Legal Consideration of Transfer Refusal by 119 Rescuers

The regulation on organization and operation of rescue and aid party was amended. This Regulation is designed to provide legal formality in order to protect not only the patients' right but also 119 rescuers from liability, which is due to treatment refusal by patient and the discretionary refusal of transfer by 119 rescuers on the non-emergency situation. This study looked over the constitute of violation of emergency medical service act related to the discretionary refusal of 119 rescuers, the criminal liability owing to omission and the possibility of national indemnities on the damage of patients. This study also analyzed the courts' decision and attitude by exploring overseas judicial precedents and examined what should be considered on the execution of the newly enacted law. Finally, this study put emphasis on the importance of medical director's control, documentation of every procedure, 119 rescuer's authorization on the refusal of transfer by securing patient's informed consent.ope

Legal Aspects of the Application of the Lay Rescuer Automatic External Defibrillator (AED) Program in South Korea

The American Heart Association has stated that the automatic external defibrillator (AED) is a promising method for achieving rapid defibrillation, and emphasized that AED training and use should be available in every community. The demonstrated safety and effectiveness of the AED make it ideally suited for the delivery of early defibrillation by trained laypersons, and the placement of AEDs in selected locations for immediate use by trained laypersons may enable critical intervention that can significantly increase survival from out-of-hospital cardiac arrest. The American Heart Association recommends the installation of AEDs in public locations such as airports, thus allowing laypersons to conduct defibrillation and cardiopulmonary resuscitation on the occasion of adverse cardiopulmonary events. In Korea, the Ministry of Health and Welfare officially prohibits the installation of AEDs in public locations on the grounds that cardiopulmonary resuscitation and defibrillation are understood as medical practices that can be conducted only by licensed medical practitioners. The purpose of this article is to discuss the necessity for AEDs and the appropriate process for their implementation in Korea, by examining the current pre-AED status of Korea and the relevant legal aspects. © 2008 Elsevier Inc. All rights reserved

Medico-legal consideration of gastric lavage in acutely intoxicated patients [4]

[No abstract available

The Ethical Attitude of Emergency Physicians Toward Resuscitation in Korea

This study was conducted to assess the various ethical attitudes of emergency specialists in Korea toward resuscitation. A questionnaire investigating the following key topics concerning the ethics of resuscitation was sent to emergency specialists in Korea: when not to attempt resuscitation, when to stop resuscitation, withdrawal of life-sustaining treatment, diagnosis of death by non-physicians, permission for family members to stay with the patient during resuscitation, and teaching with the body of the recently deceased patient. We found broad variation in medical practice at patient death and in the ethical considerations held and followed by emergency physicians (EPs) during resuscitation in Korea. Initiating and concluding resuscitation attempts were practiced according to ethical and cultural norms, as well as medical conditions. Guidelines for resuscitation ethics that are based on the Korean medico-legal background need to be developed. Education of EPs to solve the ethical dilemma in resuscitation is needed. © 2008 Elsevier Inc. All rights reserved

Physician liability for procedure related injury: Focused on central venous catheterization

Central venous catheterization (CVC) is one of essential procedures in critical care medicine. CVC is relatively safe when performed by experienced physicians. Complications may occur due to various risk factors. Although the incidence of CVC-related complications is not high, a serious risk may ensue in cases of such complications. Procedure related complications could lead to civil and criminal lawsuits. This study reviewed the occurrence patterns and rulings of the courts related to CVC in South Korea and tried to find pitfalls that medical professionals should keep in mind before, during and after medical procedures. Various patterns of CVC-related lawsuits have been raised. During the procedure, physicians should perform their duty considering risk factors such as patients' underlying diseases and age. In addition, before the procedure, physicians must obtain written consent for CVC from patients or their legal guardians including explanation of rare complications that could be lethal. After the completion of CVC, surveillance of anticipated complications including chest radiographs should be conducted for the immediate management of any possible complications. (C) 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved

Physicians’ attitude toward the withdrawal of life-sustaining treatment: A comparison between Korea, Japan, and China

End-of-life care decision making has become a matter of serious ethical and legal concern in the three Far East Asian Countries of China, Japan, and Korea. Researchers in the three countries collaboratively conducted a comparative descriptive study with respect to physicians’ perspectives concerning end-of-life care decisions. In spite of cultural similarities, each country has its own unique set of social, cultural, and political circumstances. So the content and scope of policies and laws on end-of-life decision reflect the differing views of people based on their social status, moral values, religious beliefs, and economic status. © 2016, Copyright © Taylor & Francis Group, LLC

A survey of the perspectives of patients who are seriously ill regarding end-of-life decisions in some medical institutions of Korea, China and Japan

Purpose The debate about the end-of-life care decision is becoming a serious ethical and legal concern in the Far-Eastern countries of Korea, China and Japan. However, the issues regarding end-of-life care will reflect the cultural background, current medical practices and socioeconomic conditions of the countries, which are different from Western countries and between each other. Understanding the genuine thoughts of patients who are critically ill is the first step in confronting the issues, and a comparative descriptive study of these perspectives was conducted by collaboration between researchers in all three countries. Methods Surveys using self-reporting paper questionnaire forms were conducted from December 2008 to April 2009 in Korea (six hospitals in two regions), China (five hospitals in four regions) and Japan (nine hospitals in one region). The subjects were patients who were critically ill who had been diagnosed as having cancer. A total of 235 participants (Korea, 91; China, 62; Japan, 52) were eventually recruited and statistically analysed. Results Most respondents had sometimes or often thought of their own death, mostly fear of 'separation from loved ones'. They wanted to hear the news regarding their own condition directly and frankly from the physician. A quarter of them preferred making end-of-life care decisions by themselves, while many respondents favoured a 'joint decision' with their family members. The most favoured proxy decision maker was the spouse, followed by the children. Most admitted the necessity of 'advance directives' and agreed with artificial ventilation withdrawal in irreversible conditions. The most common reason was 'artificial prolongation of life is unnecessary'. Most respondents agreed with the concept of active euthanasia; however, significant differences were sometimes observed in the responses according to variables such as patient's country of origin, age, gender and education level. Conclusion Patients in Far-Eastern countries gave various responses regarding end-of-life care decisions. Although familial input is still influential, most patients think of themselves as the major decision maker and accept the necessity of advance directives with Westernization of the society. Artificial ventilation withdrawal and even active euthanasia may be acceptable to them

Preimplantation Genetic Screening and the Right of the Person Producing Embryos

염색체의 수적, 구조적 이상 유무를 보기 위하여 착상전유전자선별검사(Preimplantation Genetic Screening, PGS)가 활용되고 있다. 생명윤리법은 배아나 태아를 대상으로 하는 유전자검사의 목적을 제한하고 있으나 의학적 적응증이 필수적인 요건이 아니기 때문에 의학적 적응증이 없는 착상전유전자선별검사도 여성 또는 부부가 원한다면 가능하다. 착상전유전자선별검사를 선택하기 위해서는 필수적으로 체외수정을 통한 임신방식을 선택하여야 하며, 검사 과정에서 배아를 선택하여 착상을 시도하고 선택되지 않은 배아를 폐기하는 문제가 있다. 착상전유전자선별검사의 의학적 한계로 인해 정상 염색체의 배아가 불필요하게 폐기될 가능성도 있다. 여성의 신체에 대한 자기결정권에 근거하여 임신 방식의 선택이나 건강한 아기를 출산하기 위하여 착상전유전자선별검사를 활용할 수 있다. 그러나 의학적 적응증이 없는 착상전유전자선별검사는 성별선택이나 우생학적 문제, 사회경제적 조건에 의해 특정 생명과학기술에 접근할 수 없는 경우 또 다른 차별의 문제를 만들어낼 수 있다. 출산에 관한 선택권에 근거하더라도 의생명과학기술의 적용과 활용이 윤리적 법적 문제를 야기하지 않도록 균형 있는 생명윤리정책 방향의 설정이 필요하다. Preimplanatation genetic screening (PGS) is used to detect numerical chromosome abnormalities and structural chromosome rearrangements. The Bioethics and Safety Act limits the use of genetic diagnosis and screening for embryos and fetuses. But PGS is an treatment option that is relatively unregulated and lack standardization compared with other form of preimplantation genetic diagnostic testing since medical indication is not a prerequisite for PSG. It is possible for pregnant women or couples to request PSG without medical indications. The choice to use PSG is necessarily restricted to pregnancies that result from assisted reproductive technology such as In vitro Fertilization (IVF), which entails the problem of selecting embryos to implant and destroying unselected embryos in the screening process. There is also the possibility that embryos that do not actually have chromosomal abnormalities will be needlessly destroyed, due to the current technical limitations of PSG. The use of PSG could be grounded in womens right to self-determination of ones body, to support the means of pregnancy chosen by women, and to facilitate the birth of a healthy child. However, PSG without medical indications can cause problems relating to sex-selection and eugenics, as well as create additional issues of discrimination in cases where socio-economic factors make certain biomedical technologies inaccessible. Even if based on the right to choose in matters regarding pregnancy and birth, establishing a balanced political approach on bioethics is needed for the application and usage of biomedical technology considering further ethical and legal concern

Ventricular wall rupture after myocardial infarction and cardiac arrest

[No abstract available