• 제목/요약/키워드: Duty Autonomy

검색결과 42건 처리시간 0.026초

환자의 모를 권리와 의사의 배려의무 (Patient's 'Right Not to Know' and Physician's 'Duty to Consideration')

  • 석희태
    • 의료법학
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    • 제17권2호
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    • pp.145-173
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    • 2016
  • 우리나라에서 전통적으로 환자의 자기결정권 내지 자율권은, 의사의 보고성 설명의무에 대응하는 알 권리 그리고 의사의 기여적 설명의무에 대응하는 수진 동의권 및 수진 거절권, 양자를 '중심'으로 해서 논의되어 왔다. 환자의 자율적 결정의 내용으로서 형성 피력되는, 자기 신체 및 의료 상황에 대해 알고 싶지 않은 희망과 그로 인한 이익에 관한 지위- 도덕적 법적 지위 - 는 환자로부터의 알 권리와 동의권의 포기 또는 (의사가 부담하는) 설명의무의 면제라는 소극적 지위 차원에서 인식되었다. 그리고 설명 동의 원칙 도그마의 적용에 의한 역기능 문제는 설명 동의 원칙의 적용 배제 및 그에 따른 의사의 책임 부인이라는 역시 소극적 접근법에 의해 '주로' 인식되었다. 즉 환자의 그러한 알고 싶지 않다는 '무지(無知)의 희망'을 실현시켜 줄 법적 수단이 환자의 '모를 권리' 및 의사의 '부작위 배려의무'라는 '적극적 지위'로 이해되고 인정되지 않았던 것이다. 이러한 당사자의 적극적 지위 설정이 전제되지 않으면 실제상 및 이론상 문제가 제기된다. 환자가 동의권을 포기한다고 선언하거나 의사의 설명의무를 면제한다고 표명했음에도 불구하고, 의사가 굳이 환자를 상대로 설명 내지 보고를 행하여 환자에게 큰 손해가 발생한 경우에, 의사의 그 행위를 규범적으로 어떻게 평가할 것인가가 문제인 것이다. 한편 의사가 설명의 역기능을 우려하여 설명을 행하지 않았고, 그 행태에 대해 적절한 것이란 평가가 가능한 경우에, 그 재량적 불설명의 적법성을 인정할 직접적 근거가 무엇인지를 밝히는 것 또한 문제이다. 이러한 문제를 해결하기 위해 근본적으로 환자에게 '모를 권리'라는 지위를, 의사에게 '배려의무'라는 지위를 인정할 필요가 있다. 요컨대 이 권리와 의무 개념은 환자의 자율성 관념의 충실화와 설명역기능 현상의 적정한 방지라는 법규범적 요구를 충족시키는 데에 매우 유용한 도구로서 수용할 수 있다.

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교육자치의 이념에 토대한 지방아카이브 논의 공공기록물법 제11조의 개정 필요성을 중심으로 (Discussion on Local Archives Based on the Ideology of Educational Autonomy : Focused on the Need to Amend Article 11 of the Public Records Act)

  • 정상명
    • 기록학연구
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    • 제72호
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    • pp.33-89
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    • 2022
  • 최근 경상남도기록원과 서울기록원의 개원에 이어 시·도의 지방기록물관리기관 설치를 위한 업무가 활발하게 진행되고 있다. 이 과정에서 시·도 지방기록물관리기관의 등장에 따른 기록물관리 업무에 직·간접적으로 영향을 받는 기관이 있으니 바로 시·도교육청이다. 현행 공공기록물법 제11조는 시·도지사에게만 지방기록물관리기관 설치 의무를 부여하는 등 시·도 중심으로 규정되어 있는 반면, 시·도 교육청은 기관 설치 의무로 갖고 있지 않을뿐더러, 시·도 지방기록물 관리기관이 설치될 경우 소관 기록물 중 보존기간 30년 이상의 기록물을 이관해야 하는 의무 등만 명시되어 있다. 이는 시·도교육청과 시·도가 헌법과 법률에 따라 각자 시·도 단위에서 고유의 업무와 역할을 수행하는 것을 고려할 때 적절하지 않다. 따라서 이 연구는 시·도교육청과 시·도가 기본적으로 지방교육자치와 지방자치를 실현하는 핵심 기관으로서 각자 관할 지역에서 독립적으로 고유 사무를 담당하는 대등한 행정기관이라는 점을 법적·제도적 및 역사적으로 비교하여 살펴보고, 지나치게 시·도 중심으로 구성되어 있는 현행 공공기록물법 제11조의 개정 필요성과 함께 시·도교육청의 지방기록물관리기관 설치에 따른 기대효과를 제시하였다.

의료소비자의 비급여 진료에 대한 자기결정권 행사와 관련 요인 (Factors Associated with the Exercise of Right to Self-determination about non-benefit Medical Services)

  • 김지은;함명일;이혜원;김선정
    • 한국병원경영학회지
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    • 제27권1호
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    • pp.11-19
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    • 2022
  • Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision. Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA). Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination. Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

병원에 종사하는 의료기사 직종의 전문직업성과 조직성과 (The Medical Professionalism and Organizational Performance of Medical Technician in Hospital)

  • 임정도
    • 한국콘텐츠학회논문지
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    • 제13권12호
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    • pp.910-920
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    • 2013
  • 본 연구는 35개 병원급 이상 의료기관에 종사하는 물리치료사, 방사선사, 임상병리사, 작업치료사 437명을 대상으로 전문직업성이 조직성과에 어떠한 영향을 미치는지 살펴보고자 하였다. 분석결과 첫째, 의료기사 직종 종사자들의 전문직업성은 직업에 대한 가치 구성변수 중 직무수행능력과 직무의미성 보수의 적절성 직무자율성이 성별과 연령대에 따라 유의한 차이가 있었고, 직무에 대한 영향력은 연령에 따라서만 유의한 차이가 있었다. 둘째, 조직성과 측정변수인 직장에 대한 애착에 가장 큰 영향력을 미치는 변수는 직업에 대한 가치 변수중 보수의 적절성이었다. 셋째, 직무특성 중 현 병원 근무년수가 높을수록 직장에 대한 애착이 높다는 것을 알 수 있었다. 넷째, 직종별로 살펴본 결과, 의료기사 직종의 조직성과(직장에 대한 애착)에 영향을 미치는 전문직업성 변수들은 의료기사 직종에 따라 차이가 있었다.

의료급여관리사의 직무스트레스와 직무만족도 (A Study of Job Stress and Job Satisfaction of Medical Aid Client Managers)

  • 최정명;오진주;이현주
    • 한국직업건강간호학회지
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    • 제17권2호
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    • pp.146-154
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    • 2008
  • Purpose: The purpose of this study is to investigate the degree of job stress and job satisfaction and the relationship between job stress and job satisfaction of Medical Aid Client Managers. Method: Data were collected from 185 Medical Aid Client Managers in 234 areas between April 2-15, 2007. Collected data was analyzed for the frequency, t-test, ANOVA, Pearson's Correlation Coefficient etc. Results: The average score of job stress was 2.6. Job instability was highest as 2.9 and job autonomy was lowest as 2.2. in eight items. When the job stress of Medical Aid Client Managers was converted to 100 point, the average was 51.7 and ranked in upper 50% of Korean woman workers' job stress. Among the eight items, because the relationship satisfaction and the instability of duty regime ranked in upper 25% of Korean woman workers' job stress, those items were identified to have high stress. The average score of job satisfaction was 2.3 out 4.0 which could be interpreted as unsatisfactory. The correlation between the job stress and the job satisfaction demonstrated significant difference. Decrease of the job satisfaction was associated with increase of the job stress. In regard to the eight items, the inverse correlation was demonstrated to be significant in organization, inappropriate compensation, and workplace culture. Conclusion: Medical Aid Client Managers have high stress in carrying out their duties. They have experienced very severe instability in their duty regime. Also, they have felt alienated from their organization and experienced unfair rewards. They had low duty satisfaction but got a heavy workload and experienced overtime work. To relieve job overburden of Medical Aid Client Managers. it was necessary to improve business system and also was necessary to relieve a regional disparity of business charge.

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책무성(Accountability)의 개념분석 (Concept Analysis of Accountability)

  • 김기경
    • 간호행정학회지
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    • 제10권2호
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    • pp.233-241
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    • 2004
  • Purpose: The study was done to analyze the concept of accountability. Method: This study adopts a methode of Walker and Avant(1995) for analysis. Result: The defining attributes of accountability are obligation(competency, implementation) of justification, explanation, reporting and disclosure one's action to whom, acception of the evaluation and sanction against results of one's action. The antecedents of accountability are competency, knowledge, skills, values, duty, obligation, authority, empowerment, responsibility, autonomy. The consequences are public safety, improvement of professionalism & healthcare quality, partnership and stress & strain. Conclusions: It is required to develop the ethical concept and theory construction for accountability.

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지방자치시대의 농촌지도업무의 변화와 방향 (Trends and Directions of Agricultural Extension Services under the Local Autonomy Period in Korea)

  • 이용환
    • 농촌지도와개발
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    • 제7권1호
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    • pp.45-64
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    • 2000
  • The purposes of the study were to identify the present status of the agricultural extension services in Korea and its surrounding environment, and to search the desirable ways of improvement under the serious restructuring period occurred by the nation-wide localization, globalization and development of information technology. Agricultural extension services have made great accomplishment in the education for rural people and agricultural technology diffusion, but agricultural extension service system no longer well fits in the changed environment. Agricultural extension services in Korea should restructure the system, function and methods in order to cope with the changing technology and rural society. The objectives of the extension services should be clear and simplified so that the extension workers can understand their role and duty more clearly. The local governments should encourage the extension workers to carry out their services diligently and with the pride. Also, the extension workers should change their mind to fit in the changing world and should improve their capability for their services.

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지방직화(地方職化) 이후(以後) 농촌지도사업(農村指導事業)의 추진(推進) 방향(方向) (Direction for the Implementation of Rural Extension Service in an Age of Localization)

  • 하태일;류진춘;황대용
    • Current Research on Agriculture and Life Sciences
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    • 제16권
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    • pp.1-14
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    • 1998
  • As a result of the execution of the import liberalization and local autonomy with WTO system launching, centralized rural extension service converted to localized rural extension service. This advent of globalization and localization era affects our over all agricultural condition, moreover the duty and role of rural extension organization which take complete of rural extension, is compelled to diversified and specified technology. In this study, first we will investigate the change of agricultural, rural community, and local rural extension service in globalization and localization era. Second we will analyze the confronted problems of local rural extension service. With this study's outcome for basis, we will present new role and direction of local rural extension service which can contribute to local agricultural development.

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물리치료사의 근무실태와 직무만족도에 관한 조사연구 (A Study on the Service Performance and Job Satisfaction of Physical therapists)

  • 전제균
    • The Journal of Korean Physical Therapy
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    • 제3권1호
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    • pp.9-37
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    • 1991
  • The purpose of this . study is to examine the unsatisfactory factors of the physical therapists and to obtain the materials necessary to comply with these factors by analysing their service performance and job satisfaction, To accomplish these purposes, this study was carried out by using the questionnaires 206 physical therapists registered in the Korean Physical Therapists Association, for 35 days from January 7 to February 10, 1990. The result of this study is summarized as follows. 1. Of total respondents, the male accounted for 54.4 percent, while the female for 45.6 percent. Their age showed that 20s accounted for 65.0 percent, while the service period less than 3 years accounted for 66.5 percent. In addition, 63.6 percent of them served at the general clinics. 2. The general clinics caused the physical therapists to serve for 10 hours or more per day, where their therapy room located in the underground accounted for 41.3 percent. Their health diagnosis status indicated that nondiagnosis accounted for 63.2 percent. The number of the served patients fer a day showed that 20-30 accounted for 37.4 percent, while 30 persons or more for 25.7 percent. 53.4 percent of total subjects was unsatisfied with their duty quantity. And, the monthly salary indicated that 500,000 or less accounted for 72.3 percent. 3. The average marks by their job satisfaction factors indicated 4.42 for duty importance, 4.02 for recognization of specialized job, 3.98 for ability exercise, 1.99 for promotion possibility, 2.28 for reasonable salary, and 2.41 for welfare system, respectively, based on 5 full marks. 4. The summarized job satisfaction by factors indicated that the relation with the doctor accounted for 57.8 percent, the satisfaction status with the existing job for 53.4 percent, the ability development for 41.8 percent, respectively, and the salary for 10.2 percent. Then, the satisfaction by sex showed that the male was generally satisfied with the ability development (p<0.05), the relation with the doctor (p<0.01), and the satisfaction with the existing job, while the female was satisfied with the duty quantity(p<0.05), salary, and the situation guarantee (p<0.05). On the other hand, the satisfaction by age indicated that the subject of the lower age were satisfied with the ability development (p<0.01), the relation with the doctor(p<0.05), the salary, and the situation guarantee. Also, the satisfaction by the service section showed that the physical therapists serving at the general hospital were satisfied with the ability development (p<0.01), the duty quantity (p<0.01), the salary(p<0.01), the situation guarantee(p<0.01), and the satisfaction with the existing duty (p<0.05), while the physical therapists at the hospital and the rehabilitation center were unsatisfied with the salary (p<0.01). In addition, The satisfaction with the service period at the existing section indicated that the physical therapists less than 3 years were highly satisfied with the ability development, the relation with the doctor, the situation guarantee, and the existing duty(p<0.05), while the physical therapists more than 6 years tended to show the lower satisfaction, And the satisfaction with the monthly salary indicated that the higher the monthly salary, the higher the satisfaction with the relation to the doctor(p<0.05), the duty quantity(p<0.01), the salary(p<0.01), and the situation guarantee (p<0.01). 5. The correlation between general characteristics and job satisfaction factors indicated that the sex was directly correlated to the marital status (r=-0.442), while it was reversely correlated to the age (r=-0.564) , total career (r=-0.229), and the relation with the doctor (r=-0.233). Additionally, the age was directly correlated to the total carreer (r=-0.677), and the service period at the existing section (r=0.491), while the age was reversely correlated to the marital status (r=-0.678). Accordingly, the higher job satisfaction of the physical therapists was related to factors such as their duty importance, recognization of specialized occupation, ability exercise, autonomy, relation to colleagues, decision-making's consideration, and relation with the doctor, while the lower job satisfaction includes the opportunity of promotion, salary, welfare system, service time, duty quantity, and situation guarantee. For this reason, if the factors of the lower job satisfaction are solved, then it will be possible to encourage the motive of these physical therapists, and the acyivate their duties. More over, it is also possible to improve the medical service, Additionally, if the general physical therapy room in the hospital and in the public health center are established, more development should be accomplished in the physical therapy.

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근로환경이 주관적 건강상태에 미치는 영향 (Effects of the Working Environment on Subjective Health Status)

  • 이용원
    • 한국산업보건학회지
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    • 제27권3호
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    • pp.210-220
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    • 2017
  • Objectives: This study was conducted to prepare fundamental data and prevention measures on health promotion and occupational disease, and to assess the effects of the working environment on subjective health status and absenteeism among workers using data from the third working environment survey in Korea. Methods: This study's subjects were composed of 29,711 wage workers from the 3rd working environment survey data. The dependent variables were several diseases, subjective health status and absences, and the independent variable was the working environment. The collected data were analyzed by One-Way ANOVA, Pearson's correlation and stepwise multiple analysis using the IBM SPSS(ver. 20.0) statistical package program. Results: The effecting factors for cardiovascular disease were age, working shift and emotional state. The effecting factors for anxiety and depression were years of education, working condition, duties, and emotional state. The effecting factors of insomnia were duty and emotional state. The positive effecting factors for absent days were work standing, working shift, number of night shifts, autonomy, and duties. The positive effecting factors of subjective health status were age, work standing, working years, working shift, appropriateness of working hours, leadership of superiors, duties and emotional state. Conclusions: Based on the above results, the author considers that it is necessary to improve the working environment to reduce absent days, such as by reducing of number of night shifts and giving autonomy regarding duties, and to improve the working environment for subjective health status such as by controlling the appropriateness of working hours and stability of the emotional state. In addition, this study provides fundamental data on health promotion and occupational disease among workers.