• Title/Summary/Keyword: Duty to Inform

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A Study on the Perception Changes of Physicians toward Duty to Inform - Focusing on the Influence of the Revised Medical Law - (설명의무에 대한 의사의 인식 변화 조사 연구 -의료법 개정의 영향을 중심으로-)

  • Kim, Rosa
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.235-261
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    • 2018
  • The Medical law stipulates regulations about the physician's duty to inform to contribute to patient's self-determination. This law was most recently revised on December 20, 2016, and came into effect on June 21, 2017. There has been much controversy about this, and it has been questioned whether or not it will be effective for physicians to comply with the duty to inform. Therefore, this study investigated perceptions of physicians of whether they observed the duty to inform and their legal judgment about that duty, and analyzed how the revision of the medical law may have affected the legal cognition of physician's duty to inform. This study was conducted through an online questionnaire survey involving 109 physicians over 2 weeks from March 29 to April 12, 2018, and 108 of the collected data were used for analysis. The questionnaire was developed by revising and supplementing the previous research (Lee, 2004). It consisted of 41 items, including 26 items related to the experience of and legal judgment about the duty to inform, 6 items related to awareness of revised medical law, and 9 items on general characteristics. The data were analyzed using SAS 9.4 program and descriptive statistics, Chi-square test, Fisher's exact test and Binary logistic regression were performed. The results are as follows. • Out of eight situations, the median number of situations that did not fulfill the duty to inform was 5 (IQR, 4-6). In addition, 12 respondents (11%) answered that they did not fulfill the duty to inform in all eight cases, while only one (1%) responded that he/she performed explanation obligations in all cases. • The median number of the legal judgment score on the duty to inform was 8 out of 13 (IQR, 7-9), and the scores ranged from a minimum of 4 (4 respondents) to a maximum of 11 (3 respondents). • More than half of the respondents (n=26, 52%) were unaware of the revision of the medical law, 27 (25%) were aware of the fact that the medical law had been revised, 20(18%) had a rough knowledge of the contents of the law, and only 5(5%) said they knew the contents of the law in detail. The level of awareness of the revised medical law was statistically significant difference according to respondents' sex (p<.49), age (p<.0001), career (p<.0001), working type (p<.024), and department (p<.049). • There was no statistically significant relationship between the level of awareness of the revised medical law and the level of legal judgment on the duty to inform. These results suggest that efforts to improve the implementation and cognition of physician's duty to inform are needed, and it is difficult to expect a direct positive effect from the legal regulations per se. Considering the distinct characteristics of medical institutions and hierarchical organizational culture of physicians, it is necessary to develop a credible guideline on the duty to inform within the medical system, and to strengthen the education of physicians about their duty to inform and its purpose.

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

  • Suk, HeeTae
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.145-173
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    • 2016
  • A patient's Right to Self-Determination or his/her Right of Autonomy in the Republic of Korea has traditionally been understood as being composed of two elements. The first, is the patient's Right to Know as it pertains to the physician's Duty to Report [the Medical Situation] to the patient; the second, is the patient's Right to Consent and Right of Refusal as it pertains to the physician's Duty to Inform [for Patient's Consent]. The legal and ethical positions pertaining to the patient's autonomous decision, particularly those in the interest of the patient's not wanting to know about his/her own body or medical condition, were therefore acknowledged as passively expressed entities borne from the patient's forfeiture of the Right to Know and Right to Consent, and exempting the physician from the Duty to Inform. The potential risk of adverse effects rising as a result of applying the Informed Consent Dogma to situations described above were only passively recognized, seen merely as a preclusion of the Informed Consent Dogma or a denial of liability on part of the physician. In short, the legal measures that guarantee a patient's 'Wish for Ignorance' are not currently being understood and acknowledged under the active positions of the patient's 'Right Not to Know' and the physician's 'Duty to Consideration' (such as the duty not to inform). Practical and theoretical issues arise absent the recognition of these active positions of the involved parties. The question of normative evaluation of cases where a sizable amount of harm has come up on the patient as a result of the physician explaining to or informing the patient of his/her medical condition despite the patient previously waiving the Right to Consent or exempting the physician from the Duty to Inform, is one that is yet to be addressed; that of ascertaining direct evidence/legal basis that can cement legality to situations where the physician foregoes the informing process under consideration that doing so may cause harm to the patient, is another. Therefore it is the position of this paper that the Right [Not to Know] and the Duty [to Consideration] play critical roles both in meeting the legal normative requirements pertaining to the enrichment of the patient's Right to Self-Determination and the prevention of adverse effects as it pertains to the provision of [unwanted] medical information.

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Physician's Duty to Inform Treatment Risk: Function, Requirements and Sanctions (의사의 위험설명의무 - 법적 기능, 요건 및 위반에 대한 제재 -)

  • Lee, Dongjin
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.3-32
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    • 2020
  • Under the Korean case law, physicians are obliged to disclose or inform the risk associated with a specific treatment to their patients before they perform the treatment. If they fail to do this, they are liable to compensate pain and sufferings. If the patient can establish that he or she would not have consented at all to the treatment had he or she been informed, the physicians are liable to compensate all the loss incurred by the treatment. In this article, the author examines the legitimacy of this case law from the perspective of legal doctrine as well as its practical affect on the medical practice and the furtherance of self-determination of the patient. The fundamental findings are as follows: The case law that has physicians who failed to inform treatment risk compensate pain and sufferings for the infringement of the right of self-determination seems to be a disguised and reduced compensation of all the loss based on the possible malpractice, which cannot be justified in view of the general principles of tort liability. It is necessary to adhere to the requirements of causation and imputation between the failure to inform treatment risk and the specific patient's consent to the treatment. If this causation and imputation is established, all the loss should be compensated. Otherwise, there shall be no liability. The so-called hypothetical consent defence shall be regarded as a part of causation between the failure to inform and the consent. The suggested approach can preserve the essence of physician-patient relationship and fit for the very logic of informed consent better.

A Study on the Interhospital Transfer of Emergency Patients (응급환자 전원에 관한 판례의 태도 - 대법원 2005. 6. 24. 선고 2005다16713 판결 -)

  • Lee, Jae-Yeol
    • The Korean Society of Law and Medicine
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    • v.10 no.1
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    • pp.389-420
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    • 2009
  • Main Issue of Supreme Court Decision 2005Da16713 Delivered on June 24, 2005 is about the duty of medical care in the interhospital transfer of patients. According to the above Supreme Court Decision, in the interhospital transfer of patients, the decision to transfer should make from the aspect of medical treatment. The hospitals and doctors keep the duty of medical care. In addition to the duty for hospitals/doctors to check the capacity and availability of the hospital to which the patient is transferred, there are also duties to inform about emergency medical service and to sufficiently explain the need for the transfer, the medical conditions of the patient to be transferred and the hospital from which the patient is transferred. The hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer. including information upon referral, completeness of medical records, patient monitoring and so on. The interhospital transfer requires the consent of doctor belonging to the hospital to which the patient is transferred after the consideration of capacity and availability of the hospital and the informed consent of patients or legal representatives.

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The Legal Interest of Doctor's Duty to Inform and the Compensation to Damages for Non-pecuniary Loss (의료행위에서 설명의무의 보호법익과 설명의무 위반에 따른 위자료 배상)

  • Yi, Jaekyeong
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.37-73
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    • 2020
  • Medical practice with medical adaptability is not illegal. Consent to medical practice is also not intended to exclude causes of Illegality. The patient's consent to medical practice is the exercise of the right to self-determination, and the patient's right to self-determination is take shape through the doctor's information. If a doctor violates his duty to inform, failure to inform or lack of inform constitutes an act of illegality of omission in itself. As a result, the legal interest of self-determination is violated. The patient has the right to know and make decisions on his or her own, even when it is not connected to the benefit of life and body as the subject of the body. If that infringed and lost, the non-property damage shall be recognized and the immaterial damage must be compensated. On the other hand, the violation of the duty of information does not belong to deny the compensation for physical damage. Which the legal interest violated by violation of the obligation to inform is the self-determination, and loss of opportunity of choice is recognized as ordinary damage. However, if the opportunity of choice was lost because of the infringement of the right to self-determination and the patient could not choice the better way, that dose not occur plainly bad results, under the prove of these causal relationship, that bad results could be compensated. But the unexpectable damage could not be compensated, because the physical damage is considered as the special damage due to the violation of the right of the self-determination.

Comparing the application of social network service with existing method on the efficiency and velocity of spreading mobilization order -Based on the circumstance of Ulchi focus lens training of South Korean military- (기존의 예비군 동원 방식과 소셜네트워크를 응용한 새로운 동원 체계의 효율 및 확산 속도 비교연구 -을지 포커스 렌즈 훈련 상황 전제-)

  • Sung, Ki-Seok;Kang, Sung-Woo
    • Journal of the Korea Safety Management & Science
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    • v.14 no.3
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    • pp.183-191
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    • 2012
  • Since June 25th 1950, the beginning of the cold war (Korean war), Korean peninsula is still in a state of war. Officially South and North Korean government call a truceafter three years from the beginning day, however both countries are still having several combats in these days. So every Korean citizen male has duty for serving military duty and this lasts even after the serving regular military force, as reserved military. Although South Korea is very small country, the size of military is very large so informing all reserved military takes some time. Since this nation is confronting the enemy and considering the global potential threat, South Korean military needs expedite informing system to call up the reserved military to active duty. In this project, the current informing system has been analyzed and compared with the new method which is using social network service such as Twitter. However mobilization order is very critical. So in our new model there are two ways combined. Using twitter to inform and then use traditional ways to finish the order. This method will provide more efficient and accurate way to cover the call ups.

Informed Consent and Refusal of Treatment in Emergency Medical Situation (응급의료에서의 설명·동의 원칙과 응급의료거부죄)

  • Lee, Jung-eun
    • The Korean Society of Law and Medicine
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    • v.23 no.1
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    • pp.37-80
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    • 2022
  • By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

A Study on the Marine Environmental Protection of Northeast Asian Seas in International Law (국제법상 동북아해저환경보존에 관한 연구)

  • 이윤철
    • Journal of the Korean Institute of Navigation
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    • v.19 no.2
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    • pp.77-97
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    • 1995
  • The protection of the marine environment is one of the main international legal problems in recent years. In parallel with the industrial development, a great quantity of chemical materials were used and in consequence, mass transportation of oil and other dangerous materials was required on the one hand, and discharge of industrial wasters drew also the attention on the other hand. Furthermore, oil tankers accidents, mass use of nuclear materials, sea-bed exploration and exploitation stimulated further deep human concern on the marine environment. The expansion of international concern to new and more dangerous sources of marine pollution regarded more strict and legal control on the Oil Tanker(DWT 95, 000tons, Cb=0.805) model. Calculation results are compared to the international, especially regional level. In particular, this study is concerned with the preservation of the Northeast Asian Seas surrounded by Japan, the Russian Far East, South Korea, North Korea, China and Taiwan. These adjacent countries must intensify cooperation regarding the prevention, reduction and control of the contamination of the sea. And this cooperation between the States concerned should, as much as possible, be aimed at maximizing the effectiveness of measures to prevent or abate transboundary environmental pollution. To achieve this purpose, States concerned should be imposed upon duties such as duty to assess the environmental impact, duty to inform, duty to consult and duty to assist on the basis of general principle of international law, international customary law and other various resolutions of international bodies. Depending on the nature and extent of actual or potential transboundary pollution with the use of a natural resource or the environment in general the establishment of some form of institutionalized cooperation between the States concerned may become useful or indispensable. The functions of this Organization are, inter alia, to keep the implementation of the Convention and the protocals under continuous observation, to make recommendations on regional or sub-regional rules and standards to be elaborated and on measures to be taken by the Contracting Parties, to be notified of any grave and imminent danger from pollution or threat of pollution by the Contracting Parties and to promote in close cooperation with appropriate governmental bodies additional measures to protect the marine environment of the Northeast Asian Seas, and so on. Above mentioned countries, first of all, are located within the Northeast Asian Seas geographically and, therefore, take responsibilities of preserving the clean sea against marine interferences regardless of any difference of the social, political and economic systems. They must be followed under the UNCLOS and other marine conventions. Under the present circumstances, Northeast Asian Seas will become dead seas in case that there is no instant and prompt action against pollution. Hence we have an absolute obligation to promote the development of the mandatory international environmental law, which in turn can faciliate more effective implementation of the regional cooperation by the neighbouring states within this area.

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Implementation of the 200-Watts SSPA for X-band Pulse Compression Solid State Radar (X-대역 펄스압축 Solid State Radar를 위한 200W SSPA 개발)

  • Kim, Min-Soo;Lee, Chun-Sung;Lee, Sang-Rock;Rhee, Young-Chul
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.46 no.12
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    • pp.22-29
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    • 2009
  • In this paper, we developed the 200-Watts SSPA(Solid State Power Amplifier) for the X-band pulse compression solid state radar. The developed X-band SSPA is consists of 3-stage CSA(Corporate Structured Amplifier) modules in pre-amplifier stage, driver-amplifier stage and main-power amplifier stage. The main-power amplifier stage of SSPA designed by balanced type using GaN HEMT with enough power and gain to generate power more than 200-Watts in X-band. The developed SSPA has performance with more than total gain 59dB and output power 200-Watts in condition of frequency range 9.2-9.6GHz, pulse period 1msec, pulse width 100usec and duty cycle 10%. The developed SSPA in this paper can apply to high quality solid state radar system with pulse compression technique.

Interhospital Transfer of Emergency Patients and Informed Consent (응급환자의 전원과 의사의 설명의무)

  • Bae, Hyun-A
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.249-293
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    • 2012
  • Inter-hospital transfer, depending on its medical and legal appropriateness, affect the prognosis of patients and can even lead to legal disputes. As Emergency Medical Service Act, any physician shall, in case where deemed that pertinent medical service is unavailable for such patient with the capacities of the relevant medical institution, transfer without delay such patient to another medical institution where a pertinent medical service is available. For medico-legally appropriate inter-hospital transfer, the head of a medical institution shall, in case where he transfers an emergency patient provide medical instruments and manpower required for a safe transfer of the emergency patient, and furnish the medical records necessary for a medical examination at the medical institution in receipt of such patient. And transfer process must comply with the requirements prescribed by executive rule such as attachment of the referral, provision of ambulance, fellow riders and informed consent of transfer. Those engaged in emergency medical service shall explain an emergency medical service to an emergency patient and secure his consent. In addition to the duty to inform about emergency medical service to the patient and his or her legally representative, there is also a duty for doctors to sufficiently explain to the patient and his or her legally representative during inter-hospital transfer that the need for the transfer, the medical conditions of the patient to be transferred and emergency treatment that will be provided by the hospital from which the patient is going to transferred. Likewise, the hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer by transferring doctors.

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