• 의료법학
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• 제16권1호
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• pp.255-288
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• 2015

의료사고는 환자의 생명, 건강과 직결되는 경우가 많기 때문에 사전에 예방하는 것이 바람직하다. 그러나 의료사고가 발생한 경우에는 당사자 간의 감정이 첨예하게 대립되기 전에 조정을 통해 신속하고도 원만하게 해결할 필요가 있다. 한국소비자원은 신속 공정하고 효율적인 해결을 목적으로 의료분쟁 조정업무를 수행하고 있고, 이는 동일한 업무를 수행하고 있는 한국의료분쟁조정중재원 역시 마찬가지이다. 그런데 한국소비자원과 의료분쟁조정중재원은 업무중복 및 그로 인한 비효율을 이유로 통폐합에 대한 논의가 끊임없이 제기되어 오고 있지만, 소비자의 선택권 보장, 경쟁을 통한 상호 발전을 위해 두 기구가 공존하는 것이 바람직하다. 그러므로 소비자원이 조정중재원과 공정한 경쟁을 할 수 있도록 법적, 제도적 뒷받침을 해주어야 한다. 그것은 소비자원을 위 한 것이 아니라 궁극적으로 소비자를 위한 것이다.

• 의료법학
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• 제14권2호
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• pp.217-260
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• 2013

In connection to the civil liability of the medical malpractice, plaintiff and courts are solving the medical disputes with theory of the liability based on tort law. because contract law does not enact the right of claim of solatium and a plaintiff's lawyer and courts hesitate to use contract law. Medical treatment of doctor is main debt in medical contract and its in-complete performance gives rise to the violations of human's life, body and health. Consequently a breach of medical contract leads to violations of person-al rights. These violations spring from liability of contract as well as tort and damages from them are recognized based on medical contract law. A duty of explanation of doctor is a independent and appendant debt to the treatment debt. However its breach provokes violations of human's life, body and health as well as a right self-determination. Therefore consolation money claim should be recognized. In case of the violation of patient's life, body and health, patient's family al-so can demand consolation money due to the violation of their's own mental pain. However in case of the violation of only patient's self-determination without informed concent, they can not demand it by reason of the violation of patient's self-determination. But by reason of the violation of patient's life, body and health that were recognized by proximate causal relation between violation of duty of explanation and abd execution, they can do.

• 대한예방한의학회지
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• 제21권2호
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• pp.45-53
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• 2017

Background and Aim : Lately the age of competition has come among the medical service area. At the same time disputes over the medical practice related to the medical person's territory tend to increase. In part it is due to the increased medical persons but in part it is because the medical practice is not defined clearly in the Medical Service Act for the practice of each medical person. So the legal definition of medical practice will be discussed here. Materials and Method : The cases from the court have been confirmed the difference between the two medical persons regarding the actual events. Legal aspects of medical practice in Korean medicine and the related cases will be reviewed and analysed. Results : The form of medical practice consists of administrating Korean medicine treatment and providing guidance for health based on Korean medicine. For medical doctors the practice includes medical treatment and guidance for health. Circular definition in the Medical Service Act over the medical practice, medical person and medical instruments makes it difficult to understand the whole idea. Therefore, the court has a tendency to decide the medical practice of medical doctor of Korean medicine from the some reliable points which is: 1) it is based on the principle of traditional Korean Medicine, 2) it is practiced by the medical doctor of Korean Medicine, 3) it can do harm to the patient without proper involvement of the medical doctor of Korean Medicine. Now the Act on the promotion of Korean Medicine and Pharmaceuticals makes it include the concept of "scientifically applied and developed" medical practice of Korean Medicine. Conclusions : With the essential change in the Act on the promotion of Korean Medicine and Pharmaceuticals, it is expected that even slight change can be seen in the court cases. However, still the concept of medical practice in the Medical Service Act remains the same. Modernisation of Korean Medicine, enhancement of textbooks and clinical practice training and the effort to amend the law to clearly define the medical practice of Korean Medicine will contribute to the clinical and academic environment. Evidence based Korean Medicine and even the unification of east-west medicine could be considered for the situation.

• Journal of Acupuncture Research
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• 제29권6호
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• pp.85-89
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• 2012

Objectives : This study is to evaluate the current situation of Japanese tourists for medical tour of Daejeon University hospital and to draw up a plan for better policies. Methods : 59 Japanese tourists visiting oriental medicines hospital of Daejeon University from January 2012 to September 2012, were analysed in the statistics. And 8 of them answer a questionnaire about reasons for selection of Daejeon University hospital, satisfaction for thread embedding therapy and side effects of thread embedding therapy. Results : A total of 59 foreigners visited oriental medicines hospital of Daejeon University for medical service, consisting of 54 females(92 %), the thirties to fifties 71 % by age. The 87.5 % of patients answered that the reason for choosing this hospital was the subsidization of the medical expenses, and 50 % for appropriate payment, 37.5 % for safety, 12.5 % for recommendation of the people who had good experience at this hospital. The 71% of patients selected thread-embedding therapy for treating wrinkles. The degree of satisfaction was evaluated as quite satisfaction of 87.5 %, full satisfaction of 12.5 % showing that a whole number of the patients treated with thread-embedding therapy showed relative satisfaction. This evaluation is, however, a short term survey which should lead to a further term study. For the evaluation of side effects of thread-embedding therapy, 75 % of patients answered as pain occurred during the therapy, 62.5 % as edema, 50 % as hypodermal bleeding. Conclusion : First of all, there should be more constructive promotion and support for medical tour of oriental medicines, ultimately leading to promoting better clusters of oriental medicines. Secondly, support in terms of a medical law should be established for medical disputes, and the best follow-up service should be considered.

• 한국병원경영학회지
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• 제5권1호
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• pp.1-23
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• 2000

This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.

• 대한치과의사협회지
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• 제53권2호
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• pp.82-95
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• 2015

Background: Interest in medical malpractice claims and accidents is a day-to-day social issue to general public as well as medical personnel. Related laws and regulations already have been established, and institutions based on the laws and regulations also have been founded. However, in our dental community, interest and response to the issue seem insufficient. Methods: We searched four medical literature databases that are mainly cited in the medical community. Keywords including 'dental malpractice claims', 'patient safety' and 'medical accident' were used for the search. Among the selected literatures, we chose specific ones separately whose content is authentic and easily approachable. Results: Medical malpractice claims and accidents tend to increase around the world. As the cost or the difficulty level of surgery increases, the dispute rate also increases, which appears even more apparent in developed countries. Preventive measures to prevent the disputes and accidents are not significantly different. Three critical of them include relationship of doctor with patient, the informed consent and medical record. Conclusion: Tools for accident occurrence or communication improvement have been introduced. All of those cost time and money. However, education or professional request of liability insurance companies, self-education and provision of guidelines can be immediately implemented. To implement those, dentists' promotion at the regional or national level is imperative. rhBMP-2 is widely used at sinus augmentation, alveolar bone defect, and socket preservation.

• 대한치과의료관리학회지
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• 제5권1호
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• pp.13-21
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• 2017

연구목적: 본 연구에서는 임상에 근무하고 있는 치과위생사를 대상으로 임상경력에 따른 의료사고 및 분쟁 경험, 심리상태, 예방교육 대한 인식정도를 파악하고자 한다. 연구방법: 본 연구는 2012년 5월 1일부터 6월까지 경남 지역의 일부 치과 병·의원에 근무하는 치과위생사를 대상으로 자기기입식 설문지 총 330부를 대상으로 분석하였다. 수집된 자료는 SPSS (Statistical Package for the Social Science) ver 18.0 프로그램을 이용하여 빈도분석, 교차분석, ANOVA로 분석하였다. 연구결과: 1. 환자의 불평 및 불만으로 문제가 된 경험이 있는 경우와 치과위생사의 업무로 인한 불평 및 불만을 경험한 경우 모두 임상경력이 많은 6년 초과 군에서 각각 70.3%, 30.7%로 나타났다. 2. 환자의 불평, 불만 문제제기 되는 경우 중 진단, 치과진료기구 및 재료와 관련된 경우, 스케일링, 인상채득, 보철치료, 소아환자에서 통계적으로 유의하게 나타났으며, 전체적으로 임상경력이 높은 6년 초과 군에서 횟수가 많이 나타났다. 3. 환자의 불평 및 불만을 경험한 후의 심리상태 중 '과정은 힘들었지만 있을 수 있는 일이라 생각하고 잊었다'는 160명으로 그 중 임상경력이 6년 초과가 38.1%, 3년 미만이 37.5%으로 비슷하게 나타났고, 임상경력 3~6년은 24.4%으로 나타났으며, 통계적으로 유의한 차이를 보였다. 4. 치과위생사의 의료사고 및 분쟁 예방교육에 대한 사항에서 '진료 시 문제제기나 분쟁발생에 대한 의구심이 든다'에 '가끔 그렇다'고 답한 임상경력 3~6년 73.6%으로 높았으며, 예방교육 필요성 여부에서는 '필요하나 시급하지 않다'는 응답이 많았으며 그 중 임상경력 3년 미만이 60.0%로 가장 많았다. 의료분쟁 증가여부에서는 '예'가 많았으며 임상경력 6년 초과가 87.1%으로 가장 높았으나 통계적으로 유의하지는 않았다. 결론: 치과위생사를 대상으로 한 의료사고 및 분쟁에 대한 예방교육이 시급한 것으로 사료된다.

• 의학교육논단
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• 제24권3호
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• pp.240-249
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• 2022

This study explored the public's response to an incident involving publicity about how physicians broke bad news to a terminal cancer patient by analyzing 1,960 comments from three online news websites that reported on this event using Braun and Clarke's theme analysis methods. Three themes and 10 subthemes emerged from the public's responses to the way the physicians broke the bad news. Theme 1 (a physician is a person who tells the facts) contained the following subthemes: physicians are responsible for delivering facts, but it is a matter of consideration for patients to deliver bad news to them, empathy and consolation should be expected from people other than physicians, and physicians who say what patients want to hear are cheaters. Theme 2 (there is a problem with physicians) included the following subthemes: the physicians' empathy or personality and problems with their communication methods. Theme 3 (there are obstacles to communication with dying patients) had the following subthemes: physicians become emotionally dull and find it very stressful to break bad news, giving hope to dying patients can lead to medical disputes, and empathy and consolation are also costly. When breaking bad news, the physicians delivered factual information, but they did so inappropriately, and emotional support for the patient was insufficient. In medical communication education, it is necessary to emphasize training in emotional support. In the medical field, an environment should be created where physicians can communicate as they have learned.

• 대한한의학회지
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• 제45권1호
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• pp.182-201
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• 2024

Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine. Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert. Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed. Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.

• 의료법학
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• 제16권2호
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• pp.159-193
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• 2015

병원감염 사례에 관한 판결의 주류적 태도는 병원감염 발생으로 인한 손해의 분담을 사실상 환자 측에 전가하는 문제가 있다고 판단되므로, 손해의 공평 타당한 분담을 그 지도 원리로 하는 손해배상제도의 이념에 비추어 환자 측의 증명책임을 대폭 완화하기 위한 방법을 강구할 필요성이 있다. 이와 관련하여 진료계약을 민법상 전형계약으로 규정하고, 병원감염과 같은 의료 측이 전적으로 지배할 수 있었던 경우에는 일반적 진료상 위험이 실현된 때 진료자의 오류가 추정된다고 명문으로 과실추정규정을 둔 독일민법을 검토하였다. 진료계약은 매우 빈번하고 광범위하게 일반 국민의 실생활에서 체결되고 있으며, 그로 인한 분쟁도 다양하게 발생하고 있으므로, 진료계약을 독일과 같이 민법의 전형계약으로 규정함으로써 계약 내용과 분쟁 발생 시 증명책임 등에 관해 규율할 필요성이 있다. 병원감염 사건의 경우 법률에 의해 과실을 추정하고, 병원감염 예방을 위한 노력을 철저히 시행한 기관에 한하여 병원감염 사고로 인한 손해가 발생한 경우 그 비용을 지원하도록 사회보험을 통한 제도적 보완이 필요하다고 생각되며, 향후 이에 관한 면밀한 연구와 검토가 요구된다.