• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.34-42
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• 2004

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

• Journal of Korean Academy of Nursing
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• v.24 no.2
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• pp.190-205
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• 1994

Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

• Neonatal Medicine
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• v.15 no.2
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• pp.119-122
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• 2008

Clinical research is a necessity, not an option, for developing better and new medicines and therapeutic modalities. But in the course of clinical research, there are rules and guidelines that should be followed to ensure the due respect for persons, beneficence, and justice for persons who voluntarily participate in the research as described in the Belmont Report. Good Clinical Practice (GCP) is an "international scientific and ethical quality standard for designing, conducting, recording, and reporting" clinical trials. The main purposes of GCP would be to protect rights, safety, and well-being of trial subjects, in compliance with the principles of Declaration of Helsinki, and to assure that the data obtained from clinical trials are credible. In order to achieve these, investigators must be fully aware of the meanings as well as actual procedures involved in the research and should make the best effort to comply with GCP. For those individuals who belong to vulnerable populations, such as neonates, in addition to the general principles of GCP, further measures to ensure added protection should be implemented. It is our duty to develop and provide better care through clinical research even for neonates. But in doing so, we have to make sure that the importance of protecting the rights, safety, and well-being of the subjects supersede the interests of science and society.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.149-179
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• 2010

In November 2007, the Korean Constiutional Court held that a joint penal provision in which the individual employer is punished when his or her employee is determined to have committed a crime was unconstitutional, because the joint penal provision had no contents for the culpability of an individual employer and thus violated the constitutionally protected principle of culpability. After the Korean Constitutional Court's judgment, since December 2008 the Ministry of Justice began to change the old joint penal provision into the new revised joint penal provision. On January 2010, the old joint penal provisions of 110 laws were revised. The new revised joint penal provision adds only an additional sentence: "If a juristic person, an entity or an individual perform due care and supervision over its employee for the prevention of such a crime, it will be exempted from the punishment". But an presumption of negligence clause that is added in the new revised joint penal provision is still vacuum in concerned with supervision responsibility. Probably the new form of penal provision, that is understood to be a kind of the presumption of negligence, could let the burden of proof be changed from the public prosecutor to the accused, in other words employer-side. Especially, when joint penal provision is applied to hospital as administrative punishment, according to the hospital is a (juridical) foundation or not, the application of the joint penal provision is different and unfaithful. In my opinion, therefore, a corporation liability could be considered according to various liability of employee's business and the crime its employee committed because of an organizational failure of the corporation.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.41-72
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• 2018

In the division of labor (or teamwork) in medicine, the responsibility of medical and nursing staff should be separated or distributed to justify negligent criminal offenses. The present work refers to the standards by which the due diligence and responsibility of the individual persons are to be determined and delimited. In this context, it has been proven that objective theory as a measure of due diligence is appropriate. From a moral point of view, when assessing due diligence, it makes sense to impose greater individual or higher performance demands on the perpetrator, but law and order require that due diligence should result from socially relevant human behavior. To give objective measure of negligence and to provide the highest level of personal responsibility, so that man can not be burdened too much responsibility and it is accordingly with an equality theorem. Afterwards some points are presented, which should be considered in a concrete fact in the determination of the medical negligence. Medical action has specific characteristics such as professionalism, discretionary and exclusive, unbalance of information. These characteristics distinguish medical actions from general negligence. The general level of knowledge, the urgency, working condition and working environment of the medical facility, duration of the professional practice, assessment of the medical activity are crucial in this context. As a standard of delineation of due diligence, I have used the permitted risk and the principle of trust. In the horizontal division of labor, the principle of trust applies. The principle of trust applies in principle in cases of division of labor interaction, when doctors in the same hospital exercise their own specific occupational field or everyone works in another hospital. However, this is not true for every case. In the vertical division of labor, the principle of trust does not apply and the senior physician can not trust the assistant doctors. In this case, the principle of trust is converted into a duty of supervision for assistant doctors by the senior physician. This supervision requirement could be used as a random check.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.159-193
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• 2015

Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.

• Journal of the Korean Society of Safety
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• v.30 no.1
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• pp.137-143
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• 2015

Fire fighter are exposed to the situations which are hard to predict due to continuous and accidental changes which hinder their fire fighting activity. As these threats of safety accident act as fear factors, they are doing insecure fire fighting activities. Therefore, as unclear and abnormal risks of working environment such as the riskiness of expansion of disaster, instability, obstacles of activities, abnormality, urgency, etc. increase, safety accidents are caused. This study analyzes the actual condition of safety and health and awareness of fire fighter who are exposed safety accidents during their fire fighting activities and utilize such result as the basis data to secure safety of fire fighter, keep efficient safety control and prevent accidents. The results of analysis are as follows. As rescue works among all fire-fighting works shows the highest emotional stabilization and the highest post-traumatic stress disorder is shown in fire sergeant level positions, and fire fighters whose working period is 10-15 years, reinforcing safety training to long-term workers is necessary. As the result of survey regarding safety awareness, the highest awareness level was shown in fire sergeant level positions, and fire fighters whose working period is over 20 years, and when it comes to operation of fire fighting equipments, fire-fighting workers and workers having 1-4 years of working period showed high safety awareness. The more serious injury in a fire fighter experienced as the first injury after working as a fire-fighter, the more cause-and-effect relationship was shown between personal physical condition and work, and it is shown as obstacles of fire fighting activities and affects to post-traumatic stress disorder. Moreover, as after-work off duty activities also affect to official disaster, systematic improvement of working environment is required. Occupational medical work compatibility evaluation considering the distinct characteristics of works to secure fire-fighter' health care together with fire-fighting capability is shown to be necessary.

• The Journal of the Korea Contents Association
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• v.13 no.7
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• pp.311-321
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• 2013

Health is an essential element of human living and participation in society. Due to its significance, government tries to maintain the healthy life of tis people by providing health care and enhancement systems that focus on health welfare. Despite such efforts, there is still a loophole in the public system. The health problem in socially disadvantaged people, especially single mothers, becomes the cause of poverty, and the poverty again results in the poor health conditions. That is why the private sector became interested in this health issue. In this case study about the participants in the healthcare support programs for single mothers in the private sector, their experience and change related on participation in the programs were investigated in depth. As results, the following significance and quantitative performance in supporting the health right for single mothers were explored. Since single mothers could not have cared for their health because their duty for not only parenting but also family's living, th participants thought that they attained good fortunes and their own social networks. Moreover, their life attitude changed to active and their family relationship was also improved as they got out of ambiguous anxiety of health and attained self confidence.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.439-455
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• 1998

This is the descriptive investigation study intended to provide basic informations to develop concrete method of nurse arbitration which can improve the quality of nursing care on family by investigating and analyzing the perception and practice on family nursing of clinical nurse. 332 nurses working in 4 university hospitals in Seoul have been the object and the collection of data have been conducted by visiting cooperated by the department of nursing in university hospital from April 4th through April 17th 1998. The measuring instrument of the perception and the practice on family nursing which was written by the researcher was used based on the family nursing arbitration by recently amending Calgary Family Arbitration of the Model of Wright & Leahey. Cronbach's a value of this instrument was .9288 in the perception and .9168 in the practice the collected data have been analyzed by frequency percentage, averaged value. t-test, F-test(ANOVA), Duncan's Multiple Range, Pearson's Correlation Coefficient, and the results are as the follows: 1. The perception on patient's family nursing of clinical nurse showed comparatively high by 3.22 in average(maximum 3.52, minimum 2.82) on the basis of 4 point but the practice showed low by average 2.47(maximum 3.02, minimum 2.11), By providing the patients and their family with "The information about the health problem of the which is the role of giving explanation and information about the disease. the nurse presents the method of their helping patient and in case that the family lack of knowledge about the health problem and crisis of the patient which is the role of education about the method of solving the crisis and change. the nurse educates about the necessity and method of taking care of the crisis and the changes. The third question that the relation of recognizing the difficuly of family and cooperating with them in supporting the patient for mutual function is to be formed showed high in the degree of perception and practice of the necessity. 2. General characteristics of perception about patient's family nursing of the object showed no significant difference except the concerns about the family usually(F=5.472. p<.001) and general characteristics which showed significant difference in the degree of practice were educational background (F=3.177, p<.05), clinical experience (F=2.462, p<.05) and position(F=7.029. p<.001), and attention about patient's family(F=10.603, p<.001), 3. The relation between perception and practice about the nursing on patient's family showed pure correlation but the degree was very low(r=.188, p<.05). The above results showed that the clinical nurses has been high understanding about the necessity of patient's family nursing but the degree of practice has been very low due to the lack of education about the family nursing, having no ways of nurse arbitration for practical duty and lack of political administrative support. Therefore concrete and systematic family situation and arbitration method to be applied clinically are required to be developed and also the education about patient's family nursing and the development of the course for clinical practice are required and political and administrative support for clinical practice about patient's family nursing is required as well.

• The Korean Journal of Air & Space Law and Policy
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• v.25 no.2
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• pp.201-230
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• 2010

With starting the industry of automobiles, railroads and mining, the legal principle of "erlaubtes Risiko" that began as a means of maintaining the revitalized world for the cause of social utility has interpreted as a system of negligence theory in the precedent while it has gained academic recognition. Yet in aircraft operation, which is one area of high technology, CAT which can be the cause of some accidents or events or thunderstorm with turbulence is an abnormal meteorological phenomenon with frequent change that cannot be monitored perfectly just as some patient with unstable condition and that cannot be ascertained about not only the possibility of its happening but also the degree of how big the accident is. Yet the use of jet current which has the possibility of CAT can be an act of high social utility where we not only drastically cut down on time fuel also guarantee the arrival and departure on schedule when landing in airports that have thunderstorm which does not appear as fatal risk. Although we could take some measures where we can predict and avoid the potential risk, easing the regular duty of care is necessary by applying the legal principles of permitted risk concerning the incidents and accidents caused by operating in areas with the risk of turbulence or CAT with the low probability by the reason of social utility.