• The Korean Society of Law and Medicine
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• v.22 no.3
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• pp.97-124
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• 2021

In medical institutions, there are radiation-related workers such as radiological technologists, physicians, dentists, and dental hygienists who handle diagnostic radiation generators. Also, there are work assistants, such as nurses and assistant nurses, who assist in radiation treatment or transfer patients to the radiation examination room. Radiation exposure management for radiation-related workers is carried out under the 「Medical Service Act」, but there is no legal basis for work assistants, etc. And the management of radiation exposure for diagnosis is regulated by the 「Medical Service Act」, and the management of radiation exposure by therapeutic radiation and nuclear medical examination is governed by the 「Nuclear Safety Act」. Thus, to improve the management of radiation exposure for diagnosis, the regulations on radiation exposure management for diagnosis under the 「Medical Service Act」 were compared and reviewed with those of the 「Nuclear Safety Act」. As a result, the main contents are as follows. First, it is necessary to legislate to include nurses, assistant nurses, and clinical practice students who are likely to be exposed to radiation besides radiationrelated workers as subjects of radiation exposure management for diagnosis. Second, when a radiation-related worker for diagnosis is confirmed to be pregnant, the exposure dose limit should be defined. Third, it is necessary to revise the regulations on the types of personal exposure dosimeters in the 「Rules on the Safety Management of Radiation Generators for Diagnostics」. Fourth, it seems that health examination items for radiation-related workers, radiation workers, and frequent visitors should be the same. Fifth, It is necessary to unify and regulate diagnostic radiation and all medical radiation, including therapeutic radiation and nuclear medicine, in one legal system.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.3-7
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• 2010

Purpose: The usefulness of Positron Emission Tomography (PET) images in diagnosis, staging, recurrent and treatment response evaluation has already been known. However, tumors which are small size, located in lower lobe of lung or upper lobe of liver are shown misalignment, distortion and different Standard Uptake Value (SUV) by respiration in PET images. Therefore, if radiotherapy based on normal respiration, it may cause low treatment response or more side effects because targets which had to treat, out of treat range or over dose to normal tissue. The purpose of this study is to evaluate attenuation-correction with Average CT (ACT) for more accuracy SUV measurement and minimize artifact by respiration. Materials and Methods: 13 patients, who had tumors which are around the diaphragm, underwent ACT scan after Helical CT (HCT) scan with PET/CT (Discovery DSTE 8; GE Healthcare). We quantified the differences between attenuation corrected image with HCT and attenuation corrected image with ACT in artifact size and maximum SUV ($SUV_{max}$). Artifacts were evaluated by measurement of the curved photogenic area in the lower thorax of the PET images for all patients. $SUV_{max}$ was measured separately at the primary tumors. Analysis program was Advantage Workstation v4.3 (GE Healthcare). Patients were injected with 7.4 MBq (0.2 $mC_i$) per kg of $^{18}F$-FDG and scanned 1 hour after injection. The PET acquisition was 3 minute per bed. Results: Significantly lower artifact were observed in PET/ACT images than in PET/HCT images (below-thoracic artifacts caused by under corrected $1.5{\pm}3.5$ cm vs. $13.4{\pm}4.2$ cm). Significantly higher $SUV_{max}$ were noted in PET/ACT images than in PET/HCT images in the primary tumor. Compared with PET/HCT images, $SUV_{max}$ in PET/ACT images were higher by $5.3{\pm}3.9%$ (mean value) tumor. The highest difference was observed in Lower lobe of lung (7.7 to 8.7; 13%). Conclusion: Due to its significantly reduced artifacts in lower thoracic, attenuation corrected image with ACT images provided more reliable $SUV_{max}$ and may be helpful in monitoring treatment response. Moreover, ACT can separate upper lobe of liver and lower lobe of lung, it may be helpful in interpretation. ACT will be clinically useful, considering increased dose caused by ACT scan and adapt.

• The Korean Society of Law and Medicine
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• v.14 no.1
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• pp.43-83
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• 2013

Medical treatment has great potential for conflict. Even the best-trained doctors can commit medical malpractice that result in continuing physical or mental disabilities or even death. Medical conflicts have been increasing over years. The medical conflicts between patient and medical professionals that result from medical professionals' mistakes are often fueled by a violation on the pretext of the injuries form medical malpractice and can lead to litigation. The litigation usually cost a lot of money and time. The extension of the litigation period as well as expensive cost and lack of medical knowledge placing a great burden on patients. Alternative Dispute Resolution(ADR) is more efficient than litigation. In 1988, the medical dispute mediation system has been introduces as the Act on Remedy for Damage from Medical Accident and Medical Dispute Mediation by Korean Medical Association came into effect after 23 years of enactment efforts. Medical Dispute Mediation Act(hereinafter referred to as the "MDMA") has finally entered into force from 8 April 2012. The purpose of the MDMA is to promptly and fairly redress injuries caused by medical malpractice and create a stable environment for medical services of public health or medical professionals by providing for matters regarding the mediation and arbitration of medical disputes(MDMA ${\S}1$). In an effort to secure the fair, speedy and inexpensive resolution of every malpractice case, the Korea Medical Dispute Mediation and Arbitration Agency(hereinafter referred to as the "K-MEDI") was established. Following the MDMA, the K-MEDI shall endeavor to ensure the medical dispute mediation or arbitration proceedings are conducted in a prompt, fair, and efficient manner, and patients and medical professionals shall attend proceedings in good faith with mutual trust and understanding when they participate in medical dispute mediation or arbitration proceedings.

• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.1-11
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• 2022

The Act on Decisions on Life-Sustaining Treatment has been in effect since 2018 for end-of-life patients. However, only 20~25% of deaths of terminally ill patients comply with the law, while the remaining 75~80% do not. There is significant confusion in how the law distinguishes between those in the terminal stage and those in the dying process. These 2 stages can be hard to distinguish, and they should be understood as a single unified "terminal stage." The number of medical institutions eligible for life-sustaining treatment decisions should be legally expanded to properly reflect patients' wishes. To prevent unnecessary suffering resulting from futile life-sustaining treatment, life-sustaining treatment decisions for terminal patients without the needed familial relationships should be permitted and made by hospital ethics committees. Adult patients should be permitted to assign a legal representative appointed in advance to represent them. Medical records can be substituted for a patient's judgment letter (No. 9) and an implementation letter (No. 13) for the decision to suspend life-sustaining treatment. Forms 1, 10, 11, and 12 should be combined into a single form. The purpose of the Life-sustaining Medical Decisions Act is to respect patients' right to self-determination and protect their best interests. Issues related to the act that have emerged in the 3 years since its implementation must be analyzed, and a plan should be devised to improve upon its shortcomings.

• The Korean Society of Law and Medicine
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• v.20 no.2
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• pp.141-171
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• 2019

Nurses are medical personnels under the Medical Service Act and perform medical practice such as medical assistance at medical institutions. The nurse, a medical personnel, provides emergency medical service to emergency patients in the pre-hospital emergency medical system as a 119 rescuer based on the Act on 119 Rescue and Emergency Medical Services. The scope of practice of nurses is comprehensively defined in the Medical Service Act and specified through precedents. In contrast, The scope of work of emergency medical technician is listed in detail. It is understood that nurses in the pre-hospital emergency medical service system have a wider scope of practice than emergency medical technician. In particular, the scope of practice of nurses as emergency medical personnel in the pre-hospital emergency medical system should be interpreted differently within the medical institution, considering the urgency of the patient, being transferred to the emergency medical institution, and the specificity of medical direction through tele-communication.

• Journal of radiological science and technology
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• v.44 no.5
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• pp.525-534
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• 2021

In order to provide high-quality medical services to the public and contribute to the improvement of public health, it is necessary to enact an independent law according to the work of radiological technologists. Therefore, this study intends to review the regulations related to radiographers in the Medical Service Technologists, etc. Act. and to present opinions and directions for enactment of individual laws for radiological technologists. An online survey was conducted to 15,000 radiological technologists working in medical institutions and education sites in Korea; 1,027 people (6.85%) responded. The questionnaire consisted of 3 questions on demographic characteristics, 5 questions on the scope of work, and 12 questions on the revision of the Medical Service Technologists, etc. Act. and the establishment of the Radiological Technologist Independent Act. Reliability and factor analysis were performed on 9 questions measured on a Likert 5-point scale in "Revision of the Medical Service Technologists, etc. Act. and the establishment of the Radiological echnologist Independent Act" among the questionnaire items. Reliability for the total 9 questions was Chronbach α=0.728. There was a high perception that the regulations related to radiological technologists were insufficient in the current Medical Service Technologists, etc. Act., and the perception that examinations performed by radiological technologists at medical institutions were included in medical practice was high. If the Radiological Technologist Independent Act is enforced, a high percentage of respondents said that they could receive legal protection through the institutionalization of the scope of work, that the status of radiological technologists would be improved, and the scope of work would be expanded. The response that the scope of work of radiological technologists should be included was the highest at 96.6%. In the analysis according to demographic characteristics, it was found that 96.7% of the respondents were agreed regardless of the factors. Radiological technologists will have to work hard to secure the public health by coping with new radiology devices, procedures and treatment methods. Therefore, as the results of this study, it is expected that the enactment and implementation of the Radiological Technologist Independent Act will contribute to the improvement of the quality of treatment for patients and to the public health.

• Journal of Arbitration Studies
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• v.30 no.1
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• pp.185-198
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• 2020

In the event of a medical conflict in South Korea, civil lawsuits can be very complicated, time-consuming, and costly. Under the Medical Conflict Conciliation Act, the mediation system has expanded its function to coordinate disputes between individuals and medical institutions in a more efficient manner prior to litigation. Currently, conflict mediation organizations and legal systems are established in each sector, and the Healthcare Dispute Settlement Commission will also play an important role in the public sector. In this study, the characteristics of the evaluation system of the Korea Institute of Medical Conflict Arbitration are examined; and, by looking at the case of medical examinations, it is proposed to show the mediation system and the manner and role of the examinations. Medical expertise is a very important area of the qualitative standards and expertise of participants because the participants must play a role in medical consultation and appraisal in connection with medical experts.

• Journal of the Korea Society of Computer and Information
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• v.19 no.4
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• pp.139-147
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• 2014

Medical disputes the problem that occurs essentially among the rapidly increasing of the demand for health care and the attention of the public health. The subject of dispute is mostly criminal penalties and civil redress due to a physician's medical malpractice, resolved by agreement was prioritized. They trying to solve through the litigation and exercise the skills. But, the lack of clear standards and related legislation make difficult to solve the problem. for this, "The Act of Medical Malpractice Damage's Relief and Mediation for Medical Dispute Resolution" (Medical Disputes Adjustment Act) was enacted in April 7, 2011 and performed in Apr. 8, 2012. To solve the problem autonomously between the parties. It is the legislative intent such as mediation or arbitration to solve the conflict between the parties. But there are some problems that examined from the perspective of constitutional review with the criminal and civil problems. Therefore, this paper will find out the legal issues about Medical Dispute Adjustment Act and the constitutional and civil issues. And want to expect to be prepared the more stable and efficient solution of medical disputes.

• Journal of radiological science and technology
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• v.44 no.5
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• pp.503-512
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• 2021

The purpose of this study is to check the extent to which "instruction of physician or dentist" defined in the Medical Service Technologists, etc. Act is applied in relation to radiography examination procedures for radiological technologists. In addition, it is intended to present basic data on the requirement to revise the Medical Service Technologists, etc. Act in the radiological technologist's duty area and scope of work, The subjects of this study were radiological technologists with license, and the response data were collected after sending the questionnaire link written on the online questionnaire form. The final number of respondents were 1,018, and the response rate was 6.8%. Most of the negative responses were "I have never received 'instruction' for radiologic examination by a physician or dentist, including a radiologist in a medical environment." There were a high perception that "the professionalism in radiation examination on radiological technologists are higher than that of a physician or dentist." They answered that the current continuing education has a great impact on maintaining and continuing professionalism and learning new knowledge in the radiology field. In addition, the radiological technologists provide a very high level of education in areas related to radiography procedure ethics such as patient care, patient safety, and patient privacy protection, as well as specialized fields such as radiation-related examination methods, radiography examination dose, and patient exposure dose. Radiological technologists replied that they were receiving it consistently. In conclusion, in the current medical environment, the 'instruction' of a physician or dentist cannot be seen as being realistically performed. The phrase 'instruction' of a physician or dentist as defined in the Medical Service Technologists, etc. Act is considered inappropriate in respect of the fact that the state recognizes the qualifications of the medical service technologist through a license. It is thought that revision to a new term suitable for the current medical environment is necessary.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.187-192
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• 1995

Anaplastic carcinoma of the thyroid (ACT) is a rare subtype of thyroid neoplasm. This tumor represents approximately 5-10% of all thyroid malignancies and has poor prognosis ACT often arises on a long-standing thyroid nodule and has been documented to be associated with a variety of more well-differentiated thyroid carcinomas. We experienced a case of anaplastic thyroid carcinoma who had had about a year history of thyroid getter. The patient had been injected with sclerosing agents in treatment of preexisting golfer. The ACT in this case had varied cytologic and histologic appearances: pleomorphic, giant cell, spindle and squamoid. Immunohistochemically, strong cytoplasmic positivity for cytokeratin was seen in all kinds of tumor cells. Ultrastructurally, the evidences of epithelial differentiation were seen such as intercellular junctions and tonofibrils.