• Title/Summary/Keyword: degree of danger

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Psychotherapist's Liability for Failure to Protect Third Person (정신질환자의 타해(他害)사고와 의료과오책임)

  • Son, Heung-Soo
    • The Korean Society of Law and Medicine
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    • v.11 no.1
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    • pp.331-393
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    • 2010
  • Psychiatrists who treat violent or potentially violent patients may be sue for failure to control aggressive outpatients and for the discharge of violent inpatients. Psychiatrists may be sued for failing to protect society from the violent acts of their patients if it was reasonable for the psychiatrists to have known or should have known about the patient's violent tendencies and if the psychiatrists could have done something that could have safeguarded in public. The courts of a number of jurisdictions have imposed a duty to protect the potential victims of a third party on persons or institutions with a special relationship to that party. In the landmark case of Tarasoff v Regents of University of California, the California Supreme Court held that the special relationship between a psychotherapist and a patient imposes on the therapist a duty to act reasonably to protect the foreseeable victims of the patient. Under Tarasoff, when a therapist has determined, or under applicable professional standards should determine, that a patient poses a serious threat of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. In addition to a Tarasoff type of action based on a duty to warn or protect foreseeable victims of psychiatric outpatients, courts have also imposed liability on mental health care providers based on their custody of patients known to have violent propensities. The legal duty in such a case has been stated to be that where the course of treatment of a mental patient involves an exercise of "control" over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls on the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient. After going through a period of transition, from McIntosh, Thompson and Brady case, finally, the narrow rule of requiring a specific or foreseeable threat of violence against a specific or identifiable victim is the standard threshold or trigger element in the majority of states. Judgements on these kinds of cases are not enough yet in Korea, so that it may be too early to try find principles in these cases, however it is hardly wrong to read the same reasons of Tarasoff in the judgements of Korea district courts. To specific, whether a psychiatric institute was liable for violent behavior toward others depends upon the patients conditions, circumstances and the extent of the danger the patients poses to others; in short, the foreseeability of a specific or identifiable victim. In this context if a patient exhibit strong violent behavior toward others, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly attack others or unidentifiable victim. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only requires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. All these principles have been established in cases of the U.S.A and Japan. In this article you can find the reasons which you can use for psychotherapist's liability for failure to protect third person in Korea as practitioner.

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Analysis of the Risk Factors Influencing the Severity of Injury in Pediatric Multiple Trauma Patients (소아 다발성 외상 환자의 중증도에 영향을 미치는 위험인자에 관한 분석)

  • Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.68-74
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    • 2010
  • Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

Survey on Working Condition of Radiological Technologists (방사선사(放射線士)의 동무(勤務) 실태(實態)에 관한 조사연구(調査硏究))

  • Choi, Jong-Hak;Jeon, Man-Jin;Park, Young-Sun
    • Journal of radiological science and technology
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    • v.9 no.1
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    • pp.51-63
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    • 1986
  • We got the following results from the 324 radiologic technologists as we surveyed their working condition by using the questionaire, who were working in the medical institutions (general hospitals and doctor's clinics) situated in the area of Seoul city, Kyung ki-do and Chung-chong-do since June to December 1985. 1. Their daily average working time was almost within 10 hours (in 93.9% of general hospitals, 66.1% of clinics). 2. About the numbers of holidays, 85.5% of general hospitals have one holiday per week,41.3% of clinics have one holiday per week or 38.5% of clinics have one holiday per two weeks. 3. Duty appointment of radiologic technologists in the department of radiology is taking charge of each part after serving for a certain part for some period (42.8%), taking charge of the special part continually or by turns in other working parts (35.3%). On the other hand in the clinics they took charge of all parts continually (53.2%) or by turns with their own situations. (30.3%). 4. Their daily working amount is too much in 51.6% of general hospitals or 45.8% of clinics. 5. They answered it was hard in 81.4% of general hospitals or 43.1% of clinics about the degree of difficulty of their work. 6. Their monthly salary is higher in the clinics than in the general hospitals and higher in Seoul area than in Kyung-ki or Chung-chong area. 7. Their yearly bonus .ate is 400%-600% (69.2%) in almost general hospitals, 100%-300% (57.8%) in th. clinics. 8. Danger allowance is paid with the monthly salary in 62.8% of the general hospitals or 19.2% of clinics and license allowance is paid in 44.7% of general hospitals or in 12.8% of clinics. 9. Their initial salary (except bonus) is about 200,000 won (in 76.8% of general hospitals, in 67.8% of clinics). 10. Their salary is raised regulary every year in 52.6% of general hospitals, but it is irregulary in 73.4% of clinics. 11. Promotion system is managed in 48.4% of the general hospitals or in 14.7% of clinics. 12. Retirement allowance is assured in 96.9% of the general hospitals or in 63.3% of clinics. 13. Main cause of their retirement is moving to more paid hospitals, better hospitals in working condition or facilities, moving to another cities, to the hospitals with more opportunities of promotion or choosing other jobs etc. 14. Human relationship with doctors, nurses or co-worker technologists as a member of medical team appeared almost intimate and good.

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A Study of Burn Accidents in Children towards Developing a Program for Prevention (어린이 화상사고의 실태와 예방대책 프로그램 개발에 대한 연구)

  • Han, Jeong-Seok;Seo, Mi-Hye
    • The Korean Nurse
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    • v.36 no.4
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    • pp.61-74
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    • 1997
  • This study is a descriptive study which was done to examine the circumstances surrounding burn accidents in children in order to develop a burn prevention program. The subjects for the study were the mothers of 107 children admitted to two burn specialty hospitals in seoul and the mothers of 172 healthy children attending day care or kindergarten. The tool used in the study was developed by the researchers, pretested and refined. Cronbach's alpha was 0.72. Data collection was done between November 1995 and April 1996. Statistically analysis was done using SAS Version 6.04 and the data was analyzed using test, chi square, regression and logistic analysis. A suumary of the results shows the following : Eighty percent of the children in both groups lived in nuclear families but comparatively more of the children with burn accidents lived in apartments. More of the parents in the group of healthy children had university education and held white collar or professional jobs, while the parents of the children with burn accidents were slightly younger than the parents of the healthy children. but not significantly younger. A significantly greater number of families of children with burn accidents had more than one child and the characteristics of the children with burn accidents that they were more frequently boys, either first or last born and very active. Most of the burn accidents occurred in fall or winter. sometime between noon and midnight and the majority occurred in the home and were caused by hot liquid. In 86% of the cases emergency care was not given at home but the child was brought to the hospital emergency unit. Most of the burns were second degree or greater. involved the arms or legs. required admission, and 41.5% occurred when the parents were preparing or eating meals. In a test of knowledge of preventive measures, the mothers of children who had suffered burn accidents scored slightly higher than the mothers who had no experience with burn accidents, but this was not statistically significant. As to what to do in the case of a fire, the mothers of the healthy children had more knowledge about who to notify. but 70% of the mothers in both groups did not know how to escape from the house if it was of fire. 80 to 96% did not know what do to in case of a fire, such as rolling if clothes were on fire. 80% did not know what emergency care to give for a burn, and 74 to 87% did not know when it is appropriate to try to put out a fire. It can be concluded from this study that. since the results show that the most frequent situation which resulted in burn accidents was when the parents were not aware of the danger of burns or were not paying attention to the child. and when there were no protective devices to prevent burns. and that accidents most frequently occurred at home. the most effective way of preventing accidents is to develop in the parents a "safety mind", Since burn accidents in children are usually more severe than in adults. the physical. emotional. psychological and social damage is greater. In order to develop and awareness of this in the general public. the use of mass media. books and pamphlets and other educational media that provide education on prevention of burn accidents need to be utilized.

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Negligence liability of hospitals for suicide of patient (정신질환자의 자살과 의료과오책임)

  • Son, Heung-Soo
    • The Korean Society of Law and Medicine
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    • v.7 no.2
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    • pp.9-74
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    • 2006
  • Due to the awareness of their rights for medical liability and the advancement of legal principles, it becomes also not hard to find those who seek damages against hospitals, doctors and nurses for the suicide committed under the protection of psychiatric institute in Korea these days. Judgements on these kinds of cases are not enough yet, so that it may be too early to try to find principles used in these cases, however it is hardly wrong to read following things from above cases. That is, to gain the case, plaintiffs should show (1) there exists an obligation of "due care"(there is a special relation between patients and hospitals), (2) the duty is violated on the basis of the applicable standard of care, (3) whatever injures or damages are sustained are proximately caused by the breach of duty and (4) the plaintiff suffers compensable damages. To specific, whether a psychiatric institute was liable for wrong death or not depends upon the patients conditions, circumstances and the extent of the danger the patients poses to himself or herself; in short, the foreseeability of self-inflicted harm(the doctor should have or could reasonably have foreseen the patient's suicide and the doctor's negligence actually caused the suicide). In this context if a patient exhibit strong suicidal tendencies, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly dashes from an attendant and jumps out a window or otherwise attempts to injure himself or herself. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only re quires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. Most of these principles have been established at cases of the U.S.A and Japan. In this article you can also find the legal organizations of medical liability and medical contacts on the suicide of patients who have psychiatric diseases under Korean negligence law.

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The Patterns of Accidental Injury in Young Children and Effect of Safety Education on Their Mothers Performance of Preventive Measures (영유아의 사고유형 실태조사와 안전교육 효과 분석)

  • Song In-Ja;Han Jung-Suk
    • Journal of Korean Public Health Nursing
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    • v.12 no.1
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    • pp.55-74
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    • 1998
  • In the past most major accidents resulted in death, but today there is a dramatic increase in the number of people who survive such accidents but who are left with permanent injury. Particularly, children who are inquisitive about their surroundings but immature in their ability to assess danger, are more vulnerable to accidents and their causes as well as to determine attitudes towards prevention. The main objective of the study was to assess the effectiveness of using an accident prevention manual for accident for accident prevention education. The study was a quasi-experimental study using a questionnaire format. The subjects of the study were 393 mothers of children attending six day care centers in Seoul. Data collection was done between May 1 and June 15, 1997. The tools used for the study were a questionnaire developed the researchers and a manual for accident prevention. The collected data were analyzed using SPSS. The results of the study are as follows: 1. Types of accidents included stabbing, bums, falls from heights, choking, falls on slippery surfaces, traffic accidents, drowning, poisoning, and electrical shock in that order of frequency. 2. The main causes of accidents in children were from cosmetics and household medications. 3. The most frequent locations of accidents in the home were the bathroom, kitchen, and stairways in that order. 4. For $90.4\%$ of children safety seats were not used when the ridding in a car. 5. In examining the parents' accident prevention practices, it was found that many parents used only . one electrical outlet for many appliances, tending to overload the electricity lines and that they were not practically concerned bout the flammability of children's pajamas, indicating a less than positive attitude towards fire prevention. 6. The parents had not provided their children with any instruction on accident prevention or on what to do after an accident had occurred. 7. After the use of pamphlet in an accident prevention education program, it was found that there was a statistically significant difference in the degree to which children carried out safety measures (t=14.96, p=.000) and in their safety habits (t=-1.67, p<.1) indicating an effectiveness in this method of education. The results of this study showed that there are many things in a child's environment that can cause accidents and that the possibility of an accident occurring is high. So nurses looking after children should be aware of the need for safety education to prevent accidents in the home and plan to provide appropriate educational material to help parents with this education.

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Current Status of Alien Plants in the Reservoir Shoreline in Korea (우리나라 저수지 호안에서 외래식물의 현황)

  • Cho, Hyunsuk;Cho, Kang-Hyun
    • Ecology and Resilient Infrastructure
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    • v.2 no.4
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    • pp.274-283
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    • 2015
  • The reservoir shores seem to be vulnerable to biological invasion. The purpose of this research was to find out the floristic composition of alien plants and their relationship between environmental factors on reservoir shorelines in Korea. We investigated flora of alien plants and environmental factors of geomorphology, hydrology, water quality and soil on the shoreline of a total of 35 reservoirs with different water level managements. There were 56 species of alien plants, which was 15% of the total plant species identified in the study of reservoirs. A total of 57% of these alien species were the species which were introduced shortly after opening the port from 1876 to 1921 in Korea. More than 80% of the alien plants on the reservoir shores originated from America and Europe. The current distribution of Ambrosia trifida and Paspalum distichum were restricted in the central part and the southern region of the Korean Peninsula, respectively. The water level fluctuation, flood frequency at the median water level, water pollution index, coverage of rock exposure and mean degree of shoreline slope were determined as important environmental factors that have an effect on the characteristics of shoreline alien flora. Our results suggest that the reservoir shore was in danger of being invaded by alien plants due to the water level management and other human disturbances. For effective conservation of the reservoir ecosystem, periodic monitoring systems are required for the early detection of alien species on the reservoir shore.

Determination of Risk Indicators for Establishing the Health Evaluation System of Old Trees (노거수의 건강성 평가체계 정립을 위한 위험 지표인자의 검증)

  • Zhang, Zhong-Feng;Xia, Tian-Tian;Kang, Ho-Chul;Kang, Tai-Ho
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.4
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    • pp.49-60
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    • 2018
  • The protection and management of old trees is important in the context of heritage protection and landscape construction. The purpose of this study is to determine the risk indicators of the health evaluation system for the old trees, and to provide methods for the protection and management of the old trees that are at risk. According to the index and weighted values obtained in the previous study the scores can be calculated on a 100-point scale. According to the score, the grades are divided into 5 levels. This study takes the case of a total of 30 old trees, including a Chinese juniper, located in Gyeongju Yangdong village, to evaluate the degree of danger in their actual condition. The results showed that of the Chinese juniper tree is at the healthy level, with the score of about 70, and is therefore in Level C. The trees in Yangdong village at high risk should be improved quickly. The standards set for the 5-level score graph and the establishment of a health evaluation system can reflect the actual situation of the old trees in Yangdong village, so it is both practical and scientific.

Study on the Operation Characteristics of Heat Detectors through Fire and Wind Tunnel Experiment (풍동실험과 화재실험을 통한 열감지기의 동작특성에 관한 연구)

  • Ryu, Hocheol;Kim, Doohyun
    • Journal of the Society of Disaster Information
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    • v.11 no.2
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    • pp.203-209
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    • 2015
  • The heat detector detects heat in the fire and is an important core element of the automatic fire alarm system used generally for every fire prevention objects. The heat detector is distinguished in spot type and spread type and in spot type, there are differential and thermistor types. These heat detectors give a great influence on the loss of people and property according to the sensitivity of response such as operation time and operation temperature in actual fire and in overseas people apply it for the development of products that can be operated in the early stage of fire including certification, quality management, and comparison standard by introducing response time index through the theory of heat balance that considers the heat loss and ventilation tests. In Korea, the response time index is introduced and used in the head of sprinkler products, but it is not applied to the heat detector at present. It is necessary to introduce the response time index that shows the sensitivity of response of the heat detector the installation standard for the heat detector that the response time index is applied should be different according to the fire weight, danger degree of fire, and shape of buildings. Through this study, it tries to help reduce lives and property of people through the swift warning by installing detectors suitable for the building structure.

A Comparative Study of knowledge, attitude, and practice by Before-after trafffic safety education : focusing on the 4th grade student in elementary school (교통안전교육 전 . 후의 지식, 태도 및 실천에 관한 비교 연구 -초등학교 4학년 학생을 대상으로-)

  • 임승지;이명선
    • Korean Journal of Health Education and Promotion
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    • v.16 no.1
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    • pp.31-43
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    • 1999
  • Increase of automobiles become today's environmental problem decreasing space for our children's playground. The traffic situation around us shows automobiles over filled the public roads and started to intrude even on the side walks. Children's traffic safety education for the awareness of the danger from traffic mishaps, and for the behavior to cope with preventives measure by continual learning programs in systematized method is very important need in current health education. For this research, the subject was represented by 243 students from 4th grade in D Elementary School located at Daechi-dong, Seoul. During total of 5 weeks (September 4, 1997 to September 30, 1997), lessons were taught to the subject. Lessons consist of traffic safety education and customized education program that were designed and developed specificially for the subject level. In this research, Case group of 3 classes and control group of 3classes were predetermined before subject's degree of knowledge, attitude, and practice was analized. The difference before and after the training of this education was observed to verify the effectively and to find the influential factors of this education program. On September 2-3, survey study was performed after the training. the results of this study were as follows: 1. The knowledge analysis from the comparison between before and after of the training shows case group and control group scored(8.36, 8.86) before the traning, but scored(10.36, 8.52) after the traning. the difference from the result of the case group is statistically significant(p〈0.001). 2. The attitude analysis from the comparison between before and after of the training shows case group and control group scored(48.23, 49.87) before the training, but scored (51.05, 48.45) after the traning. the difference from the result of the case group is statistically significant(p〈0.001) 3. The practice analysis from the comparison between before and after of the training shows case group and control group scored (27.42, 28.08) before the training, but scored(30.49, 28.25) after the training. The differece from the result of the case group is statistically significant (p〈0.001). 4. The correlation analysis of traffic safety education's influence on traffic safety knowledge, attitude, and practice before training shows the relationship between attitude and practice was satistically significant(p〈0.05). The result after the training shows the relationship between knowledge and attitude, attitude and practice, and knowledge and practice was all statistically significant(p〈0.001).

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