No abstract available.
Supreme Court Decisions*

This paper offers a commentary on three aspects of the Supreme Court's recent decision (2011Da22092). First, contrary to the Court's finding, this paper argues that epidemiological evidence can be used to estimate the probability that a given risk factor caused a disease in an individual plaintiff. Second, the distinction between specific and non-specific diseases, upon which the Court relies, is shown to be without scientific basis. Third, this commentary points out that the Court's finding concerning defect of expression effectively enables tobacco companies to profit from the efforts of epidemiologists and others involved in public health to raise awareness of the dangers of smoking.
Jurisprudence* ; Korea* ; Lung Neoplasms ; Public Health ; Risk Factors ; Smoke ; Smoking ; Supreme Court Decisions* ; Tobacco

A theoretical study advocated for alleviating the worker's responsibility of burden of proof to establish the causality of an occupational disease, since such a responsibility is unfair to the worker. The recent judgment has adopted some of these arguments for alleviating the worker's responsibility of burden of proof, and the judgment is significant since it is the first Supreme Court decision to recognize the causality of occupational diseases. The judgment expressly confirms that it is more proactive to recognize the causal relationship between work and certain diseases, and to provide compensation for industrial accidents to employees who are exposed to harmful substances at all times. In addition, the judgment also confirms that coverage of industrial safety and health risks is in accordance with the original purpose and function of the industrial accident insurance system, which aims to share risks through public insurance.
Accidents, Occupational ; Compensation and Redress ; Insurance ; Judgment ; Models, Theoretical ; Occupational Diseases ; Supreme Court Decisions

BACKGROUND: The purpose of this study is to describe the characteristics of malpractice claims related to hemopneumothorax and to identify the causes and potential preventability of such claims. MATERIAL AND METHOD: A retrospective study was performed by reviewing the records in the Lawnb website and Lx CD-rom: the records on closed malpractice claims involving hemopneumothorax were abstracted from the files available for analysis. The records were reviewed and were analysed to determine the etiology of hemopneumothorax, patient age, results of lawsuit and indemnity payment, underlying diseases, cause of death or complications, and the factors associated with a successful defense. RESULT: Seven closed claim involving hemopneumothorax were founded in the data for malpractice. Three claims were supreme court decision, one was a high court decision and three claims were district court decision. The most common cause of death was tension pneumothorax. Four of which resulted in indemnity payments. CONCLUSION: While malpractice claims involving hemopneumothorax were uncommon, they resulted in a high rate and amount of indemnity payments. Claims are more common in pediatric patients. In case of iatrogenic hemopneumothorax, post-procedural X-ray can improve patient outcome and is also associated with decreased indemnity risks. Informed consent is also important.
Cause of Death ; CD-ROM ; Hemopneumothorax* ; Hemothorax ; Humans ; Informed Consent ; Jurisprudence ; Malpractice ; Pneumothorax ; Retrospective Studies ; Supreme Court Decisions

After a year of court trials initiated by the immediate family of a patient in a permanent vegetative state, the National Supreme Court of Korea ruled that the family have the right to decide for the removal of ventilator from the patient. This was a particularly significant court case that established a precedent for the Korean society as a whole, since there currently is no statutory framework regarding rights to self-determination to refuse any extraordinary means of treatment in Korean legal system. While much of Korean healthcare providers and the government itself have focused on designing and developing a comprehensive blueprint for Advance Health Directives for patients, the recent outcome has created an important opportunity for all parties of the Korean society. Therefore, the Korean government and legislature will need to systematically study and establish a procedural preparation for legislation. The providers will also have to carefully examine the moral and ethical dimensions of Advance Directives to promote the patients' interests in accordance with civil rights of the patients. Lastly and most importantly, the individuals must reflect on our own moral values, regardless of their current health. To exercise their own will and to relieve their relatives from difficult decisions, they must also educate themselves about living will and healthcare proxy, and elucidate their value history with family. No one can exactly lay out the course of life to death, but it is possible to steer the final journey of life to a more humane death. A society must value the life itself, but the journey to death should also be made humane by respecting one's own choice.
Advance Directives ; Civil Rights ; Delivery of Health Care ; Health Personnel ; Human Rights ; Humans ; Korea ; Living Wills ; Persistent Vegetative State ; Proxy ; Supreme Court Decisions ; Ventilators, Mechanical

PURPOSE: We wanted to describe the characteristics of the malpractice claims related to acute appendicitis and to identify medico-legal problems and potential preventability of such claims. METHODS: A retrospective study was performed by reviewing the records at websites that furnishes judicial precedents. The records on closed malpractice claims involving acute appendicitis were abstracted from the files that were available for analysis. The records were reviewed and analyzed to determine the causes of the lawsuits, the pre- and post-operative diagnoses, the comorbid conditions of the patient, the causes of death or post-operative complications, the results of the lawsuits and the factors associated with a successful defense. RESULTS: Twelve closed claims involving acute appendicitis were founded in the malpractice data. Two claims were Supreme Court decisions and ten were district court decisions. The causes of lawsuit were categorized as follows: delay in diagnosis or operation, mistakes during operation, inappropriate management of postoperative complications and problems related to general anesthesia. 3 claims were assigned to each of the 4 particular causes of lawsuits. The most common causes of death were abscess with peritonitis and sepsis, and ten of which resulted in indemnity payments. CONCLUSION: Appropriate explanation and attention in the diagnosis/progress of appendicitis, getting an informed consent from the patient, the patients' comorbid conditions, early decision making in diagnosis/operation and proper care in the operation were critical for preventing lawsuits related to acute appendicitis.
Abscess ; Anesthesia, General ; Appendicitis* ; Cause of Death ; Decision Making ; Diagnosis ; Humans ; Informed Consent ; Jurisprudence ; Malpractice ; Peritonitis ; Postoperative Complications ; Retrospective Studies ; Sepsis ; Supreme Court Decisions

The Supreme Court decision made on May 21, 2009 about the withdrawal of futile life-prolonging medical care from a persistently vegetative patient provided a legal basis for patients to consent to death with dignity, and also spurred a lively debate in Korea. The legal grounding of this decision was based on the principles of human dignity, worth, and the right to pursue happiness articulated in the Article 10 of the Constitution. The Death with Dignity Act was legislated to regulate decisions about life-prolonging medical care on February 3, 2016, after extensive debate and a focus on consensus that led to two revisions. However, the issue has not been completely resolved. First, the definition of the process of dying is unclear, because the points that determine whether a patient is dying are different from a simple assessment of whether an artificial ventilator should be attached or detached. Second, the purpose of this law is the protection of human dignity, worth, and the right to pursue happiness. However, nutrition, fluids, and oxygen must continue to be supplied, even after cessation of life-prolonging medical care. Is providing a continuous supply of nutrition, fluids, and oxygen a reasonable way to satisfy the goals of Article 10 of the Constitution? Third, if the withdrawal of life-prolonging medical care is possible based on the family's agreement without the patient's input, what is the legal value of advance directives? In conclusion, it may be necessary to partially revise the law regulating decisions on the withdrawal of life-prolonging medical care through further debate.
Advance Directives ; Consensus ; Constitution and Bylaws ; Happiness ; Humans ; Jurisprudence ; Korea ; Oxygen ; Persistent Vegetative State ; Personhood ; Right to Die ; Supreme Court Decisions ; Ventilators, Mechanical

The development of life sustaining treatment technology including artificial ventilation has given us the moral problem, considering the human dignity and futility of medical treatment, until when these treatments could be given to terminally ill patients. In Korea, there were two supreme court decisions a significant impacts on the withdrawal of life sustaining treatment. After these decisions, Korean medical society has developed a guideline for advance directives and has also established a voluntary hospital ethics committee. The patient's right of self- determination right and the paternalistic approach of medicine should be balanced at an optimal level, because benefits of medical advances should be adjusted to take into account the burden of life prolongations. Decision making always has been difficult because related to ethical values, and there a broad spectrum of value-laden attitudes within Korean society. The legalization of end-of-life care should be from the respect of the professional autonomy of medical society. Under these considerations, we should supply alternative methods like hospice care, which can help to manage the withdrawal of life support appropriately, and also make an effort to relieve the economical burden of patients.
Advance Directives ; Decision Making ; Ethics Committees ; Ethics Committees, Clinical ; Hospice Care ; Hospices ; Hospitals, Voluntary ; Humans ; Jurisprudence ; Korea ; Medical Futility ; Patient Rights ; Personal Autonomy ; Personhood ; Professional Autonomy ; Societies, Medical ; Supreme Court Decisions ; Terminally Ill ; Ventilation ; Withholding Treatment