의 예규에 대한 해석을 새롭게 하고 사학연금기금의 세무회계상 개선방안을 도출하고자 하였다. 퇴직수당의 급여지급은 엄밀하게 살펴보면 기금회계의 대상이 아니라 연금제도의 고유사업인 연금회계의 대상으로 보는 것이 타당하다. 이와 같은 현행 공단의 회계처리 및 기금회계 과세대상의 문제점을 인지하고 이를 면밀히 분석해보고자 한다. 본 연구는 사학연금기금의 법인세 부담으로 인한 연금재정악화를 사전에 방지할 뿐만 아니라 사학연금기금에 대한 안정화를 도모하고자 하는 방안 연구의 일환으로 법적 개선안 도출을 목적으로 하고 있다. 공단은 사립학교 법인을 대신하여 공단에서 대신 지급하면서도 이에 대해 기부금으로 보는 규정으로 인해 법인세를 납부하고 있어 부담금을 대신하여 납부하면서 법인세도 부담하고 있는 이중부담을 안고 있는 것이다. 본 연구에서는 이와 같은 사항을 토대로 다음과 같이 개선방안을 제시하고자 한다. 우선, 공단내부회계규정의 수정을 통해 퇴직수당의 연금회계 적용을 주장하고자 한다. 퇴직수당제도는 연금급여와 관련된 것으로 비과세대상의 고유목적사업 회계에 해당됨에도 불구하고 퇴직수당을 기금회계에서 기부금으로 처리하는 것은 법 논리상 타당하지 않다고 본다. 둘째, 학교법인을 대신하여 기금에서 대신 지급하였다는 것은 연금제도를 유지하기 위해서 연금법상에서 강제로 부과된 부담금으로 이를 필요경비로도 보아야 한다. 셋째, 학교경영기관이 마땅히 부담하여야 할 부담금임에도 불구하고 사학연금기금에서 부득이하게 지급하고 있음을 감안하여 퇴직수당부담금은 현행의 법인세법상 기부금 한도초과 대상에서 제외하는 특례규정을 신설하는 것이다. 본 연구는 최근 법인세가 과세되고 있는 사학연금기금의 과세 문제점을 살펴보고 이에 대한 개선방안을 제시하였다는 점에서 기존 연금제도의 틀 안에서 퇴직수당제도의 법적 부담을 검토한 연구와는 달리 법인세법상의 세무적 검토를 하였다는 점에서 의의가 있다고 할 수 있다.

• Journal of radiological science and technology
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• v.45 no.5
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• pp.407-412
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• 2022

Cerebral aneurysm coil embolization has the advantages of accurate, low patient burden, and fast recovery time, but efforts are needed to reduce dose due to the burden of exposure radiation dose during interventional procedures. In this study, the area dose product(DAP/Gy·cm²) and fluoro time(min) according to the size of the aneurysm and the location of aneurysm were investigated according to insurance recognition regulations aneurysm classification cerebral aneurysm coil embolization. According to the research method, classification according to the size and location of the aneurysm is first, the size of the aneurysm is divided into less than 4mm, more than 4mm to less than 8mm, and more than 8mm, and second, the dose to the area based on the location site (DAP/Gy·cm²) and fluoro time(min) based on the location site were observed. As a result, the location of the cerebral aneurysm procedure was found to be the Paraclinoid site. During cerebral aneurysm coil embolization, the area dose was 107 Gy·cm² and fluoro time was 47.41 minutes, showing lower results than domestic studies, and when comparing the area dose product with foreign studies, the area dose product results were similar to that of Turkey and Saudi Arabia. It is expected that it can be used as an objective analysis indicator to establish diagnostic reference levels (DRLs) and patient radiation defense guidelines according to the size of cerebral aneurysm and location of cerebral aneurysm procedures during interventional procedures.

• Journal of Genetic Medicine
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• v.6 no.1
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• pp.38-55
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• 2009

Purpose: This study was undertaken to provide the framework for development of a genetic counseling training program, and an accreditation and certification process suitable for non-M.D. genetic counselors in Korea. Materials and Methods: Global standards of genetic counseling curriculums, training program accreditation (TPA), and the certification process for genetic counselors (CPGC) in the U.S.A and Japan were reviewed, and a questionnaire survey was performed to elicit opinions among health-care providers including physicians, nurses, technicians, researchers, and educators. In addition, input from professional communities, including the Korean Society of Medical Genetics (KSMG) and Institute for Genetic Testing Evaluation, was sought in formulating the framework of this study. Results: Comparison of U.S.A. and Japan educational systems showed similarities in curriculum, accreditation, and certification programs. Analysis of 117 respondents opinions showed a high level of agreement in the area of global standards; 88% indicated that KSMG should be in charge of TPA and CPGC, while 77% favored a certification exam composed of both written exam and interview components. Conclusion: Based upon this study we propose that the KSMG should be in charge of providing the TPA and CPGC for non-MD genetic counselors. Requirements for the entrance to a Master's degree genetic counseling program should be open to successful four year undergraduate students in all areas, provided the candidates demonstrate the abilities to master the graduate level of study in human genetics, clinical genetics, statistics, psychology, and other required subjects. Eligibility for certification should include qualified candidates of genetic counseling with no formally approved education, but a sufficient amount of clinical experience, in addition to accredited program graduates. Certification examinations should be carried out every two years and the certification should be good for five years, as is the case in Japan.

• Korean Journal of Social Welfare
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• v.58 no.1
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• pp.395-423
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• 2006

The purpose of this study was to investigate the various contents of legal life's conflicts and constitutional applications by analysing on the constitutional judicial precedents regarding to social welfare law. The total cases of constitutional precedents are 62 totally, and 22 precedents among 62 are analysed through content analysis. These 22 constitutional precedents consist of nine cases of concerning Social Insurance Act, six cases in National Pension Act, two cases in National Basic Livelihood Protection Act and one cases in Social Welfare and Service Act. The major contents of these precedents are regarding to operational principles of social insurance system, rule of entitlements, benefits, social welfare organizations and the constitutional right such as property right, equal right, right of happiness. And also there are precedents to review how the rule of Act is interpreted or how the process of right protection is. Findings in this study show that Korean Constitutional Law has characteristics of welfare nationalism and social capital economics orientations, and sanctions legislation and administration discretion.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.299-346
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• 2016

There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.