• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
• /
• v.7 no.2
• /
• pp.311-319
• /
• 2017

Recently invasion of privacy problem in medical information have been issued following the interest in secondary use of large medical information. These large medical information is very useful information that can be used in various fields such as disease research and prevention. However, due to the privacy laws such as Privacy Act and Medical Law, these informations including patients or health professionals' personal information are difficult to utilize secondary. Accordingly, various methods such as k-anonymity, l-diversity and differential-privacy that can be utilized while protecting privacy have been developed and utilized in this field. In this paper, we study differential privacy processing procedure, one of various methods, and find out about the differential privacy problem using Laplace noise. Finally, we propose a new method using the Shamir's secret sharing method and symemetric key encryption algorithm such as AES for this problem.

• The Korean Society of Law and Medicine
• /
• v.23 no.1
• /
• pp.37-80
• /
• 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.

• The Journal of Korean Physical Therapy
• /
• v.20 no.4
• /
• pp.61-69
• /
• 2008

Purpose: We evaluated caregivers' understanding of patients' diseases and disuse syndrome, the understanding of exercise and massage related to rehabilitation and the necessity of education about these, the difference in education and realities of the care-giving field, and the extra services needed in the field. Methods: The survey using questionnaires was performed from June 2008 to August 2008 with 220 people participated in caregive education programme in daegu city and area near dagu city. Among the 220 submitted questionnaires, 184 which were faithfully answered were selected and they were analyzed by i-STATistics statistical program. Results: The educational focus of the first and second level caregivers, as defined by the second clause of the 29th article of the Elderly Welfare law, is on basic knowledge of diseases such as dementia, stroke, and depression. However, other diseases are not covered and the information does not include information on decreased function, complications, functional rehabilitating exercises, or preventing disuse syndrome for long term patients. The most common diseases, in order of prevalence, are stroke, dementia, diabetes mellitus, Parkinson disease, arthritis, and geriatric inertness. The general level of awareness about disuse syndrome was low, and patients, while understanding the need for massage and rehabilitative exercise, receive little education about the proper methods and therefore cannot use them. Patients also did not understand how participating in these activities could reduce medical fees, indicating that further education on massage and rehabilitative exercise is needed. Caregivers desired to include positive rehabilitation, massage, and exercise-related services in their services. Finally, differences in caregiver education and reality resulted from a lack of diversity in education. Conclusion: We suggest providing education on disuse atrophy and improving the lack of diversity in the care-giving education system.

• Research in Community and Public Health Nursing
• /
• v.4 no.1
• /
• pp.25-37
• /
• 1993

This study was designed to identify the performance of occupational health services of 37 industries located in Kyung in area. The data was collected by a structured questionnaire developed by the Academic society of Community Nursing. This analysis had two factors, one was related to six of the industries, and the other was the actual assignment procedures of the health team members. This study was undertaken from December 4, 1992 to January 21, 1993. The results of the study were as follows: 1. The study group was primarily manufacturing industries which employed 300-1,000 employees. 2. The actual assignment state of occupation health team members with the exception of nurses was not kept to the regulations of the industrial safety health law. 3. The following was the analysis of the performance of occupational health services with two factors: 1). The larger the size of the six industries, the more the performance of health education, health assessment, and health screening. 2) The actual. practice of occupational health team members working environmental measurement, was more frequently performed by a nurse other than health team members together. 4. 1) The subscription rate of the laborers for primary health screening was 94%, and of these 10% had the need of secondary health screening. As a results of the secondary health screening the degrees were 'A' 45%, 'C' 92%, 'R' 21%. Of these degrees 'C', 'R' 4% were follow up cases. 2) 43% of laborers needed special health screening and .of these the subscription rate was 99%. The main item of the special health screening was physical factors. After the special health screening 46% required .follow up, 30% required medical treatment, only reporting 18%, change work 8%, suspension from work place 2%.

• Health Policy and Management
• /
• v.33 no.4
• /
• pp.421-431
• /
• 2023

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternal/newborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion: Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

• The Korean Journal of Emergency Medical Services
• /
• v.1 no.1
• /
• pp.100-111
• /
• 1997

This is the first Korea study to evaluate the effects od the safety of ambulance driving and the occurrence of ambulance traffic accidents and to provide basic informaion for the description of various factors to reduce the ambulance traffic accidents. The major insturment of this study were Krean Self-Analysis Driver Opinionnaire. Questionnaire contains 8 items which measure driver's opinions or attitudes : driving courtesy, emotion, traffic law, speed, vehicle conditions, the use of drugs, high-risk behaviors, and human factors. To take the analysis of data, the total of 350 divers were investigated ambulance divers and others in Taejon City and others (6 City) from 1996. 1. July to 1996. 31. July. The data were analyzed by the descriptive statistics and the logistic regression - path analysis - with SPSS and SAS package program. The result are as follows : 1. There was desirable attitude group(16.2%) and undesirable attitude group(17.6%) on safety ambulance driving. 2. It have suggested that risk factors of ambulance traffic accidents much affected with emotion and speed control on safety ambulance driving < Y(Accdient) = -2.64 + 0.57 $X_1$ (Emotion Control) + 0.30 $X_2$(Seed control) + E > and motor traffic acident much affected with emotion control and high-risk behavior on safety driving < Y(Accident) = -1.11 + 0.33 $X_1$(Emotion Control) + 0.29 $X_2$(High-risk Behvior) + E > 4. The primary emphassis of ambulance drivers was make us realized that improthatnt factors on safety ambulance driving were 1)making way for emergent ambulance, 2)driver's career, 3)The ability of emergency medical technics, and the knowledge or under standing of ambulance way difficut(or easy) of accdess. 5. Almost 96.6% of respondents have agreed to necessity of emergency medical technics for ambulance drivers. 6. Almost 94.6% of respondents have consented to necessity of emergtency medical technicians for ambulance driving. 7. It have suggested that the proportion of traffic accident proportion by desitable attitude group(16.7%) was much less than that of undesirable attitude group(30.8%) on safety ambulance driving(P < 0.05)/Ps) Accidents are unplanned, unforesen incidents which can lead to harmful or unfortunate outcomes, Collisons are not accidents, since the basic cause of the majority of collisons invovles high-risk human behavior. Although there are many factors which contribute to accident causation, four basic factors seem to predominate in most traffic related situations. These four factors include: the human factor, the vehicle factor, the environmental factors and destination factor(Peto G. et al. 1995).

• Korean Security Journal
• /
• no.17
• /
• pp.255-276
• /
• 2008

The important items, which should be considered in Private Investigation Law, can include subjects, licenses, the scope of business, qualifying examinations, and supervisory and penal provisions. The subjects of Private Investigation Law should be permitted to be both natural persons and juridical persons in terms of providing various services, but should be permitted to be juridical persons and should be administered on a license system, even in order to ensure public interests. Concretely, the introduction scope of Private Investigation Law can be regulated to include the followings: that is, investigating the whereabouts identification of runaways and missing children, investigating the personal identification, habit, way of action, motivation, whereabouts identification, real child confirmation, association, transaction, reputation, and personality of specific persons or specific groups, investigating the whereabouts identification of missing persons, owners of government-vested properties or renounced properties, investigating the whereabouts of lost properties or stolen properties, investigating the causes of fire, character defamation, slander, damage, accident, physical disability, infringement on real estate or movable property, and investigating all sorts of accidents including traffic accidents, insurance accidents, and medical malpractices. In the qualifying examination, examinees' age should be restricted to be over age 25. The person, who is exempted from its primary examination, should be restricted to be the person, who has the career of over 20 years in related fields, in consideration of its equity with other certificates of qualification. In the supervisory institution, as the policy institution is the supervisory institution in many countries including France (the police) and Japan (public security committee), so the National Policy Agency should be the supervisory institution in consideration of management aspects. In the penal regulations, especially, we should clarify the management of personal information (personal information protection, personal information management), and so should prevent the infringement of people's basic rights, and then should ensure the public interest.

• The Korean Society of Law and Medicine
• /
• v.18 no.1
• /
• pp.237-264
• /
• 2017

With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

• The Korean Society of Law and Medicine
• /
• v.17 no.2
• /
• pp.177-219
• /
• 2016

A commercial advertisement is not only a way of competition but also a medium of communication. Thus, it is under the constitutional protection of the freedom of business (article 15 of the Constitution) as well as the freedom of press [article 21 (1) of the Constitution]. In terms of the freedom of business or competition, it should be noted that an unfair advertising (false or misleading advertisement) can be regulated as an unfair competition, while any restraint on advertising other than unfair one might be doubted as an unjustifiable restraint of trade. In terms of the freedom of press or communication, it is important that article 21 (2) of the Constitution forbids any kind of (prior) censorship, and the Constitutional Court applies this restriction even to commercial advertising. In this article, the applicability of these schemes to advertising of the so-called learned professions, especially physician, are to be examined, and some proposals for the reformation of the current regulatory regime are to be made. Main arguments of this article can be summarized as follows: First, the current regime which requires advance review of physician advertising as prescribed in article 56 (2) no. 9 of Medical Act should be reformed. It does not mean that the current interpretation of article 21 of the Constitution is agreeable. Though a commercial advertising is a way of communication and can be protected by article 21 (1) of the Constitution, it should not be under the prohibition of censorship prescribed by article 21 (2) of the Constitution. The Constitutional Court adopts the opposite view, however. It is doubtful that physician advertising needs some prior restraint, also. Of course, there exists severe informational asymmetry between physicians and patients and medical treatment might harm the life and health of patients irrevocably, so that medical treatment can be discerned from other services. It is civil and criminal liability for medical malpractice and duty to inform and not regulation on physician advertising, to address these differences or problems. Advance review should be abandoned and repelled, or substituted by more unproblematic way of regulation such as an accreditation of reviewed advertising or a self-regulation preformed by physician association independently from the Ministry of Health and Welfare or any other governmental agencies. Second, the substantive criteria for unfair physician advertising also should correspond that of unfair advertising in general. Some might argue that a learned profession, especially medical practice, is totally different from other businesses. It is performed under the professional ethics and should not persue commercial interest; medical practice in Korea is governed by the National Health Insurance system, the stability of which might be endangered when commercial competition in medical practice be allowed. Medical Act as well as the condition of medical practice market do not exclude competition between physicians. The fact is quite the opposite. Physicians are competing even though under the professional ethics and obligations and all the restrictions provided by the National Health Insurance system. In this situation, regulation on physician advertising might constitute unjustifiable restraint of competition, especially a kind of entry barrier for 'new physicians.'

• Research in Community and Public Health Nursing
• /
• v.10 no.1
• /
• pp.106-120
• /
• 1999

Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.