• 의료법학
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• 제13권1호
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• pp.199-247
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• 2012

According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

• 의료법학
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• 제20권2호
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• pp.3-39
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• 2019

헌법재판소가 2012년 8월 23일 낙태죄 규정을 합헌으로 결정한 이후에도 낙태죄 폐지에 대한 논란은 지속되어 왔다. 낙태죄의 존폐논란은 최근에만 일어난 일이 아니라 이미 형법제정 당시부터 있었던 것으로, 대한민국의 근대입법과정과 역사를 같이 한다. 당시 형법제정과정에서 낙태죄의 전면삭제를 주장하면서 수정안을 제출했던 의원들은 사회·경제적 적응사유를 핵심적인 제안이유로 제시하기도 하였다. 이후 개발독재기에도 낙태죄의 폐지가 논의되었으나, 이는 여성의 인권을 보장하기 위한 것이 아니라, 박정희 독재정권의 '산아제한', '가족계획'이라는 국책사업과 관련이 있었다. 이후 인공임신중절을 제한적으로나마 허용하는 「모자보건법」의 제정은 유신으로 국회가 해산된 후 입법권을 대신하게 된 비상국무회의에서 1973년 2월 8일 이루어졌고, 1973년 5월 10일부터 시행되었다. 그나마 일부라도 낙태의 합법화를 포함하는 「모자보건법」이 가능했던 배경은 당시 유신독재가 어떠한 이견도 허락하지 않았기 때문에, 종교계에서도 반대 의견을 표명하기 어려웠기 때문일 것으로 보인다. 이렇게 제정된 「모자보건법」은 지금까지 약간의 수정만을 거치며 그대로 유지되어왔다. 낙태죄 존폐론의 논거들도 형법제정 당시와 큰 차이 없이 그대로 평행선을 달려왔다고 볼 수 있다. 2012년 8월 23일 헌법재판소의 결정에서도 합헌의견과 위헌의견이 4:4로 팽팽하게 맞섰었다. 다만 헌법재판소의 위헌결정을 위한 정족수를 채우지 못하여 합헌으로 결정하였다. 이 낙태죄 폐지 논쟁은 이번 헌법재판소의 헌법불합치 결정으로 일단락되었고, 국회는 새로운 입법이라는 과제를 부담한다. 즉 국회는 적어도 2020년 12월 31일까지 개선입법을 이행하여야 하고, 그때까지 개선입법이 이루어지지 않으면 낙태죄조항들(「형법」 제269조제1항, 제270조제1항)은 2021년 1월 1일부터 효력을 상실한다. 따라서 아래에서 우선 형법상 낙태죄 규정에 대한 헌법재판소 헌법불합치 결정의 논거가 무엇인지를 살펴보고(II), 과거의 헌법재판소와 대법원의 논증구조와 어떠한 점에서 차이를 가지는지, 그리고 헌법재판소 헌법불합치 결정에서 나타난 쟁점을 무엇인지를 검토한 후(III), 헌법재판소가 제시한 기준에 따른 입법재량의 범위 안에서 입법방향과 이미 제출된 「형법」과 「모자보건법」의 개정안에 대하여 검토(IV)하였다.

• 보건교육건강증진학회지
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• 제1권1호
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• pp.21-36
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• 1983

It is assumed that menarche is affected not only by the biological factors such as nutrition and genetic heritage, but also it is affected by other socio-cultural environmental factors including weather, geographic location, education and level of modernization. Also recent trend of menarche in Korea indicates that a lot of discussion are being generated to the need of sex education as a part of formal school education. The purpose of this study is to develop the school health education program by determine the age of menarche, the factors relavant to time of menarche and psycho-mental state of students at the time in menarche and investigate the present state of school health education relate to menarche of adolescents. The total number of 732 girls was drown from first, second and third grades of 4 middle schools in Seoul. For the data collection the survey was conducted during the period from May 1 to May 20, 1982 by using prepared questionair. The major results are summarized as follow; 1. Mean age at menarche and the percent distribution of menarche experienced. It was observed that about 68.7% of sampled students have been experienced menarche at the time interviewed. For the each group, age at menarche is revealed that among the students about 37.8% are experienced menarche for under 12 years old group, 62.1% for 13 year-old group, 80.6％ for 14 year-old group and 95.5% for over 15 years old. In sum it was found that the mean age at menarche was 12.3 years old, ranged from age at 10 as earlist the age at 15 as latest. 2. Variables associated with age at menarche. 1) There was tendency those student who belong to upper class economic status have had menarche earlier than those student who belong to lower class. Therefore, economic status is closely related to age at menarche. 2) In time of mother's education level, it is also found that those students whose mother's education levels from high school and college are experienced menarche earlier than those students whose mother's education levels from primary school and no-education. 3) However, in connection with home discipline, there was no significant relationship between age at menarche and home disciplines which are being treated "Rigid", "Moderated ", "Indifferent". 4) Degree of communication between parents and daughter about sex matters was found to be associated each others in determination of age at menarche. 5) It was found that high association between mother's menarche age and their daughter's menarche age was observed. Mother's age at menarche earlier trend to be shown also as earlier of their daughters. 6) Those students belong to "D & E" of physical substantiality index are trend to be earlier in menarche than those students in the index "A & B". 3. Psycho-mental state at the time of menarche. Out of the total students 68.2% had at least one or more than one of subjective symptoms. Shyness was shown as most higher prevalent symptom and others are fear, emotional instability, unpleasant feeling, depression, radical behavior, inferior complex and satisfaction appeared. Very few cases are appeared be guilty and stealing feeling. 4. The present status of school health education program related to menarche. As to the source of information about menarche, teacher was a main source with average index 5.88 and the other informants were mother & family member, friends, books and magagines, movies, television, and radio. For the problem solving at menarche, mother & family members were subject to discussion with an average index 6.02 as high. The others for discuss and knowledge about menarche were books, magagine, friends, teachers, and self-learning based on own experienced. The time of learning about menarche, it was learned as highest percentage with 43.2% at a 6 grades of primary school, middle school with 34.4%, 5 grade of primary school with 18.2%, and 4 grade of primary school with 4.0% respectively.

• Child Health Nursing Research
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• 제9권2호
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• pp.206-220
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• 2003

Purpose: this study was intended to search the relationship between perception of the infant temperament in mother of infant at the age of 1～12 months and maternal confidence and satisfaction in performing maternal role, and to submit a basic data to establish a nursing intervention program which is helpful for determination of infant development and performing maternal role promotion by identify variables associated with infant temperament. Method: The subjects of this study were 300 mothers of infant at the age of 1～12 months who visited well baby clinic in 4 hospitals in Busan city and Kyoung-Nam province. Final analysis was performed in 293 cases. Seven cases was excluded in this study because of its inappropriate data collection. The data was collected from 1st July to 15th August 2002. The questionaries which were fill-up by mother were collected. Infant temperament was measured by using the tool of 'what my baby is like'(WBL) which was developed by Priham et. al.(1994) and translated by Bang(1999). The scale of postpartum self evaluation which was developed by Lederman et al(1981) and translated by Lee(1992) was used for the confidence and satisfaction of maternal role. All statistical analyses were performed using SPSS-PC for window, version 10.0: frequency, percentage, minimum, maximum, mean, SD, t-test, ANOVA, Post-hoc test(Scheffe's test), Pearson Correlation Coefficients. Result: The mean score of maternal perception of the infant temperament was 6.17±1.04, and mother recognized her infant as positive. The mean score of confidence of maternal role was 2.89± .41 and this revealed in an average level. The mean score of satisfaction of maternal role was 3.29± .51 and this revealed in a higher level. There was a weak significant positive correlation between the score of maternal perception of infant temperament and confidence of maternal role(r=0.176, P= .003), but there was no significant correlation between satisfaction of maternal role(P> .05). It revealed the more maternal perception of the infant temperament as positive, the higher confidence of maternal role. There was a moderate significant positive correlation between confidence of maternal role and satisfaction of maternal role(r=0.410, P= .000). It revealed the more confidence of maternal role, the higher satisfaction of maternal role. The variables related with the score of maternal perception of infant temperament were the type of delivery (t=-2.600, P= .010), experience of learning baby care(t=2.382, P= .018), maternal perception on baby's health status(F=3.467, P= .033), maternal perception on her health status(F=3.467, P= .027), baby's age(F=3.080, P= .028). Conclusion: Our result showed the confidence of maternal role was increased as the maternal perception of infant temperament was positive, and conformed that the confidence of maternal role was also related with satisfaction of maternal role. Prenatal education, type of delivery, baby's age were also related with the maternal perception of infant temperament. So, nursing intervention program of developmental stage maybe necessary in order to help maternal perception of infant temperament as positive, and it will be increased the confidence of maternal role and satisfaction of performing maternal role which was considered as real indicate of achievement of maternal role.

• Asian-Australasian Journal of Animal Sciences
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• 제24권9호
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• pp.1268-1273
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• 2011

The present study was conducted to determine a feasible method of protein concentrate extraction from rice bran (RBPC) and its effect as a substitution for skim milk in early weaning pig diets. An investigation to extract protein concentrate from full fat rice bran was undertaken to determine the best ratio of water and rice bran, the amount of NaOH and a HCl solvent to use in a simple paddle-type mixer with modified spinning to produce RBPC. The results stated that the best ratio for water mixing in the RBPC extraction process was 1:5 with 20 g NaOH and 30 min in a paddle-type mixer at 300 rpm. A mix of 250 ml 0.2 N HCl was optimum for neutralization and protein precipitation. After the fluid was spun out with a washing machine, the sediment was left for 12-14 hours to complete the filtration. One kilogram of rice bran could produce an average of 324.5 gram RBPC and it contained 3.40% ash, 496.48 kcal of GE/100 gram, 1.94% crude fiber, 28.20% ether extract, 7.64% moisture and 16.66% crude protein, respectively. A total of 45 crossbred piglets, weaned at 3 weeks of age were allotted into control diet (A) and dietary treatments formulated with a four different rates of RBPC substitution for skim milk at a percentage of 25 (B), 50 (C), 77 (D) and 100 (E) respectively, in a randomized complete block (RCB) design. All piglets had free access to feed and water until 8 week of age when the experiment ended. Feed intake, average daily gain, growth rate and feed efficiency were not affected by dietary treatments. Blood test parameters after completion of the growth trial indicated normal health. Even though the mean of cell hemoglobin concentration was significantly different between treatments (p<0.05) it was still within the normal range. The cost difference for BW gain of 100% RBPC substituted for skim milk in the weaning diet was approximately 35% lower than that of the control and the relative cost of production was 96.67, 92.85, 70.75 and 64.48% lower for the replacement of 25, 50, 75 and 100% of skim milk respectively. These results implied that this technology is feasible for use by small scale farmers to improve their self-reliance.

• 의료법학
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• 제18권1호
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• pp.3-35
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• 2017

우리나라에서는 1979년 대법원이 처음 설명의무 위반으로 인한 손해배상을 인정하였고, 그 후 판례를 통해서 설명의무의 구체적 내용이 형성 발전되어 오고 있다. 의사의 설명의무는 헌법 제10조와 진료계약상의 의무에 근거하고 있고, 보건의료기본법 제12조 및 개별 법률에서도 설명의무에 관한 내용을 규정하고 있다. 그런데, 2016. 12. 20. 개정된 의료법 제24조의2에 설명의무에 관한 규정이 신설되었고, 개정 의료법은 2017. 6. 21.부터 시행될 예정이다. 개정 의료법에 따르면, 설명의무의 대상이 되는 의료행위는 '사람의 생명 또는 신체에 중대한 위해를 발생하게 할 우려가 있는 수술, 수혈, 전신마취'이다. 이러한 의료행위를 할 때에는 반드시 사전에 법정사항이 기재된 서면으로 설명을 하고 동의를 받아야 한다. 만약, 이를 위반하면 300만원 이하의 과태료 처분을 받게 된다. 개정 의료법의 내용과 학설 및 판례를 통해서 인정되어 온 설명의무에 관한 기존 법리를 비교 검토해 보면, 양자 간에 상당한 차이가 있음을 확인할 수 있다. 그에 따라 개정의료법의 시행 이후에도, 기존 설명의무에 관한 법리는 크게 영향을 받지 않을 것으로 보인다. 그러나, 동일한 사안에서 설명의무 위반 여부에 관한 판단이 민사상 손해배상사건과 의료법 위반으로 인한 과태료처분사건에서 서로 달라지는 것은 법적 안정성이나 법질서 전체 통일의 관점에서 바람직하지 않다. 개정 의료법상의 설명의무에 관한 내용을 기존 법리에 맞게 수정하거나 독일의 경우와 같이 진료계약의 내용에 포함시켜 민법에서 규율하는 것이 바람직하다고 생각한다.

• 한국노년학
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• 제38권3호
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• pp.501-519
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• 2018

본 연구의 목적은 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 대한 인식을 탐색하는 데 있다. 이를 위해 서울시 3개 치매지원센터에 등록된 초기 치매환자를 돌보는 가족 돌봄제공자 12명(여성 8명, 평균연령=$71.4{\pm}10.4$세)을 대상으로 반 구조화된 개별 심층면담을 이용하여 수집된 자료에 대해 질적 내용분석을 시행하였다. 본 연구를 내용 분석한 결과 6개 범주, 17개의 하위 범주가 도출되었는데 구체적인 연구결과는 다음과 같다. 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 관한 인식은 치매환자와의 의사소통 촉진 수단과 치매환자의 자율성 보장 수단, 치료 촉진 기회, 가족 돌봄제공자의 부담감 증가 원인, 치매환자와의 관계 악화 원인, 우선순위 변화에 따른 선택 사항의 여섯 가지 범주로 나타났다. 또한, 공유 의사결정의 상황과 시기 및 공유 의사결정에 대한 인식이 가족 돌봄제공자의 경험을 통해 만들어졌다는 점을 알 수 있었다. 따라서 치매 관련 교육 시 간접경험을 통해 공유 의사결정을 선택 사항으로 생각하는 가족 돌봄제공자들에게 공유 의사결정을 경험할 수 있는 기회 등을 제공하는 것이 공유 의사결정에 대한 인식 제고에 도움이 될 수 있을 것으로 사료된다. 이상 결과에 근거하여 초기 치매환자의 자기결정권 존중과 가족 돌봄제공자들의 부담감을 감소시키기 위해 공유 의사결정을 성공적으로 할 수 있는 실제적이고 총체적인 교육 프로그램의 개발 및 평가 연구를 제언한다.

• 문화기술의 융합
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• 제7권1호
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• pp.570-575
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• 2021

인간은 오감을 풍요롭게 느끼면서 생활하기 때문에 인간의 행복한 삶을 영위하기 위해서는 청력이 손상되지 않도록 주의하여야 한다. 생활환경에서 입게 되는 청력손상은 특정 주파수대역이 먼저 손상되는 부분대역에서 청력손상이 일반적이다. 그러나 청력손상의 초기 통증이 별로 나타나지 않아서 그 증세를 초기단계에는 알아내기가 어렵다. 본 연구에서는 간단한 어플 등을 통해 손쉽고 빠르게 청력손상을 자가 측정할 수 있는 고속 측정법을 제안하였다. 이 방법은 voice soub-band별 이득 보상된 pure tone 9개를 번갈아 양쪽 귀에 들려줌으로써 자신의 청력손상을 스스로 고속 판별하게 된다. 1인당 27초 동안 18번의 톤 펄스를 들려주었을 때, 12명의 피험자들 중에서 1명이 부분청력손상 의심자로 확인되었다. 그리고 피험자들에게 들린 횟수 청력판별법을 알려주니, 실험참가자들 스스로가 자신의 청력손상여부를 바로 판별해 내었다. 이러한 측정방법은 스마트 폰으로 27초 내에 양쪽 귀의 청력을 간단히 판단함으로서 병원에서는 10분 이상 소요되었던 청력측정이 비교적 정확하게 이루어져서, 시간과 비용을 줄이면서 청력건강을 유지할 수 있음을 파악하였다.

• 한국산학기술학회논문지
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• 제22권2호
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• pp.539-547
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• 2021

본 연구는 암환자의 사전연명의료의향서 지식, 좋은 죽음 인식이 연명의료중단 태도에 미치는 영향을 파악하여 암환자의 연명의료중단의 자기결정 활성화를 위한 간호 중재프로그램 개발 기초 자료를 제공하고자 시행되었다. 외래 또는 입원치료를 받는 성인 암환자 167명을 대상으로, 2019년 9월 15일부터 2020년 3월 30일까지 자료수집을 하였다. 수집된 자료의 통계분석은 SPSS 21.0을 이용하여 평균과 표준편차, t-test, ANOVA, Pearson 상관계수, 다중회귀분석으로 하였다. 연구결과, 대상자의 사전연명의료의향서 지식은 1점 만점에 0.74±0.21점, 좋은 죽음 인식은 4점 만점에 2.87±0.42점, 연명의료중단 태도는 5점 만점에 3.46±0.49점이었다. 본 연구결과 연명의료중단 태도는 사전연명의료의향서 지식, 좋은 죽음 인식과 정적 상관관계로 나타났으며, 영향을 미치는 변인은 사전연명의료의향서 지식, 좋은 죽음인식, 가족과 연명의료중단 논의 여부로 나타났고, 설명력은 16.0%이었다(F=10.355, p<.001). 따라서, 암환자의 연명의료중단 태도 향상을 위해 사전연명의료의향서 지식 및 좋은 죽음 인식을 높일 수 있는 프로그램 개발이 필요하며, 가족과 환자의 사전 논의에 도움을 줄 수 있는 중재 방안이 필요하다.

• 간호행정학회지
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• 제5권1호
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• pp.113-136
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• 1999

There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.