• Title/Summary/Keyword: Korean medical disputes

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Right-relief System of the Disputes to the Reviewing Medical Expenses in Health Insurance (건강보험 진료비 청구 및 심사지급에서의 권리분쟁과 구제)

  • Kim, Un-Mook
    • The Korean Society of Law and Medicine
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    • v.8 no.2
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    • pp.119-164
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    • 2007
  • Improving the formal objection system regarding reviewing medical expenses requires authority and confidence in the aspect of well-functioning the health insurance review and assessment system, legally and appropriately. The purposes of improvement of the formal objection system should aim for protecting the people's right of health. On handling the formal objections, the disputes of the rights should be settled economically and promptly by fairness, specialty, and objectivity in the health insurance review and assessment administration. Therefore, in order to promote the administrative specialty of health insurance, the formal objection committee needs to be organized independently and guaranteed expertly. Under the current formal objection system, however, the organization of committee lacks right-relief function, recognition and public relation as a health insurance appeal system, and related professional man powers. It is also analyzed that there are several controversial points, such as mass deliberation to the formal objection committee and its conference procedure. As a measure of improvement, it is analyzed that the committee needs to be organized independently with a proper number of professional man powers. The strict deliberation procedures and the prohibition of the decision-making by non-conference are also required to be empowered. The formal objection procedure provides the beneficiaries and the claims legitimately, so that it secures the legal relations on the health insurance system. Therefore, on the conference process of formal objection, the expert and guaranteed protection should be provided promptly, and its procedures to the appellants should also be assisted kindly.

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The Judicial Precedent Analysis of Medical Litigation in the field of Pediatric Ophthalmology (소아안과 영역에서 발생한 의료소송의 판례 분석)

  • Lee, Mee-Sun;HwangBo, Min;Seo, Hyung-Sik
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.25 no.3
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    • pp.78-87
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    • 2012
  • Objective : The purpose of this study is to describe the characteristics of medical malpractice related to pediatric ophthalmology and to identify the causes and potential preventability of medical litigation in Korean medicine. Methods : A study was performed by analysing 8 cases of lawsuit in the year between 1968 and 2011, which were selected among the medical dispute cases involving pediatric ophthalmology. Results : The eight closed claims occurring in the field of pediatric ophthalmology were founded in the data for medical malpractice. One claim was supreme court decision, two claims were high court decisions and five claims were district court decisions. Conclusions : While malpractice claims occurring in the field of pediatric ophthalmology were uncommon, they resulted in a high rate and amount of indemnity payments. For reduction of medical disputes, improvement of clinical trials and clinical medical cares is emphasized, and informed consent is also important.

A study of the Office for Saving Lives (活人署), a government office in the Joseon, through its history and use of a standing prescription (조선 시대 활인서 연구 - 연혁 및 상비처방을 중심으로)

  • Park, Hun-Pyeong
    • The Journal of Korean Medical History
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    • v.33 no.1
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    • pp.11-20
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    • 2020
  • The Office for Saving Lives (活人署) (OSL) was the office in charge of the treatment and relief of the poor in the Joseon Dynasty. This study disputes prior scholarship on the OSL by analyzing the use of a ready-made prescription and by focusing on the personality of the OSL's medical institutions. The work of the three government offices, the Office of Great Mercy (大悲院) (OGM), which was the formal office of OSL, the Office of Benefiting People (惠民署) and the Office of Aiding Life (濟生院), overlapped in the area of relief of the common people. But OGM was different from the other two in that it was not a purely medical office, had no educational function, and did not manage medicine. By analyzing a standing prescription, this article argues: 1) Heojun's influence on the composition of a standing prescription is absolute. 2) Epidemic warm disease (溫疫) was a major social problem in terms of emergency medical care at the time. 3) In the late Joseon Dynasty, the treatment of epidemic warm diseases became more sophisticated than the previous era.

A Study of Major Issues in the Act (Draft) on Remedy for Damage from Medical Accident and Medical Dispute Mediation, etc. (의료사고 피해구제 및 의료분쟁 조정 등에 관한 법률(안)의 주요 쟁점에 관한 고찰)

  • Park, Joon-Su
    • The Korean Journal of Health Service Management
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    • v.4 no.2
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    • pp.107-117
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    • 2010
  • In this paper, the researcher looked into major issues in the "Act (Draft) on Remedy for Damage from Medical Accident and Medical Dispute Mediation, etc." which was proposed by the Health & Welfare Committee, the National Assembly of the Republic of Korea, and which was pending with the Legislation & Judiciary Committee. Then the researcher pointed out worrisome problems therein and presented suggestion" to improve problematic situations. First of all, the researcher examined the following items which are major points in the aforementioned Act: 1) Establishment of Korea Medical Dispute Mediation and Arbitration Center, 2) Procedures for mediation and arbitration of medical disputes, 3) Establishment of Medical Injury Compensation Association, 4) Introduction of proxy payment for damages, 5) Compensation for no-fault medical accidents, 6) A system concerned with special cases on criminal punishment. Next, the researcher closely reviewed the following possible issues: 1) Limit of arbitrary mediation, 2) Postponement of the system concerned with special case on criminal punishment, 3) Examination of reasons for rejection, 4) Function and role of the Appraisal department, 5) A possibility of being reduced to an evidence collection procedure for lawsuit, 6) A possibility of no-fault compensation rather than injury compensation, 7) Operational issues related proxy payment for damages. Lastly, the researcher presented suggestions on how to improve each problematic issue.

Medical Image Watermarking Based on Visual Secret Sharing and Cellular Automata Transform for Copyright Protection

  • Fan, Tzuo-Yau;Chao, Her-Chang;Chieu, Bin-Chang
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.12 no.12
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    • pp.6177-6200
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    • 2018
  • In order to achieve the goal of protecting medical images, some existing watermark techniques for medical image protection mainly focus on improving the invisibility and robustness properties of the method, in order to prevent unnecessary medical disputes. This paper proposes a novel copyright method for medical image protection based on visual secret sharing (VSS) and cellular automata transform (CAT). This method uses the protected medical image feature as well as VSS and a watermark to produce the ownership share image (OSI). The OSI is used for medical image verification and must be registered to a certified authority. In the watermark extraction process, the suspected medical image is used to generate a master share image (MSI). The watermark can be extracted by combining the MSI and the OSI. Different from other traditional methods, the proposed method does not need to modify the medical image in order to protect the copyright of the image. Moreover, the registered OSI used to verify the ownership and its appearance display meaningful information, facilitating image management. Finally, the results of the final experiment can prove the effectiveness of our method.

Legal Issues on Deception of Fraud and Abuse of Paid Medical Expenses (요양급여비용 허위청구와 사기죄의 법적 쟁점)

  • Hwang, Manseong
    • The Korean Society of Law and Medicine
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    • v.14 no.2
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    • pp.11-41
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    • 2013
  • Article 347 of criminal law provides the act of deceiving another, thereby taking property or obtaining pecuniary advantage from another. On the other hand, the concepts of fraud and abuse are confused upon interpretation since the definition in National Healthcare Insurance Law is unclear, and it affects closely to the administrative measures such as surcharge levy by the period of inspection, therefore, the disputes continue in the forms of formal objection, administrative ruling and administrative litigation. This study aims to look over the legal problems on application of criminal fraud toward the abuse of 'Paid Medical Expenses(Article 57, Sections 1 and 4 of the National Health Insurance Act)'. The main issues are concept of abuse(Article 57, Sections 1 and 4 of the National Health Insurance Act), the problems of Directions of Health-Welfare Ministry on aspect of 'Nullum crimen sine lege' Principles, the proper sentenc-ing guidelines of fraud.

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Review of Medical Dispute Cases in the Pain Management in Korea: A Medical Malpractice Liability Insurance Database Study

  • Kim, Yeon Dong;Moon, Hyun Seog
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.254-264
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    • 2015
  • Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

A Study on the Meaning of Xiebaisan Made by Qianyi - Focused on Wujutong's Critiques - (전을(錢乙) 사백산(瀉白散)의 방의(方義)에 대한 소고(小考) - 오국통(吳鞠通)의 비판을 중심으로 -)

  • Baik, Yousang
    • Journal of Korean Medical classics
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    • v.32 no.1
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    • pp.191-204
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    • 2019
  • Objectives : Focusing on Wujutong's critiques for Xiebaisan misuse, this study investigates how Xiebaisan and its constituent drugs have historically been used by medical doctors and analyzes the disputes in the controversial context with a summary. Methods : The contents of Xiebaisan prescription were collected and examined from the past literature and medical database, and the issues related to the debate were examined by analyzing the contents. Results : In the results of exploring the opinions of medical doctors, in general, Xiebaisan and Sangbaipi, a major medicinal drug, were seen to play a role in the work of reinforcing and reducing. In particular, Ye Tianshi was used with cold and pungent medicine to Xiebaisan as a method of releasing heat with pungent medicine for acute fever in spring, and at the same time, care was taken to avoid depletion of secretion in the stomach. Conclusions : Wujutong's critique is that in early symptoms of viral infection, the misuse of Xiebaisan seems to emphasize the adverse effects of the illness. It is hoped that further research on Xiebaisan incremental medication will be conducted in the future to help clinical applications of Xiebaisan system medication.

An Analysis of Korean Supreme Court Cases Regarding Medical Practice and Clarifying the Meaning of Medical Practice (의료행위에 관한 용어정리 및 판례분석)

  • Noh, Tae-Heon
    • The Korean Society of Law and Medicine
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    • v.11 no.2
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    • pp.11-74
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    • 2010
  • This article analyzes legal meaning and definition of medical practice examining Korean Supreme Court cases. Until now, there is no right answer about the meaning of medical practice and it is also hard to define of it. Moreover, not only Acts and regulations containing medical practice but also many cases ruling a person who practice medicine, the concept of medical practice involves various meanings. So, it has caused confusion. In order to solve this problem, this article divides the medical practice's meaning into range and nature within prohibition article of the Medical Act about unlicensed personnel who practice medicine. After providing a explanation of the meaning of medical practice according to amendment of the Act, this article disputes the meanings of the several cases following the amendment. And then analyzing non-medical person's unlicensed medical practice and medical person's unlicensed medical practice. In order to provide more accurate legal concept of medical practice when Korean government amends the Medical Act or making policies in this field, this classifying analysis approach should be needed. Looking at the result, in general, Korean Supreme Court has interpreted unlicensed prohibition clause of the Medical Act widely; not only non-medical person's unlicensed medical practice but also medical person's unlicensed medical practice. Therefore, this article suggests that the prohibition clause needs to be careful applying to non-medical practice. Because, in fact, even though there are some necessity of non-medical practice, there are no qualificatory or license system of non-medical practitioner in the Medical Acts or regulations forbidding whole non-medical practices. Furthermore, the Supreme Court has decided medical person's unlicensed medical practice too narrowly, thus it does not keep up with rapid change of medical development and people's demands these days. Regarding this subject, in order to take advantage of medical practitioners effectively and cope with increasing people's medical demands, this article proposes that medical person's unlicensed medical practice only to be prohibited in case of endangering our public health.

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The change of perspective on brain death, euthanasia and withdrawal of the life supporting medical treatments in Korea for pediatric patients (국내외 뇌사, 존엄사와 안락사에 대한 인식의 변화와 윤리 - 소아를 중심으로)

  • Kwon, Ivo
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.843-850
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    • 2009
  • A recent High Court's decision regarding the withdrawal of life supporting medical treatment (artificial ventilator) from an elderly female patient in the terminal stage has opened up a new era of the "euthanasia dispute" in Korea. With this decision, the legitimate withdrawal of life supporting treatment became possible under certain conditions and the Korean Medical Association is working toward the establishment of practical guidelines for the terminal-stage patients. However, there are still very few debates on the cases of pediatric patients in the terminal stage or suffering from fatal diseases. For pediatric patients, the core principle of autonomy and following procedure of "advance directives" are hardly kept due to the immaturity of the patients themselves. Decisions for their lives usually are in the hands of the parents, which may often bring out tragic disputes around "child abuse", especially in Korea where parents have exclusive control of the destiny of their children. Some developed countries such as the U.S.A., the U.K. and Canada have already established guidelines or a legal framework for ensuring the rights of the healthcare system regarding children suffering from severe illness, permitting the withdrawal of Life supporting medical treatment (LSMT) in very specific conditions when the quality of life of the children is severely threatened. For the protection of the welfare and interest of the children, we should discuss this issue and develop guidelines for the daily practice of pediatricians.