• Title/Summary/Keyword: 지도설명의무

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Necessity of revision of the mandatory medication guidance regulation under the Pharmaceutical Affairs Act (약사법상 복약지도의무 규정의 개정 필요성)

  • Dawoon Jung
    • The Korean Society of Law and Medicine
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    • v.24 no.2
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    • pp.119-145
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    • 2023
  • The Pharmaceutical Affairs Act stipulates medication counseling as an obligatory requirement in the case of preparation of medicine. In fact, there are many cases where pharmacists only tell patients the dose and time and do not properly guide them on taking medications. However, in light of the current situation where non-face-to-face treatment is being attempted, there is a high possibility of drug-taking accidents due to insufficient medication guidance. In addition, as an aging society progresses, the need for explanations on pharmaceuticals is increasing. If a pharmacist causes damage to a patient by failing to give appropriate medication guidance, the patient can claim compensation for damages. In addition, if a drug accident occurs due to a conflict between the pharmacist's duty to guide medication and the doctor's duty to explain, a joint tort is established between the pharmacist and the doctor. Nevertheless, there are cases in which only doctors are judged to bear the tort liability. However, the Pharmaceutical Affairs Act includes providing information for the selection of over-the-counter drugs in the medication guidance as part of the medication guidance obligation. Therefore, in order to reconsider the importance of the medication-taking guidance duty, it is necessary to define the medicationaking information provision method and the medication-taking guidance duty as separate concepts. In addition, it is necessary to amend related regulations centered on patients so that medication guidance, such as side effects of medicines and interactions with concomitant medications, can be made in detail.

The Instruction Explanation Obligation - Focusing on Cases - (지도설명의무 - 판례 경향을 중심으로 -)

  • Lee, Jung Sun
    • The Korean Society of Law and Medicine
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    • v.14 no.2
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    • pp.143-172
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    • 2013
  • In order to achieve the purpose of treatment for patients by a doctor, the instruction explanation obligation, which means that he should give patients the description in more details to prepare for postoperative sequelae or complications, is common with the advice explanation obligation as a doctor should ex-plain some information to patients. Since the advice explanation obligation is the benefit and protection of the law for self determination right, but the instruction explanation obligation is one for the integrity of body and life, one can be distinct from the other. Judgments giving the instruction on the concept of instruction explanation obligation, specific methods of implementation and a range of compensation for damage are recently being made by courts at all levels including the Supreme Court. It is the time to systematize them. The contents which have been mainly discussed so far include the essence of above mentioned instruction explanation obligation. However, when the tendency of practice is considered, the efforts are required to admit the organic relevance between instruction explanation obligation and advice explanation obligation and to explain the relationship without any contradiction. For whereabouts of li-ability of proof, patients theoretically demonstrate the failure to implement it. However, when the theoretical consistency is maintained, it is likely to fail the intent to recognize the instruction explanation obligation and it may ask patients to prove something impossible to be proven. Thus, these things should be considered. Moreover, as the instruction explanation obligation is associated with medicine instruction obligation of a pharmacist and the coverage is being extended, it is the time to require the systematic study on the theoretical limit.

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Review of 2012 Major Medical Decisions (2012년 주요 의료 판결 분석)

  • Lee, Jung Sun;Lee, Dong Pil;Yoo, Hyun Jung;Jeong, Hye Seung
    • The Korean Society of Law and Medicine
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    • v.14 no.1
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    • pp.303-354
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    • 2013
  • In 2012, the major jurisdictions regarding medical cases caused the controversial issues towards medical and legal fields by getting the judgments from the Supreme Court, which admitted the exceptional admissibility on discretionary grant. By regarding the serial negligence of medical organizations as a separate tort, the sentences which made up irrationality, were spoken by the court. As a result, if the treatment was made, which did not follow the entered matters in medical documents attached, the court announced the jurisdiction that presumes the negligence, which provided the evidence of negligence; on the other hand, this gave had the burden to medical branch to take great care for medicinal treatment. To be applicable for the Principle of Trust, the doctors have to give and take the necessary information for the treatment process and symptom decisions, which also commented in the court. Thus, this case made it difficult to apply the Principle of Trust and considered all the conditions as tough ones, which eventually induced lesser faults for patients' care. Moreover, the court confirmed that the medical ads sending the emails to the members belong to the internet portal sites, are not the inducing behavior by considering that the actions are only medical ads. Furthermore, in the case of Namsu Kim, the court's interpretation was rather limited the definition for medical practice that announced limited Erweiterung der Strafbarkeit cases by lower courts. As a consequence, it is very interesting whether the Supreme Court may change their position and concerning the duty of explanation, the trend to expand the contents and scopes for the duty of explanation continues by admitting instruction explanation obligation and all the compensations and so on.

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A Study on Recent Discussions ahout the Pysician's Explanation in Medical Litigation (의료소송에서 의사의 설명에 대한 최신 지견)

  • Baek, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.37-63
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    • 2023
  • In medical litigation, there are various cases where a doctor's 'explanation' of a patient becomes problematic. Medical explanations and guidance are required from the doctor, starting from the beginning of diagnosis, through treatment processes such as surgery, when hospitalization is necessary for treatment, during hospitalization, upon discharge, and after discharge. Furthermore, notification from the doctor or medical institution may be requested regarding the economic costs that will be incurred due to medical treatment. South Korea's judiciary has been developing legal principles regarding such doctor's explanations by distinguishing between explanations for obtaining consent for medical treatment and medical explanations related to guidance on patient treatment methods, taking into account related laws such as the stage of treatment and the Medical Service Act. Additionally, the Constitutional Court recently ruled on the non-benefit cost notification system linked to the explanation of economic costs. However, holding a doctor accountable solely because the doctor's explanation was insufficient has aspects that do not correspond to the actual situation in clinical reality, and may have a reflexive disadvantage that results in a decline in legal rights. Therefore, the doctor's explanation needs to be examined from both perspectives: guaranteeing the patient's right to self-determination and protecting his or her right to decision.

Review of 2017 Major Medical Decisions (2017년 주요 의료판결 분석)

  • Lee, Jung Sun;Lee, Dong Pil;Yoo, Hyun Jung;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.207-254
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    • 2018
  • The major court rulings delivered in 2017 include the ruling that separated the legal character of denture production agreement signed together with medical care agreement and found a subcontracting dimension in the former, and the ruling that overcame the limitations of the theory of entire appearance of a fetus as discussed in civil law by using the legal principle of insurance which suggests that unborn child insurance takes effect after the contract is signed and the first installment of the premium is paid in. As more court rulings find the medical specialists responsible for accidents and injuries from drugs, some argue that medication counseling by the druggist who makes and dispenses drugs should be upgraded. And with respect to a court ruling that denied the hospital's responsibility for an infection-involving accident even if there were no records on specific measures taken in infection management, some criticized the court for being too conservative in recognizing responsibilities. And with respect to infectious disease management, some criticized the court for its interpretation and application of the facts in the direction of denying the negligence. In addition, some claimed that it is necessary to establish institutional system for hospital infection control and its aid for victims, and to improve the system including the reversal of the burden of proof given the special nature of hospital infections. A number of rulings on the duty to disclose included the one which stated that the specific matter did not require a doctor's explanation as it was explained or the specific medical service would have been performed even if no explanation had been given. There was a greatly controversial ruling over the scope of indemnification, which accepted the occurrence of multiple scars and deformation as disorders while regarding breast as a thoracic organ. And a Supreme Court ruling over interpreting Medical Service Act was criticized as overstepping the boundary allowed in the law.

The Trend of Precedents about Calculation of Damage Compensation for Last Decade (손해배상액 산정에 관한 최근 10년간 판례의 동향 (상)(上))

  • Park, Young-Ho
    • The Korean Society of Law and Medicine
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    • v.10 no.2
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    • pp.11-36
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    • 2009
  • This thesis introduces the trends of korean courts' ruling on damages in medical malpractice cases for past 10 years. First of all, Korean courts' ruling have had a tendency to pay only non-economic damages for not taking the informed consent. If a doctor cannot get the informed consent from a patient, he compensate only non-economic damages for the infringement of self-determination rights of patient. It's enough for the plaintiff to prove the infringement of self-determination rights, if the plaintiff just want to get non-economic damages. The Korean Supreme court have ruled that if plaintiffs want to get economic damages for the infringement of self-determination rights or informed consent, plaintiffs must prove that the infringement of self-determination rights is the proximate cause of the economic damages of patient. There is another tendency for the Korean Supreme court to limit the damages in medical malpractice cases on the ground of patient's diseases' dangerousness or patient's idiosyncrasy. In the past courts often limit the damages only to 70~80% of total damages, but now a days courts mostly limit the damages to 20~30%. This thesis also introduce the Korean courts' trends about Valuing damages in personal injury actions awarded for gratuitously rendered nursing and medical care.

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Children's eating behaviors and teachers' feeding practices during mealtime at child-care centers (어린이집 급식시간 중 영유아의 식사행동 실태 및 보육교사의 식사지도 방법)

  • Yeoh, Yoonjae;Kwon, Sooyoun
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.71-80
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    • 2015
  • Purpose: The aim of this study was to investigate children's eating behaviors and teachers' feeding practices during mealtime at child-care centers. In addition, it focused on the difference of teachers' feeding practices on children age under 2 years ( ${\leq}2$ years old) and 3 years and older (3~5 years old). Methods: A total of 169 teachers working at childcare centers in Geumcheon-gu, Seoul, Korea, completed self-report questionnaires in December 2013. The questionnaires were composed of questions on children's eating behaviors, feeding practices; 'Explain', 'Praise', 'Modeling', 'Indulgent', 'Insist' and 'Reward', interaction with home, and a range of demographic information (analysis rate: 51.2%). Results: Approximately 59.2% of teachers had not taken a class on feeding practice and the average score for nutrition knowledge was 14.6 out of 30 points. The most undesirable eating behavior of children during mealtime was 'eating while walking around (36.7%)' both ' ${\leq}2$ years old' and '3~5 years old'. Regarding feeding practices according to children's undesirable eating behaviors during mealtime, there were differences between age groups. When children did not eat all of the foods that were served and did not clean up silverware or seats after having food, teachers caring for '3~5 years old' practiced 'Explain'. However, percentages of those who practiced 'Indulgent' and 'Modeling' were significantly higher in teachers caring for ' ${\leq}2$ years old' than '3~5 years old'. Conclusion: These findings indicated that teachers caring for children lack education and knowledge about nutrition and feeding practice. In addition, verbal feeding practices, like explain, were mainly used by teachers. As a result, for teachers, guidelines and programs for learning about age appropriate feeding practice during mealtime at child-care centers may be needed.

Review of 2010 Major Medical Decisions (2010년 주요 의료 판결 분석)

  • Lee, Jung-Sun;Seo, Young-Hyun;Yoo, Hyun-Jung
    • The Korean Society of Law and Medicine
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    • v.12 no.1
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    • pp.177-225
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    • 2011
  • Verdicts related to major medical litigation given by the Seoul Central District Court, the Seoul High Court and the Supreme Court in 2010 were analyzed. It's shown that in cases of the medical negligence regarding the occurrence of neonatal cerebral palsy, the plaintiff claims were dismissed using criteria proposed by associations of Obstetrics and Gynecology and Pediatrics in US, and thereof the burden of plaintiffs to prove the medical negligence has increased. In addition, in case of that the expected survival period of infants gets longer, payments for treatment and nursing after survival period determined by judges are made and it was judged to compensate it as a periodical indemnity. In case for the explanation obligation the most frequently mentioned in the medical litigation, in addition to cases of invoking the existing theory of explanation obligation, verdicts to mention the instructions of theory regarding instruction explanation obligation and the possibility of compensation for damages on property are given. Particularly, in cases for a liability of reparation by exaggerating the effects and not disclosing the risks related to treatment with stem cells, even if the treatment not approved by Food and Drug Administration is in violation of the Pharmaceutical Affairs Law, it's not illegal as violation in Pharmaceutical Affairs Law itself. But there is a certain verdict to present the possibility of an extension of the theory of explanation obligation by acknowledging the liability of reparation caused by illegal acts with no explanations of effects and risks of treatment with stem cell by doctors and pharmaceutical companies. In an incident in which a mental patient fell and died through the opened door of the roof at the hospital, a liability of reparation was acknowledged due to defects in structure installation management and this verdict drew an attention since the overall management responsibility about patients including structures was acknowledged to the hospital besides the obligations on medical practice. In case of the verdict without giving the opportunity to state the opinion with respect to the main legal issues, the responsibility of the court was emphasized since the court did not fulfill the explanation obligations. There were some cases in which payments for nursing and caring to a patient in vegetative state during the plastic surgery was admitted. However, in dental-related incidents, the proportion of cases in which plaintiff won was low since the difficulty of proving may be reflected. In the area of administrative litigation, unlike the existing position regarding arbitrary medical charge cover collected from patients in hospital, the verdict to admit the legitimacy of collection of medical treatment was given and attracted the attention of people. Verdict in which the expression related to medical advertisement was not exaggerated disposed the original verdict and pointed out the problem of excessive regulations on medical advertisement. The effort to analyze the trend of verdicts of court through reviewing the decisions and to organize should be continued, but the full decision should be disclosed as a base, and people and systems to enable the all time monitoring should be prepared.

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The Trend of Precedents about Calculation of Damage Compensation for Last Decade (손해배상액 산정에 관한 최근 10년간 판례의 동향 하(下))

  • Park, Young-Ho
    • The Korean Society of Law and Medicine
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    • v.11 no.1
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    • pp.397-445
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    • 2010
  • This thesis introduces the trends of korean courts' ruling on damages in medical malpractice cases for past 10 years. First of all, Korean courts' ruling have had a tendency to pay only non-economic damages for not taking the informed consent. If a doctor cannot get the informed consent from a patient, he compensate only non-economic damages for the infringement of self-determination rights of patient. It's enough for the plaintiff to prove the infringement of self-determination rights, if the plaintiff just want to get non-economic damages. The Korean Supreme court have ruled that if plaintiffs want to get economic damages for the infringement of self-determination rights or informed consent, plaintiffs must prove that the infringement of self-determination rights is the proximate cause of the economic damages of patient. There is another tendency for the Korean Supreme court to limit the damages in medical malpractice cases on the ground of patient's diseases' dangerousness or patient's idiosyncrasy. In the past courts often limit the damages only to 70~80% of total damages, but now a days courts mostly limit the damages to 20~30%. This thesis also introduce the Korean courts' trends about Valuing damages in personal injury actions awarded for gratuitously rendered nursing and medical care.

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A Study of the Workfare Reform in Britain : with Special References to the Ideological Change of Labour Party (영국의 근로복지(Workfare) 개혁에 관한 연구 : 노동당의 이념적 변화를 중심으로)

  • Moon, Jin-Young
    • Korean Journal of Social Welfare
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    • v.56 no.1
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    • pp.45-70
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    • 2004
  • This study purports to explain the difference between the welfare reform of Britain and that of either European countries or USA. For this purpose, Chapter two documents and reviews the inter-party debates around the Clause Four in the Labour Constitution, and duly ascertains the role of the reciprocity principle in the development of New Labour Project. Then, Chapter three argues that this reciprocity principle guides and controls the whole process of workfare reform of the Labour Government since 1997. Finally, Chapter four concludes that the salient features of the British workfare reform originated from recent changes of the British political climates, that is, the ideological change of the Labour Party.

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