• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.11-52
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• 2008

Based on foreign examples and past debates, the minimal conditions for passive euthanasia can be suggested as following; (1) The patient is incurable by modem medical practice and his death is impending (less than 6 months), (2) Euthanasia is practiced solely to relieve physical pain of the patient, (3) If the patient can express his will, there should be a clear and sincere request or consent, (4) More than 2 doctors including doctor in charge should consent, (5) Euthanasia should be practiced in ethical way, (6) Patient family should agree(when the patient will is assumed.) It is hard to resolve issues regarding euthanasia based on past rulings and cases without concrete law. As in United States and Germany, clear and objective provisions of euthanasia and definitive method for patient's advanced directive should be legislated to resolve medical conflict and to relieve patient and family from agony. And death with dignity debate will not be able to proceed if it is only substantively approached because of unclear definition of euthanasia and benefit comparison way of thinking. Thus it is important to establish definitive process to decided legislation of euthanasia act and resolving conflicts arising from each step of the process among interested parties exchanging medical/ethical opinions.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.176-189
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• 1998

This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

• Journal of Korean Academy of Dental Administration
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• v.7 no.1
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• pp.10-20
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• 2019

Korean dental hygienists perform more tasks in dental clinics than are described in the law. The purpose of this study was to investigate the actual work of Korean dental hygienists in dental clinics using an observational study design. Two dental hygienists observed and recorded the work performed in 1 day from the time of commencement to the time of leaving work by 18 dental hygienists working in the dental clinic in a single area. Data management, prevention of infection, counseling, calculus removal, radiography, assistance of fixed orthodontic treatment, assistance of fixed prosthetic treatment, and preparation for implant surgery were recorded. Among the tasks that take more than 1 min, the most time-consuming tasks were document management, infection control, consultation, calculus removal, preparation for implant surgery, assistance of orthodontic treatment, and assistance of fixed prosthetic treatment. Korean dental hygienists are performing various tasks, such as infection control, dental hospital/clinic management, oral disease prevention, and dental treatment assistants.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.299-346
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• 2016

There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

• The Journal of the Korea Contents Association
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• v.10 no.11
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• pp.294-303
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• 2010

Unexpected results caused by medical service are defined as malpractice, and the doctor must bear the responsibilities following the medical treatment. Malpractice disputes are disputes between patients, who are seen as the only victim in this way, and medical personnel who do not admit to the charges. Unfortunately, in reality, an official approach to mutual understanding and communication in the instance of such disputes does not exit. Based on this background, this study was attempted to prevent similar forms of medical disputes from occurrence and provide fundamental data to prepare by analyzing the medical disputes precedent. Results of the study are as follows: First, For type of medical institution, hospitals accounted for the most part as 62.9%. Second, Among total medical disputes, the cases surgery accounted for 27.8%, violation of duty care accounted for 20.6% and that of medical treatments 11.3%. Third, For a mean agreed amount by medical department, it was the highest in obstetrics & gynecology as 38,384,000 won. In conclusion, the most desirable method of dispute resolution is to prevent a cause of dispute to the root.

• The Korean Journal of Health Service Management
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• v.1 no.1
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• pp.138-153
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• 2007

As the level of the national income has been improved and the whole nation health insurance project has been spread, medical demand for dental health is also increasing. To cope with the increased medical demand, the need of dental health education and preventive dental care is recognized, and the number of dental hygienists is being increased with increase in dental clinics and hospitals. While more weight is actually given to treatment than prevention in hospitals, emphasis is placed on prevention in public health centers of state-run organizations and dental hygienists are performing the duty. According to this, dental hygienists shall be treated and recognized as professionals, who instruct people in dental health and assist the dentists in hospitals. Therefore to suggest vision to the students of department of dental hygiene, give them a solid motive, and inspire them with professional sense so that they can devote themselves to their duty with pride and self-confidence in the field can lead to contribution to dental health of each individual and the whole nation, in order to train them to be dental hygienists who are active and strive for change and development as professionals and capable of adapting themselves to the field of dental medicine. In this study, the professional sense and the recognition of the way of students belonging to department of dental hygiene were examined and based on this, a new direction for department of dental hygiene of three-year college was suggested.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.3
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• pp.85-95
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• 2016

Objectives Military medicine is the study of research which includes health, sanitation, clinic, and quarantine in military personnel. This study is focused on research the acupuncture treatment of military medicine. Methods The study on acupuncture research for Military Medicine was referred from via KoreaMed, OASIS, The Journal of Korean Military Medical Association, KMbase, KAMJE, NDSL, KISS, KISTI, PubMed, MEDLINE, EMBASE, and The Cochran library. As a result, 18 research papers were found and they were analyzed according to the year of publishment, the titles of journals, the nation of research center, the types of study, the purpose of study, the outcome of measurement, the type of acupuncture, and the assessment of acupuncture effect. And then assessed the risk of bias about RCT, NRCT, prospective cohort studies, and before and after studies. Results The number of the published research papers on acupuncture was increased since 2013. The studies were mainly published in the USA and eight out of 18 were RCT. The purpose of study is mostly for musculoskeletal and psychological disease and medical decision for acupuncture. The type of the acupuncture used is not only traditional acupuncture but also the auricular acupuncture. Even though the research results about the effect of acupuncture were excellent and positive, some of studies had a high risk of bias. Conclusions The studies state about acupuncture treatment as mostly positive and effective, however, further clinical studies are required to obtain objective clinical evidence of acupuncture treatment. Furthermore, future trials would be needed to find out effective acupuncture treatments on military duty.

• The Korean Society of Law and Medicine
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• v.20 no.3
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• pp.83-139
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• 2019

Recognition of liability for damages due to medical malpractice has been developed largely on the basis of two paths. First is the case where there is an error in a physician's medical practice and this infringes upon the legal interests of life and body, and the compensation for monetary and non-monetary damages incurred from such infringement on life and body becomes an issue. Second is the case where there is a breach of a physician's duty of explanation that results in a infringement on the patient's right of autonomous decision, and the compensation for non-monetary damages incurred from such infringement becomes an issue. However, even if there is a medical error, since it is difficult to prove the causation between the medical error of a physician and the infringement upon legal interests, the physician's responsibility for damage compensation is denied in some cases. Consider, for example, a case where a patient is already in the final stage of cancer and has a very low possibility of a complete recovery even if proper treatment is received from the physician. Here, it is not appropriate to refuse recognition of any damage compensation based on the reason that the possibility of the patient dying is very high even in the absence of a medical error. This is so because, at minimum, non-monetary damage such as psychological suffering is incurred due to the physician's medical error. In such a case, our courts recognize on an exceptional basis consolation money compensation for losing the chance to receive proper treatment. However, since the theoretical system has not been established in minutiae, what comes under the benefit and protection of the law is not clearly explicated. The recent discourse on compensating for damages incurred by patients, even when the causation between the physician's medical error and infringement upon the legal interests of life and body is denied, by establishing a new legal interest is based on the "legal principle of loss of opportunity for treatment." On what should be the substance of the new legal interest, treatment possibility argument, expectation infringement argument, considerable degree of survival possibility infringement argument and loss of opportunity for treatment argument are being put forth. It is reasonable to see the substance of this protected legal interest as "the benefit of receiving treatment appropriate to the medical standard" according to the loss of opportunity for treatment argument. The above benefit to the patient is a value inherent to human dignity that should not be infringed upon or obstructed by anyone, and at the same time, it is a basic desire regarding life and a benefit worthy of protection by law. In this regard, "the benefit of receiving treatment appropriate to the medical standard" can be made concrete as one of the general personal rights related to psychological legal interest.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.131-157
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• 2015

NHIS claimed for damages to doctors that by doing the treatment breaching medical insurance criteria caused by doctors, NHIS paid for medicine cost to pharmacy; as a result, the doctors caused the tort to NHIS. Following consecutive rulings afterwards, NHIS also argued that the medicine cost violating medical law or medical treatment expense paid to medical organizations are both the tort in civil law. NHIS claimed for all the damages, and the Supreme Court confirmed this judgment. However, within our national health insurance system, the subject of insurance payment is NHIS and the subject of medical treatment expense are also NHIS since the treatment expense is also insurance payment by asking the treatment to medical organizations. Further, national health insurance law is not made to control the violation of medical treatment cases; therefore, the breach of medical law cannot be covered by illegality of tort in civil law regarding NHIS. If that is the case, in the case that if the patients are treated according to treatment criteria via the doctors delegated the doctors' permission by Health and Welfare minister, NHIS acquired the benefits to remove the duty to give treatment payment to doctors in civil law; thus, even though the doctors have breached the medical law, NHIS does not have any damages. The fact that supreme court confirmed the ruling that the treatment is the tort in civil law towards NHIS is the judgment not counting the benefits of insurance payment as the subject but only considering the fact that NHIS paid to the doctors and this ruling have gone against the principle under civil code section 750. If the doctors have breached the medical law, the case should be sanctioned by medical law not national health insurance law, and the ruling of supreme court is assumed that they have confused both with the principle of national health insurance law and civil law.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.262-268
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• 2009

Purpose: Recently medical dispute about plastic surgery is increasing rapidly as result of growing surgery itself due to high interest in appearance and advertisement of plastic surgery. So we want to find a way to prevent similar medical accident by making better solution of plastic surgery through case analysis of medical dispute. Method: 161 cases about plastic surgery asked for aid at Korea Consumer Agency and 41 cases judged at the court was surveyed and gender, location and kind of hospital, goal and kind of operation, making operation agreement or not, kind of damage, result of process, result of lawsuit was studied from 2004.1.1. to 2006.12.31. Result: Medical doctor have to explain about symptoms of disease, method of treatment, possibility of complication, prognosis to patients before therapy so they can make decision if they take operation by doctor or not. On this survey, among the patients who underwent re - operation or had complication, 88.1%(96 from 109 cases) of them didn't get enough explanation about possibility of complication before surgery They brought lawsuit insisting they would not undergo operation if they got enough explanation about possibility of complication and result of operation before surgery. Conclusion: It is advisable that doctor must observe the duty of explanation before surgery and respect the right to decide of patient, make operation agreement and put down concrete progress note and store the pre and post operative photo to avoid medical accident. It is also needed to have guideline of therapy, Code of ethics, organization which deals with medical dispute, reconsideration of law to control that.