• 제목/요약/키워드: Medical reform

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Berufsverbot als eine Sicherungsmaßregel in Deutschland (보안처분으로서 독일의 직업금지명령 - 의사의 범죄에 대한 대응을 중심으로 -)

  • Lee, Seok-Bae
    • The Korean Society of Law and Medicine
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    • v.22 no.1
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    • pp.27-55
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    • 2021
  • Bisher wurde kein Beruf zwischen Recht und Berufsethik so diskutiert wie Ärzte. Diskussionen über die Qualifikation(od. Approbation) von Ärzten sind nicht nur eine Frage Koreas, sondern in den meisten zivilisierten Ländern ein wichtiges Diskussionsthema, wenn ein Arzt insbesondere für eine Straftat bestraft wird. Vor kurzem hat sich die koreanische Ärztekammer (the Korean Medical Association) weitgehend gegen das, "Entwurf eines Gesetzes zur Reform des Medizingesetzes" stark ausgesprochen, das die Grunde für den Entzug einer Approbation für ein Verbrechen eines Arztes erweitert. Vor allem wird auf die Gefahr hingewiesen, eine Approbation für Straftaten zu entziehen, die nicht mit beruflichen Pflichten zusammenhängen. Es ist jedoch vernünftig, den Beruf bzw. das Gewerbe zu verbieten, wenn ein Fachmann unter Missbrauch seines Beruf oder grober Pflichtverletzung die Tat begangen hat und die Gefahr bestehet, dass er bei weiterer Ausübung seines Berufs erhebliche rechtswidrige Taten der bezeichneten Art begangen wird. Die Untersagung der Berufsausübung soll die Allgemeinheit gegen die spezifischen Gefahren schützen, die mit der Ausübung eines Berufs oder Gewebes verbunden sind. Da das Berufsverbot nur die Berufsausübung untersagt, die Approbation selbst aber bestehen lässt, kann die Approbationsbehörde in eigener Entscheidungskompetenz die Approbation zurücknehmen, wiederrufen, oder in Ruhen anordnen. Entsprechend dem Verhätnismäßigkeitsgrundsatz ist aber auch das Berufsverbot auf bestimmte Tätigkeiten im Bereich des Berufs zu beschränken, wenn dies zur Erreichung des Maßregelzwecks, dem schutz der Allgemeinheit, ausreichend ist. In diesem Beitrag wurden die Voraussetzunen des Berufsverbots und die tatsächlich an Ärzte bzw. medizinische Personal gerichteten Fälle untersucht.

Material Hardship of the Poor Families in Korea: The Distributions and Determinants of Material Hardship (빈곤층의 물질적 궁핍, 실태와 영향요인 분석)

  • Lee, Sang Rok
    • Korean Journal of Social Welfare Studies
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    • v.42 no.3
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    • pp.233-265
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    • 2011
  • Material hardship measures have been used to supplement the traditional income-based poverty measures. Recently poverty researchers have increasingly used measure of material hardship to examine the well-being of low income families. Measuring the material hardship might be useful to a better understanding of the multi-dimensions of the poverty in Korea. Using the data of the Korea Welfare Panel Study(the fourth wave), I examine incidences of material hardship across quintiles of the income distributions and the factors that might affect the experience of material hardship among the poor families. Major findings are as follows. Descriptive results show that nearly one-fifth of all families had experienced at least one of the five material hardships in the year. Those in the bottom quintiles and the poor families are more likely to experience material hardship than the other quintiles and non-poor families. But, incidences of the material hardship in the middle income quintiles and low income families are not a few(18 percent and 37 percent). Logistic regression results show that family-consumption related variables, income other economic resources(asset and public assistance), and household's employment status affect the experience of material hardship among the poor families. But, material hardship among the poor families is not significantly related with family income. These results indicate that material hardship measures are the useful indicators to understanding the multi-dimensions of the poverty in Korea. And they suggest that an extensive reform of the public assistance policy is necessary to relieve the material hardships of the poor in Korea.

A Study on the Current Status of Prescribed Drugs in Oriental Health Insurance and their Improvement (한방건강보험 약제 투약 실태 및 활성화 방안 연구)

  • Kwon, Yong-Chan;Yoo, Wang-Keun;Seo, Bu-Il
    • The Korea Journal of Herbology
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    • v.27 no.2
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    • pp.1-16
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    • 2012
  • Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

The Association of Blood Concentrations of Healvy Metals and Blood Pressure in Residents Living Near Janghang Copper Smelter in Korea (제련소 주변 지역 주민들의 혈중 중금속 농도와 혈압과의 관련성)

  • Eom, Sang-Yong;Yim, Dong-Hyuk;Moon, Sun-In;Ochirpurev, Bolormaa;Choi, Young-Sook;Park, Choong-Hee;Kim, Guen-Bae;Yu, Seung-Do;Choi, Byung-Sun;Park, Jung-Duck;Kim, Yong-Dae;Kim, Heon
    • Journal of agricultural medicine and community health
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    • v.42 no.1
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    • pp.13-23
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    • 2017
  • Objectives: This study was conducted to evaluate a relationship between the blood concentrations of toxic metals and the blood pressure in people living near the copper smelter. Methods: The study included 570 adults living within 4km of the smelter. We compared systolic and diastolic blood pressure between tertiary groups for blood cadmium, mercury and lead levels, respectively. Multiple regression analysis was performed to identify risk factors affecting systolic and diastolic blood pressures. Results: In male subjects, there is a significant difference in the mean of systolic and diastolic blood pressure between tertiary groups of blood cadmium and mercury levels, but in women, there was no significant difference in the mean systolic and diastolic blood pressures in all tertiary groups of heavy metals. The results of multiple regression analysis showed that age, BMI, and cadmium concentration in men were risk factors for blood pressure. In women, age and BMI, drinking and smoking, and blood mercury were significantly influenced to blood pressure. Conclusions: Residents living near the Janghang smelter showed high concentrations of blood lead and cadmium, suggesting that they were exposed to high concentrations of heavy metals released from the smelter in the past. Such exposure may have caused some blood pressure increase. Especially, the concentration of cadmium in the case of men and the concentration of mercury in blood in the case of women were found to be significantly related to the increase of blood pressure. The local population should be advised to make efforts to reduce exposure to environmental contaminants, in order to minimize cardiovascular disease, and to pay close attention to any health problems possibly related to toxic metal exposure.

An Analysis of Nursing education Research in China : 1990-1998 (중국 간호교육관련 연구실태 분석)

  • Ko Il-Sun;Li Chun-Yu;Kim Jing-Ai
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.177-190
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    • 1999
  • This study has been conducted on the basis of the literature review of Nursing Education Research in China from 1990 through August 1998. Its purpose was to support the basic data of nursing education which is risen as major revolutionary of nursing in China and those for exchange of information between Korea-China nursing education. It is retrospective and descriptive research analyzing one hundred eighty articles published in The Journal of China Nursing. The results of the study were as follows. 1. Only 33.3% of the professors of Technical Nursing School who have played of major role of nursing education in China have carried out the study related to nursing education. Baccalaureate program professors have marked 22.2% of all studies, and diploma program professors have done 12.2% of all. Therefore, the professors of above the diploma program have done total 44.4%. It explains that the professors of baccalaureate and diploma programs have done more studies related to nursing education than those of Technical Nursing School. 2. In terms of the study design, most of the studies(38.8%) were case studies introducing the curriculum contents that were done at education institutions. And then, 28.5% were reviewing the articles, and 15.6% were descriptive studies. 3. In terms of the content of the study, 38.3% were relevant to education of Technical Nursing School, 15.0% were about baccalaureate education, and 10.4% is about diploma. 4. To analyze the specific contents of the studies ; a. In baccalaureate program, human resources (professor or teaching), course extension, lab, classes, teaching method, education philosophy, goal of education, evaluation method, and human resource development were included. b. In diploma program, teaching contents evaluation method, teaching method, and educational system were included c. In the technical school, there were qualification of professors , teaching method, evaluation method, opening the courses, teaching contents, goal of education and so on. d. Beyond these, there were practice guidance and appraisement, teaching method, and opening new courses which were not specially indicated as educational curriculum and score management as continuing education. What is above tell us that the study regarding development of university system has been progressed actively and widely. It has been for the effort of revolution which based on the China government force to reform of nursing education process during last 10 years. On the base of the result, we suggest the following questions and the alternatives. 1) Since most articles are case studies related to teaching methods and the others doesn't propose the research method. the study which is applied more exact research method is needed. 2) No study is regarding social change and health policy. Because University program, founded in 1983 is on the beginning point, the research about curriculum have to be taken as a top priority as well as to reflect social needs which are based on social changes and national health policy 3) Only one review article study tells nursing Human resource. To appear in large numbers in nursing manpower, avoid the present hospital nurses training system. Then, the study for manpower development which is able to accomplish in many fields has to be advanced. 4) Most studies did not have literature review processes, so it was impossible for researcher to know the past study tendency and there is no relation among studies as to same subject, the education about research method is needed.

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A Study on Childbrith in Late Maternal Age (노령출산에 관한 연구)

  • Han Yea Young
    • Journal of Korean Public Health Nursing
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    • v.8 no.2
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    • pp.101-113
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    • 1994
  • Maternity means all the women who are capable to conceive. In the aspect of health and medical care. however. it means the women who are now in pregnancy or have already given birth to a baby or are in a period of being recoverd from physiological changes occurred by pregnancy. According to the rapidly changing social structure. both the Quality and Quantity of the capacity of childbirth experienced by women are changing. Our society. having established a great economical growth by virtue of the highly developing and growing industrialization and urbanization. stimulates the women's advance into society and thereby increasing the number of employed women. When the women's participation in society is increased. their age of marriage is also affected. Which means there are a decrease of the capacity of childbirth in terms of quantity and a trend for women to have less children and to deliver a baby in their old age in terms of quality. On the contrary. since the number of multipara who want to have a baby in their old age is increasing. as a counter functional effect to the political project of decrease of a birth rate. concern has been focussed on childbirth in old age in the present study. And also such kind of the childbirth may be danger to the health of both mother and baby. Therefore the present study intended to provide some basic data of health education in the part of the health management of both mother and baby in the general hospital. based on understanding the realities of childbirth in. old age and things related to them. To achieve such a purpose of the present study. an analytical study by means of SPSS. was done using the data of 269 clinical records on both the newborn .babies and their mothers who had been supported by public general hospitals located in Seoul for 3 years from Jan. 1. 1991 to Dec. 31. 1993. Some significant results from the analytic study are as follows: 1. It appeared that the average age of normal. natural delivery was 33.8 years old and the average age of delivery through the cesarean operation was 35.4 years old. 2. It appeared that danger factors to childbirth women were types of the delivery and placental extrusion and danger factors to newborn babies are not so outstanding. 3. It appeared that the variables of the childbirth capacity which showed a significant difference according to each age group of women were the number of pregnancy. number of still birth, and number of existing children. That is. the age group of 'more than 35 years' had more frequency of experience In all 3 variables than the age group of 'less than 35 years'. 4. It appeared that the variables of the childbrith capacity which showed a significant difference a according to the sex of a newborn baby were number of pregnancy, number of still birth, and number of existing children. That is, the age group of 'more than 35 years' had more frequency of experience in all 3 variables than the age group of 'less than 35 years'. 5. It appeared that the health index of newborn babies which showed a significant difference was only 5 minute APGAR. That is, the health index 9.46 in the age group of 'more than 35 years' was less than an index of 9.72 in the age group of 'less than 35 years'. 6. Since a counter correlation of -0.10, as Pearson Correlation Coefficient, was showed between the age of childbirth mothers and the weight of newborn babies, it indicated that the higher age of childbirth woman, the lesser the weight of newborn baby. 7. It appeared that the number of women who had confirmed the sex of their baby before their delivery were 45 women, $67.2\%$ of total 67 women who had delivered a baby. and the expected sex by women in childbed was male with $73.1\%$ of total childbirth women expecting male birth and with their expression of feeling of female delivery. very regretful' by $39.3\%$ of total childbirth women. The results as shown above may indicate that instead of the possibility of danger to both the mother delivering a baby in old age and the baby delivered, the expectation of getting a son motivates childbirth in old age. As a conclusion, in a dimension of general hospital as well as national reform. it is required that a program of health education for childbirth in late maternal age have to be developed in the part of the health management of both mother and baby in the near future.

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Fusion of the Guardianship System and Mental Health Law Based on Mental Capacity - Focusing on the Enactment and the Application of the Mental Capacity Act (Northern Ireland) 2016 - (의사능력에 기반한 후견제도와 정신건강복지법의 융합 - 북아일랜드 정신능력법[Mental Capacity Act (Northern Ireland) 2016]의 제정 과정과 그 의의를 중심으로 -)

  • Kihoon You
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.155-206
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    • 2023
  • When a person with diminished mental capacity refuses necessary medical care, normative judgments about when paternalistic intervention can be justified come into question. A typical example is involuntary hospitalization for people with mental disabilities, traditionally governed by mental health law. However, Korean civil law reform in 2011 introduced a new form of involuntary hospitalization through guardianship legislation, leading to a dualized system to involuntary hospitalization. Consequently, a conflict has arisen between the 'best interest and surrogate decision-making' paradigm of civil law and the 'social defense and preventive detention' paradigm of mental health law. Many countries have criticized this dualized system as not only inefficient but also unfair. Moreover, the requirement for the presence of 'mental illness' for involuntary hospitalization under mental health law has faced criticism for unfairly discriminating against people with mental disabilities. In response, attempts have been made to integrate guardianship legislation and mental health law based on mental capacity. This study examines the legislative process and framework of the Mental Capacity Act (Northern Ireland) 2016, which reorganized the mental health care system by fusing guardianship legislation with mental health law based on mental capacity. By analyzing the case of Northern Ireland, which has grappled with conflicts between guardianship legislation and mental health law since the 1990s and recently proposed mental capacity as a single, non-discriminatory standard, we aimed to offer insights for the Korean guardianship and mental health systems.

Studies on the Utilization of Woodland for Livestock Farming II. Problem and Its Improvement Followed by the Join Cattle Grazing in king Won Do (임지의 축산적 이용에 관한 연구 제2보. 강원도의 새마을 "소" 임간공동방목사업의 문제점과 개선책)

  • 맹원재;윤익석;유제창;정승헌
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.3 no.2
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    • pp.100-111
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    • 1983
  • The research results reported herein had the objectives to understand and analyze the present problems of saemaeul woodland joint cattle grazing system in Kang Won Do and to take steps of improvement. The study results on actual management conditions, problems analyzed and improvement plan of total 208 joint cattle grazing area which was established 105 area in 1981 and 103 area in 1982 were summarized as follows: 1. the effectiveness of joint cattle grazing projects 1) Average daily weight gain of cattle during joint cattle grazing period was 0.4kg, showing higher daily than the conventional feeding of 0.33kg. 2) Increase of total farm income over the conventional feeding system were \1,031,357,320 during the grazing period from May to October in 1982 by adapting the 208 joint cattle grazing system, of which effectiveness of weight gain was \293,075,300 and labor saving was \543,838,750. 3) According to the results of questionaire investigation from 208 joint cattle grazing area, effectiveness of joint cattle grazing system over the conventional system were (1) labor saving, (2) feed cost saving, (3) reduced diseases, (4) increase of number of feeding, (5) inspiration of joint endeavor, (6) effect of more gain, (7) easiness of feeding and feed cost savings. 2. Problems of joint cattle grazing system. 1) Shortages of grass were a problem at second year of joint cattle grazing period due to the low regrowth rate of wild grass. 2) Proper land for woodland joint cattle grazing is belonging to land of Government ownership and it is very hard to get the permission from office of forestry for cattle grazing purpose. 3) It is also difficult to find a proper time of breeding in grazing area by the difficulty of estrus detection. 4) There are a difficulty to give a proper vaccination and medical examination for the grazing cattle. 3. Improvement plans for woodland joint cattle grazing projects. 1) Obtain sufficient roughages by hoof cultivation and oversowing pasture from the second year of joint cattle grazing period. 2) In order to increase the beef production and to use for a calf production area, Government should arrange that all proper grazing land of Government owned in Kang Won Do convert into woodland joint cattle grazing area. 3) Make a good reproductive record by mixed grazing with a excellent breeding cow in a remote area. And carry out the collective artificial insemination with synchronous puberty induced by injection of puberty stimulation hormone. 4) Make a preventive injection for blackleg, twice medication of fasciola hepatica in a year, and spray and medication of tick insecticide. 4. A policy towards upbringing of woodland joint cattle grazing area. 1) Government should thoroughly investigate about a proper land for woodland joint cattle grazing from all forests. 2) When the area is suitable for the woodland joint cattle grazing, though it is national forest or restricted area, government should make it possible to establish a grazing area. 3) On the proper land foe joint cattle grazing in the remote place, Government should support for the road construction and electric fence equipments by using of national funds. 4) There should be an administrative consideration for well promotion of the project that make woodland joint cattle grazing suitable to the characteristics of Kang Won Do. 5) In order to improve the reproduction record, Government should reform the insufficiency of artificial insemination in the joint cattle grazing area. 6) In order to maintain a proper price of cow, Government should carry out the price plan. 7) When there is any request for grassland formation in the woodland joint cattle grazing area, Government should permit it with preference.

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