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The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

The National Health Insurance Corporation has been retrieving from health care providers the payments made to them by insured patients as a result of the health care providers’ arbitrary denial of coverage under the National Health Insurance, and has been disbursing such retrieved monies back to the patients, pursuant to Article 57, Sections 1 and 4 of the National Health Insurance Act. However, such practice is an application of the law that lacks legal exactitude. Another problem with such practice is that there is no legal provision under any laws or notices that expressly prohibits arbitrary denial of coverage. A legislative solution, therefore, is called for to address these issues.

This study focuses on the protection of trial subjects, who participate in clinical trials for new drug. It takes long time to develop new drugs and the clinical trials are required. Usually, pharmaceutical company, which develop new drug, request a research institution(usually, hospital) to investigate the examination of security and side effects of new drug. The institution recruit trial subject to participate in the trials. The contract for clinical research of investigational new drug is concluded between the pharmaceutical company and the institution. This thesis studies the legal regulations for protection of participants of clinical research for new drug. In this respect the first matter of this study is to seek which relation between pharmaceutical firm and participants of clinical trials. Especially, there is a question which the trial subject is entitled to demand the pharmaceutical company which requested clinical trials the institution to supply the investigational new drug, after the contract for clinical trials had terminated or cancelled. This study take into account the liability of the pharmaceutical company to trial subject. Secondly, it is researched the roles and authority of Institutional Review Board(IRB). IRB is Research Ethics Committee of the institution, in which clinical trials for new drug are conducted. According to the rule of Korea good clinical practice(KGCP), IRB is the mandatory organization which is authorized to approve, secure approval or disapprove the clinical trials for investigational new drug in the institution. The important roles are the review of ethical perspective of trial research and the protection of trial subject. Thirdly, this paper focuses if the participants are to be paid for the participation for clinical research. This is ethical aspect of clinical trials. It is resonable that the participant is reimbursed for expenditure such as travels, and other expenses incurred in participation in trials. It is not allowed that the benefit of clinical trials is paid to trial subject. The payment should not function as financial inducements for participations of trials. Finally, the voluntary consent of the trial subject is required. The institution ought to inform the subject, who would like to participate in trials, and it ought to received informed consent in writing for subject. In this regard, it is matter that trial subject has ability of consent. It is principle that the subject as severely psychogeriatric patient has not ability of consent. However, it is required that not only healthy people but also patients are allowed to take part in clinical trials of new drug, in order to confirm which the investigation new drug is secure. Therefore there are cases, in which the legal representative of subject consent the participation of the trials. In addition, it is very important that the regulations concerning clinical trials of new drug is to be systematically well-modified. The approach of legal and political approach is needed to achieve this purpose.

Civil proceedings, surveyed results and medical expenses that are evidenced by expert witness are just one of the methods of proof. Since a judge makes decision by synthesizing all evidences on a concerned case, thus the judgement would be different from that of expert witness. It is not rational for medical institutions, of which priorities are medical treatment, to give priority to disability decision. However, despite of its importance, medical institutions less recognize about the necessity of procedural stability and predictability in expert valuation. It is necessary to identify actual problems and investigate rational alternatives to acquire fairness in valuation procedures and accuracy in calculating future medical expenses. Therefore, this research explores the problems and realities of evaluation process in medical treatments, and then discuss the alternatives of written expert opinion and estimation of future medical expenses.

Korea’s medical law prohibited medical advertisements in principle and permitted them on an exceptional cases. However, the decision of the Constitutional Court of 20005. 10. 27. 20003 Heonga 3, it was changed to a negative system which allows advertisements in principle and restricted only exceptionally. Dramatic increase of medical advertisements was made after that and many argued more deregulation because there was actually heavy regulations. In particular, there is almost no actual regulation on the article type advertisement due to the reason of protection of the freedom of press, media and occupation. However, there may be an unjust result if a specific article or specialists’ opinion is made using a newspaper, broadcasting or magazine as a form of article type advertisement to specific medical specialists or medical institution or medical treatment method that falsifies consumers or makes consumers confused by unjust medical expectations or reliability, that also deteriorates just competition and that causes the misrecognition of consumers. In fact, there were actual damages of article type advertisements on the eye whitening surgery not long after the transfer to a negative system of medical advertisements. Victims raised a medical proceeding against the doctor who carried out the surgery, but there is actually no systematic warranty except for the indemnity request. Thus, this case demonstrated a vulnerable result of a negative system. As such, it is problematic that there is no proper regulations defined in the current law and regulations because of the reason of the protection of the freedom of press, publication and occupation despite damages of such article type advertisements. Accordingly, it is urgent to apply the current prevention regulations on the article type advertisements strictly, and to set up specific regulations.

There are two opinions on the legal characteristics of damages for non-pecuniary loss, a private sanctions theory and complementary function of damages for non-pecuniary loss, briefly. There is a close connection between the legal characteristics and the function of damages for non-pecuniary loss. The functions of damages for non-pecuniary loss are consist of satisfaction, prevention(sanctions) and complementation. Several cases of medical injury relief reported to Korea Comsumer Agency are categorized as follows, 1) cases of death after having an operation, 2) diagnosed with disability after a medical accident, 3) extended damages happening related to delayed diagnosis, 4) et cetera(a plastic surgery, a treatment with oriental medicine), and the damages for non-pecuniary loss in respect to each cases are examined. In the case of occurring death or disability, Korea Comsumer Agency has set up guidelines for assessment of damages for non-pecuniary loss by classifying into major and collateral violation for a duty of care. Furthermore, the damages for non-pecuniary loss in the case of all sorts of cancers, are assessed in accordance with the degree of responsibility subsequent to dividing cancer into good and poor prognosis. When it comes to a complementary function of damages for non-pecuniary loss in the actual work, it is hard to assess the damages as it is difficult to objectify non-pecuniary loss, such as emotional distress. Though compensation for damages is major legal characteristics of consolation money, preventing a damage(private sanctions) through consolation for a victim or sanctions against an assailant also has great significance. Therefore, it is necessary to approach flexibly for mutual agreement by considering specialty(concrete facts) of individual issue thoroughly. If considering this aging society that limits the possible age for work to 60 years old, it is needed to have a complementary function of consolation money in mind not to make it less meaningful for victims due to small sum of consolation money.

Die Zeugen Jehovas lehnen Bluttransfusionen ab. Wiederholt haben Todesfälle unter Jehovas Zeugen, die mit der Ablehnung von Bluttransfusionen in Verbindung gebracht werden, in den Medien für Aufsehen gesorgt, da die Zeugen Jehovas die Übertragung von fremdem Blut aus religiösen Gründen entschieden ablehnen. Medizinische Behandlungen, auch Bluttransfusionen bedürfen grundsätzlich der Einwilligung des Patienten. Wenn sich ein Zeuge Jehovas gegen eine Transfusion entscheidet, ist dies zu respektieren. Ist ein erwachsener Patient Mitglied der Zeugen Jehovas und trägt dieser eine Patientenverfügung bei sich, die eine Bluttransfusion ablehnt, weil es dadurch zu einer "Zerstörung der Persönlichkeit" des Menschen aus religiösen Gründen komme, so ist auch diese Verfügung verbindlich, sofern sie ernsthaft ist. Bei Minderjährigen ist die Einwilligungsfähigkeit durch den Gesetzgeber bislang nicht geregelt. Minderjährige können grundsätzlich selbst zustimmen, wenn sie ihrer geistigen und sittlichen Reife nach einsichtsfähig sind. Bei Jugendlichen ab dem 16. Lebensjahr muss der Arzt ermitteln, wie einsichtsfähig sie sind und inwiefern sie selbst in die medizinische Behandlung einwilligen können. Einwilligung kann aber nicht eingeholt werden, wenn der Patient einwilligungsunfähig ist. Bei Kindern bis zum 16. Lebensjahr ersetzt die Einwilligung der Eltern in die medizinische Behandlung die Einwilligung der Kinder. Ob die Entscheidungen der Eltern über ihre unmündigen Kinder im Fall lebensbedrohlicher Krankheitsverläufe von den behandelnden Ärzten akzeptiert werden müssen, ist umstritten. Die Ablehnung einer Bluttransfusion für ein transfusionsbedürftiges Kind wäre eine Kindeswohlgefährdung. Bei Kindern ist der Weg über die Übernahme des Sorgerechts durch das Gericht unvermeidlich, falls die Eltern auf der Ablehnung einer lebensnotwendigen Transfusion beharren. Im Rahmen der objektiven Interessenabwägung ist der Grundsatz “in dubio pro vita” zu beachten. Bei erheblicher unmittelbarer Gefahr ist allerdings ein direktes Eingreifen nötig.

Medical Act. article 2 (3) stipulates that “a korean medicine doctor is in charge of providing korean medical practices and korean medical health guidance”. But, without a definition article about korean medical practice, the legal concept of it is defined by supreme court cases according to specific legal trials. To establish the concept of korean medical practice, it must be included that the common parts of practice of medicine involving “the purpose of practice”, “the subject of practice”, “the object of practice” and “other dangers”, as well as the special parts of conceptual elements of korean medical practice involving “korean medicine principle” and “differentiation” and also “manufacturing of korean medicine”. Accordingly, the definition of korean medical practice is defined as examining, diagnosing, differentiating, prescribing, manufacturing of korean medicine, treating, korean medical care guiding so as to treat diseases and to promote and to maintain health, based on korean medicine as traditionally handed down from the nation's ancestors and korean medicine principle which is scientifically developed and applied and also includes a practice that will cause physiological danger to human body and/or bring harm to public health and sanitation if it is not perfomed by korean medicine doctor.

The Korean supreme court said that Mrs Kim who was in a persistent vegetative state had a right to die if she had a presumed will or assumption of dying against Severance hospital in 2009. Presumed would be vague and can not be subjective to conjecture though, the court had a developed trial on the case. I recommend the higher valued notion such as the 'right to decide on the life extension' is more logical than assumptive will. To achieve this recommendation, I will search right to life, right to decision, human dignity and find the good relationship between them. In conclusion, I will announce that if PVS patients without advanced directives aren't able to express their will and no one could not assume their right to die in spite of meaningless life extension. So only the due and strict procedure about the extinction of meaningless PVS patients will allow them to sacrifice themselves or remove life extension ventilators. Also active euthanasia would be possible under the strict procedure of making advanced directives and the act of helping active euthanasia additionally, the crime of abetting suicide would not be executed in the legal scope.

Although the number of foreign patients visiting Korea for medical treatments or plastic surgery is rapidly increasing, countermeasures against unforeseen medical disputes involving foreign patients are adequate. To date, the record shows that most foreign patients have visited doctors at the departments of family medicine, internal medicine, dermatology (incl. plastic surgery), and healthcare centers, which, fortunately, indicates that there are not many severe, high risk patients. However, if the current growth rate continues to rise and the number of foreign patients visiting each department continues to grow, more diverse medical practices will be likely to take place in the future, and consequently, it is expected that the possibilities of medical malpractice and the costs of dispute resolution will also rise dramatically. When a medical dispute occurs, in general, a lawsuit is ultimately settled by the court. However, since this can damage the creditworthiness of medical institutions and also incur significant litigation costs, which is a typical characteristic of a medical lawsuit, medical professionals or institutions will be heavily burdened. Furthermore, an adequate policy or countermeasure against a medical dispute with a foreign patient has not yet been established, and it would be difficult to resolve a dispute by finding the middle ground, due to relative standards and policies between countries. Now, we need to improve the existing policies and prepare for countermeasures that will allow us to precisely predict the nature of such disputes, which have been increasing, and resolve them peacefully. Based on such knowledge, this study aims to establish countermeasures against medical disputes with foreign patients, and examine ways to promptly and reasonably resolve them at an early stage.