• The Korean Society of Law and Medicine
• /
• v.23 no.2
• /
• pp.67-96
• /
• 2022

"Aid in Dying" means that when a decision-making patient suffers from an incurable disease, a drug that can speed up death is prescribed by a doctor and used to lead to death. Since the suspension of life-sustaining treatment was institutionalized based on human dignity and patient autonomy, the question of whether assisted death can be legally justified in relation to the right to receive medical help to shorten one's life to die with dignity has recently been actively discussed. In Korea, since the suspension of life-sustaining treatment was institutionalized by the enactment of the Life-sustaining Treatment Decision Act in 2016, an amendment to the Life-sustaining Treatment Act was recently proposed to legalize Aid in Dying. The global trend is that human "Right to Die" is discussed in the division of life and death, from the suspension of life-sustaining treatment to assisted death, and again in the order of euthanasia. In this paper, we started discussing dignified death and institutionalized patients' right to self-determination, looked at the controversy in the United States, which legislated assisted death in many states since the 2000s, and analyzed the main contents of California's End of Life Option Act and the data after enforcement. The strict requirements for Aid in Dying, such as voluntary confirmation of patients' intentions and doctors' obligation to provide information, and the results of California's Aid in dying system, composed of relatively diverse races, were reviewed.

• 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 Korean Society of Law and Medicine
• /
• v.18 no.1
• /
• pp.3-35
• /
• 2017

The Supreme Court of Korea first admitted compensation for damages caused by breach of informed consent in 1979. From then on, specific details of informed consent are shaping up and developing through court precedents. The duty of informed consent of doctor is based on article 10 of the Constitution and medical contract, and is expressly prescribed Article 12 of Framework Act on Health and Medical Services and other acts and regulations. By the way, the regulations about duty of informed consent of doctor have been established in Medical Law revised on December 20, 2016, and the revised Medical Law will be implemented on June 21, 2017. According to the revised Medical Law, medical practices subject to description and consent are operation, blood transfusion and general anesthesia that threaten to cause serious harm to human life or to the body. When performing these medical activities, the written consent must be explained and agreed upon in advance. If a doctor violates the law, he will incur fines of less than 3 million won. Comparing and viewing the revised Medical Law and existing legal principles about the duty of informed consent, we can confirm that there is a substantial difference between the two parties. Accordingly, despite the implementation of the revised medical law, the existing legal principles are unlikely to be affected. However, from the perspective of legal uniformity and stability, it is undesirable that legal judgments on the same issues differ from each other. The revised Medical Law about informed consent needs to be reformed according to existing legal principles. And, as in the case of Germany, it is desirable to include the matters concerning informed consent in the civil code.

• The Korean Journal of Emergency Medical Services
• /
• v.14 no.1
• /
• pp.47-63
• /
• 2010

Objective : The objective of this study was to survey the job-related empowerment and job satisfaction of 119 emergency medical technicians provide emergency patients with first aid, to examine the correlation between their empowerment and job satisfaction, and to provide basic materials for developing programs to enhance 119 emergency medical technicians' empowerment and job satisfaction. Methods : The survey was conducted with 249 119 emergency medical technicians working at fire stations in an area of Gyeonggi-do during the period from June 26 to August 21, 2009. Using SPSS 14.0 program, we obtained frequencies percentages, means, and standard deviations, and performed independent two sample t-test, one way ANOVA, and Pearson correlation analysis, and Cronbach's ${\alpha}$. Results : 1) The mean score of the subjects' empowerment was 3.32, and that of their job satisfaction was 2.94. 2) As to difference according to general characteristics, no statistically significant difference was observed in empowerment but job satisfaction was statistically significantly different according to gender(t = 2.296, p = .023). 3) As to difference according to job related characteristics, empowerment was significantly different according to license type(F = 3.767, p = .011), and job satisfaction was statistically significantly different according to position(t = 3.222, p = .042), fire fighting experience(t = 2.689, p = .035), and first aid experience(t = 3.991, p = .007). 4) Empowerment was in a positive correlation with job satisfaction(r = .502, p = .000) in general, and by the sub areas of job satisfaction, the correlation with empowerment was high in order of job itself(r = .695, p = .000), interaction area(r = .493, p = .000), organizational demand area(r = .328, p = .000), working condition area(r = .153, p = .015), and wage area(r = .137, p = .031). By the sub areas of empowerment, the correlation with job satisfaction was high in order of significance(r = .424, p = .000), influence(r = .397, p = .000), competence(r = .372, p = .000), and self determination(r = .259, p = .000). Conclusion : The 119 emergency medical technicians' empowerment was in a high correlation with their job satisfaction, and had a strong effect on it. This suggests that 119 emergency medical technicians' job performance can be enhanced by improving their empowerment. These results are expected to be useful in making human resource management plans to enhance 119 emergency medical technicians' job satisfaction by empowering them.

• Journal of Korean Academy of Nursing Administration
• /
• v.5 no.1
• /
• pp.113-136
• /
• 1999

There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.

• The Korean Society of Law and Medicine
• /
• v.21 no.2
• /
• pp.163-207
• /
• 2020

Korea has been positioned as the leading country in the industry of clinical trials as the clinical trail of Korea has developed for the recent 10 years. Clinical trial has plays a significant role in the development of medicine and the increase of curability. However, it has inevitable risk as the purpose of the clinical trial is to prove the safety and effectiveness of new drugs. Therefore, the clinical trial should be controlled properly to protect the health of the subjects of clinical trial and to ensure that they exercise a right of self-determination. In this context, the fiduciary duties of doctors who conduct clinical trials is especially important. The Pharmaceutical Affairs Act and the relevant regulations define several duties of doctors who conduct clinical trials. In particular, the duty to protection of subjects and the duty to provide information constitute the main fiduciary duties to the subjects. Those are essentially similar to the fiduciary duties of doctors in usual treatment from the perspective of the values promoted by the law and the content of the law. Nonetheless, clinical trials put more emphasis on the duties to provide explanation than in usual treatment. Further research and study are required to establish the concrete standard for the duty of care. However, if the blind pursuit of higher standards for the duty of care or to pass the burden of proof to doctors may result in disrupting the development of clinical trials, limiting the accessibility of patients to new treatment and even violating the principle of sharing damage equally and properly. In addition to these duties, the laws of clinical trials define several duties of doctors. Any decision on whether the violation of the law constitutes the violation of the fiduciary duty and justifies the demand for compensation of damages should be based on whether relevant law aims to protect the safety and benefit of subjects, even if in an incidental way, the degree to which such violation breaches the values promoted by the law and the concrete of violation of benefit of law, the detailed acts of such violation. The legal interests of the subjects can be protected effectively by guaranteeing compliance with those duties and establishing judicial and administrative controls to ensure that the benefit of subjects are protected properly in individual cases.

• The Korean Society of Law and Medicine
• /
• v.13 no.1
• /
• pp.199-247
• /
• 2012

According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

• Journal of Sasang Constitutional Medicine
• /
• v.11 no.1
• /
• pp.103-117
• /
• 1999

1. Background and Purpose : Sasang Constitutional medicine is baon dividing individuals' constitutions into four categories. Determination of an individual's constitution, however, can be different according to who he or she consults with since it depends solely on the examiner's own perception and methods. Currently, the use of self-reporting questionnaires is accepted as a general approach in clinical settings, but the results of different questionnaires tend to be inconsistent. In this study, we investigated how different the results of the questionnaires are and what the inter-questionnaires agreement is. 2. Method : 1595 peoples who volunteered our research from 1997 to 1999 and were evaluated disease free were asked to mark out three questionnaires: Sasang Pattern Identification Questionnaire, QSCC I and QSCCII(QSCC I was completed by 348 patients only). 3. Results and Conclusions : Three questionnaires above produced different results as excepted. In Sasang Pattern Identification Questionnaire, the Soeumin accounted for 55.9%. With the modified version of Sasang Pattern Identification Questionnaire, the Taeumin was the majoriy(39.1 %) and, QSCCII also showed similar results(34.8% of Taeumin). In contrast, the QSCC I revealed the majority consisted of the Soyangin (59.1 %). In terms of analysis on inter-questionnaire agreement, Sasang Pattern Identification Questionnaire and its modified version showed the highest agreement of 66.3, followed by 55.6% of QSCCII and the modified version from Sasang Pattern Identification Questionnaire. Therefore, we concluded that the ideal choice to determine an individual's constitution, as far as questionnaires go, is to take results from both the modified version from Sasang Pattern Identification Questionnaire and QSCCII. We found the use of QSCC I can be confusing to reach a satisfactory agreement.