Journal of Korean Academy of Dental Administration
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v.7
no.1
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pp.1-9
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2019
This study examined the opinions of dentists on dental hygienists' practice and attempted to use it as the basis for the revision and modification of the legal system associated with dental hygienists. The subjects of this study were a total 15 dentists, including two from Gyeonggi, two from Gangwon, two from Gyeongsang, two from Jeolla, two from Chungcheong, and two from Seoul, who were surveyed face-to-face. This study revealed that from the perspective of dentists, the most important job of dental hygienists was scaling, and the most difficult job was patient counseling and response. From the perspective of dentists, there is a difference between what the dental hygienists actually perform and what is legal, and there is a high need for change. The inclusion of dental hygienists in the category of medical personnel should be accomplished to cover the practice of dental care support, and dentists opinionated that it is appropriate for dental hygienists to be included in the category of medical personnel because they directly perform oral health-related procedures. A careful review of the dental hygienists' scope of work should be performed to ensure that revisions to the law are made in accordance with the dental hygienists' actual practice. Further, it is necessary to revise the Medical Law and include dental hygienists among the medical personnel and simultaneously revise the scope of work of dental hygienists to reflect the actual dental practice.
The adult guardianship system has been introduced through amendments of Korean Civil Code for the first time in the March 2011(Act No. 10429, 7. 1. 2013. enforcement). The adult guardianship system has the main purposes to provide a lot of help vulnerable adults and elderly, and protect them on the welfare related with property act, treatment, care, etc. There could be a controversy about whether the protection Legal Guardian's consent(formerly known as the Mental Health Act) or permission of the Family Court(revised Civil Code) are required to, or the Mental Health Act should be revised, when mental patient will be hospitalized forcibly. The author proposes that mental patient with Adult guardians should be determined by Legal Guardian's consent and approval of the Family Court, but mental patient without Adult guardians could be determined by Legal Guardian's consent. The issue of Withdrawing of life-sustaining treatment could be occurred due to the aging society and the development of modern medicine, and this has provided difficult, various problems to mankind in Legal, ethical, and social welfare aspects. The need of Death with dignity law or Natural death law has been reduced for a revision of the Civil Code. Therefore, on the issue of Withdrawing of life-sustaining treatment, in the future, intervention of the court is necessary in accordance with the revised Civil Code Section, and Organ Transplantation Act and the brain death criteria may serve as an important criterion.
The rapid development and distribution of information communication industry facilitates the changes of hospital administration, introducing EMR(Electronic Medical Record) instead of paper-based medical record in the medical field. The developed countries such as U.S. have established EMR system after in the middle of 1970s because the primary advantages of EMR is to store and handle vast amounts of records efficiently and increase the quality of health care. Most of health organizations in Korea also apply medical record system to their administration. As the result, they have accomplished a scientific administration system through the use of medical record to handle a variety of patient's information including patient's confidentiality and privacy such as family history, social status, income level, and so on. However, access to and the misuse of EMR causes illegal infringement of patient's information and finally it becomes a very serious medical issue. Potential leakage and misuse of records may seriously infringe patient's privacy rights. In this respect, the related agencies in the public and private sector have been making efforts to prevent patient's records leakages. Especially, the revision bill of Medical Law in 2002 establishes the ways on the security and standards of electronic records. However, it does not provide the proper guidelines which is applied to the rapid changes of the medical environment. One of the most priorities in the hospital administration is the production and maintenance of an accurate medical records fulfilled by medical recorders. Therefore, it is very important for health care providers to hire ethical-based medical recorders. But, unfortunately most of hospitals overlook the importance of their roles. All parts including government, physician and patient must have more concerns on the problems related to EMR. Therefore, this study aims to propose the proper ways to resolve the problems coming from EMR.
Until recently the German and the South Korean medical associations reacted cautiously to the introduction of telemedicine between doctor and patient which is exclusively on the platform conducted. But the General Assembly of German Physicians voted to lift the ban on remote treatment with the amendment to Section 7 (4) MBO-Ä(Medical Association's Professional Code of Conduct) in 2018 and the situation has been fundamentally changed in Germany. From then until now 16 of 17 rural medical associations have changed their professional code to allow telemedicine. In addition the legislature started to prepare the basis for the introduction of the electronic health card (eGK) and the telematics infrastructure. So far, various laws such as Medicinal Products Act, Drug Advertisement Act and Social Code have been changed to support legalization of telemedicine and digitalization of health care. Unlike in Germany, the social circumstances such as excessive centralization of the big hospitals in Seoul and the resulting concern of small medical practices for profitability are the main obstacles to the introduction of telemedicine. However the German approach how to legalise the telemedicine and to prepare for legal and technical infrastructure is also interesting in South Korea. The discussions for and against the changes in the law and the telematics infrastructure attempted by the German government for several years indicate that not only lifting the ban on remote treatment, but also harmonization of all the related legal system could guarantee successful implementation of telemedicine.
Journal of The Korea Institute of Healthcare Architecture
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v.26
no.4
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pp.39-47
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2020
Purpose: Korea, China, and Japan can be seen as a geopolitical community that has developed through various relationships in terms of history. However, nowadays, it seems that they are pursuing different societal goals resulting from the difference in political and social systems, demographic structures, and economic situations. The law provides the minimum standards for people's lives in the direction that the society pursues. Therefore, the aim of this study is to examine the architectural differences in medical facilities and their causes comparing the legal standards of medical facilities in Korea, China, and Japan. Methods: The subject of the study is Korea, China, and Japan's legal standards of facilities corresponding to the Korean medical service act; enforcement decree of medical service act; and enforcement rules of medical service act. The scope of the study is as follows: First, the facilities standards and the reason for the revision of the standards after the 1950s when the current system of each country was established are investigated and thus the changing trends of the facilities standards that each country has pursued are analyzed. Second, the range and level presented by the current facilities standards of each country are compared and the differences are analyzed. Finally, cases in which the differences in the legal facilities standards are reflected in the actual design are compared and the effect of the facilities standards of medical facilities on the architectural plan is identified. Results & Implications: Each country differs in the legal standards of facilities because of changes in demographic structure and experience of disease. Moreover, it is identified that differences in social operating systems, especially in the operating methods of medical facilities, affect the range and level enforced by the facility standards. When investigating and researching foreign standards of facilities and cases for foreign medical facilities, it is required that they should be analyzed in consideration of the social and cultural aspects of each country.
Journal of The Korea Institute of Healthcare Architecture
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v.22
no.4
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pp.105-115
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2016
Purpose: This study is a case study of a small-mid sized hospital to promote a full-scale remodeling to ensure the quality and competitiveness of the medical services and trying to arrange the remodeling characteristics of small-mid sized hospital which is suffering from aging facilities as well as chronic congestion and lack of spaces. Methods: Research was conducted by consultation with hospital executives and each department operators, and on-site investigation, Results: The result of this study can be summarized into two points. The first one is that existing statistical value like area per bed, in the remodeling of the small-mid hospitals may not mean much. planners have to verify the necessary room space areas in close consultation with the department operators. And after confirming layout possibilities, they have to create the program. The second one is that remodeling planning can be a realistic plan with structural and installation diagnosis at the same time. If so, it is advisable to proceed architectural design from the beginning for cost and time savings. Implications: This results can be applied to small-mid hospitals to apply to the medical law revision and others.
According to the current act of Decision-Marking in Life-Sustaining Medicine, the decision to withhold or discontinue life-sustaining treatment is primarily based on the wishes of a patient in the dying process. Decision-making regarding life-sustaining treatment for these patients is made by the patient, if he or she is conscious, directly expressing his/her intention for life-sustaining treatment in writing or verbally or by writing an advance medical directive and physician orders for life-sustaining treatment. It can be exercised. On the other hand, if the patient has not written an advance medical directive or physician orders for life-sustaining treatment, the patient's intention can be confirmed with a statement from the patient's family, or a decision to discontinue life-sustaining treatment can be made with the consent of all members of the patient's family. However, in the case of an unrelated patient who has no family or whose family is unknown, if an advance medical directive or physician orders for life-sustaining treatment are not written before hospitalization and a medical condition prevents the patient from expressing his or her opinion, the patient's will cannot be known and the patient cannot be informed. A situation arises where a decision must be made as to whether to continue or discontinue life-sustaining treatment. This study reviewed discussions and measures for unbefriended patients under the current law in order to suggest policy measures for deciding on life-sustaining treatment in the case of unbefriended patients. First, we looked at the application of the adult guardian system, but although an adult guardian can replace consent for medical treatment that infringes on the body, permission from the family court is required in cases where death may occur as a direct result of medical treatment. It cannot be said to be an appropriate solution for patients in the process of dying. Second, in accordance with Article 14 of the Life-Sustaining Treatment Decision Act, we looked at the deliberation of medical institution ethics committees on decisions to discontinue life-sustaining treatment for patients without family ties.Under the current law, the medical institution ethics committee cannot make decisions on discontinuation of life-sustaining treatment for unbefriended patients, so through revision, matters regarding decisions on discontinuation of life-sustaining treatment for unbefriended patients are reflected in Article 14 of the same Act or separate provisions for unbefriended patients are made. It is necessary to establish and amend new provisions. In addition, the medical institution ethics committee must make a decision on unbefriended patients, but if the medical institution cannot make such a decision, there is a need to revise the law so that the public ethics committee can make decisions, such as discontinuing life-sustaining treatment for unbefriended patients.
Since 1990s, the use of Complementary and Alternative Medicine(CAM) has been rising rapidly all of the world. In 1983, WHO recommended that the traditional medicine actively be utilized. At the end of 20th century, as chronic and intractable diseases increased in western countries, traditional medicine has attracted considerable attention. COWM shows possibilities of new approaches for these intractable diseases. Thus, we try to show our proper approach of COWM through the international comparative study. In order to fulfill the objectives, we applied the following methodology: 1) Literature review on previous study, 2) Local survey using self-administered questionnaire, and 3) FGI(Focus Group Interview) with local experts. The results were as follows : Three Asian countries, China, Korea and Taiwan, are very active in implementing COWM policy. Japan, however, has independent system of unified medicine. In regards to the combined care policy and system, China has the most advanced COWM system among four countries. In respect to combined care education, it is needed to increase the COWM education contents and the amount of cross educational curriculum. Based on the current COWM system, Chinese, Japanese and Taiwanese doctors can prescribe both oriental and western drugs. But, Korean medical law prohibits western doctors and oriental doctors from prescribing the counterpart´s medicine. So, the revision of current medical law is urgent for COWM in Korea. And when it comes to patient satisfaction, more than fifty percent responded positively in China, Korea and Taiwan. To achieve the goal of COWM ; 1) mutual understanding and recognition of COWM is essential. 2) institutional and legal support system for COWM is desperately urgent. 3) possible international collaboration and cooperation should be sought to untangle these complex cultural dilemmas.
Telemedicine is a field of medicine in which medicine doctors who are in remote distance can treat the patients using audio, video devices which can help the diagnosis. In medicine, even the face-to-face diagnosis and treatment is the traditional way, the telemedicine could provide the convenient way for the patients in long distance, disabled or anyone who want to be stay ones' home. But telemedicine has the task to maintain the quality of medical cares compare with the traditional medicine. Among the several types of telemedicine, the specific type telemedicine in which the medicine doctors examine, diagnosis and do the prescription to the remotely distanced patients could be defined tele-prescription. Under The Medical Service act, it is unclear that teleprescription could be allowed. The Medical Service Act has introduced the specific clause for the prescription. That clause includes the duty of patients who have to receive the prescriptions directly from medical doctors. Under this clause, the constitutional court had decided the tele-prescription was illegal, but the supreme court has been decided tele-prescription could be legalized under the certain circumstances. But the other supreme court decided the tele-prescription was illegal under the article 34 of presenting Medical Service Act. So to understand the interpretations of Supreme court and Constitutional court decisions for the cases of prescription via telephone, we need to understand the history and presented reasons for the revision of prescription clause and also need to understand the other related clauses in the same act. In conclusion, To consider the values of telemedicine should be the level with the ordinary treatments, It is reasonable to interpret that the presenting Medical Service Act only legalize the telemedicine between doctor to doctor and which is regulated by the telemedicine clause.
This study explored several agenda related to license system, education, professional work of radiological technologists(RTs) and a transition process of law for them to investigate a developmental strategy of RTs as a professional career. The results are as followings : 1. The national license system for RTs was started from 1965, 1965-1972 x-ray technicians(medical assistance), 1973-present(2006) radiotechnologist(medical technologist) since then. 2. The average pass ratio of national license examination(1965-2006) for RTs was 46.6%. The method, subjects and level of the examination should be improved. 3. The education term for RTs has been changed since 1963 ; 1963-1990 two year college, 1991-1999 three year college, 2000-2006 four year and three year college depending on universities and colleges. As of 2006, there are twelve 4-year universities and eighteen 3-year colleges. The total number of new students were 1,956. 4. The new developmental paradigm should be made for technology education of RTs corresponding to the development of medicine and science. 5. The qualification system of clinical specialists in radio-technology field needs to be operated not by the non-governmental body(The Korean Radiological Technologists Association) but by the governmental body. 6. The vertical relationship among RTs, doctors and other medical workers should be rebuilt through the revision of law. Especially, doctors and dentists 'guidance authority' for RTs should be changed to 'request authority'. 7. The service extent of RTs should be extended in medical fields corresponding to professional work of RTs and a revision of the law needed for this situation.
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