독점규제법상 ‘합의의 도그마’ 논의의 향방 - 합의의 입증과 관련된 최근 대법원 판결에 대한 분석을 중심으로 -

조혜신 아주대학교 법학연구소 2015 아주법학 Vol.9 No.2

독점규제법상 부당한 공동행위를 보다 효과적으로 규제하기 위하여, 그간 법해석론에 있어서 ‘합의의 도그마’를 극복하기 위한 논의가 설득력 있게 이루어져 왔다. 하지만 최근에 선고된 일련의 대법원 판결은 오히려 합의의 도그마를 더욱 유지하는 방향으로 나아가고 있는 것으로 보인다. 살피건대, 독점규제법상 부당한 공동행위의 형사범죄적 측면, 과점적 시장구조에서 전략적 상호관계에 놓여 있는 사업자들에게도 경쟁규범이 유효한 행위규범으로 기능하여야 한다는 요구, 형사적 제재를 통하여 카르텔을 위한 합의가 경쟁질서에 미칠 위험성을 강하게 경계해 온 경쟁법의 전통 등을 고려할 때, 합의의 도그마는 입법을 통해서라면 몰라도 적어도 법해석을 통해서는 극복하기 어려운 것이 아닌가 생각된다. 합의의 도그마를 극복해야 한다는 유력한 주장은 우리나라의 산업 전반에 나타나는 과점적 시장구조에 대한 법정책적 대응의 필요성을 강조하고 있으며, 사실 이러한 요구는 매우 중대한 것이지만, 오히려 과점적 시장구조로 인해서 사업자들이 가격결정과 같은 기본적인 경영판단을 함에 있어서 이미 상당한 제약된 여지 내에 있을 수밖에 없다는 점과 오랜 동안 관련부처의 산업정책적 영향력에 광범위하게 지배되어 왔다는 사정도 여기에 함께 고려되어야 할 필요도 있다. 그렇다면 유효경쟁이 이루어지지 않고 있는 과점시장에 대한 근본적 대응으로서, 부당한 공동행위에 대한 규제 이외에 독점규제법상 다양한 규제수단들, 이를테면 시장지배적지위 남용행위에 대한 규제나 경쟁제한적 기업결합에 대한 규제를 사전적 및 사후적 측면 모두에서 입체적으로 활용할 가능성을 본격적으로 모색해야 할 시점이 아닌가 생각된다. It has been convincingly argued that we should overcome so called ‘Dogma of Agreement’ in enforcing regulation against cartel through Korean competition law. However, recent cases of Supreme Court rather seem to strengthen the dogma. Considering the criminal aspect of illegal cartel, the requirement that even undertakings facing strategic inter-relationship in oligopolistic market structure should abide by competition law, the tradition of advanced competition legislations such as US where illegal cartel has been punished as a felony, the dogma should not be given up through interpretation of current law. The argumentation that we should abandon the dogma of agreement emphasizes the need to regulate oligopolistic markets prevailing in overall industries in Korean economy, which is worthy of appreciation. Nonetheless, we should consider that undertakings in oligopolistic markets are restricted in making basic decisions like price setting because of given market structure, and they have been heavily influenced by industrial policy and guidance of government. Then, the other measures in competition law such as regulation against abuse of market-dominant position or anticompetitive M&A from both ex-ante and ex-post aspects need to be actively used in oder to fundamentally and effectively counteract against concentrated markets in Korean economy.

가맹사업법상 계약의 존속에 대한 규제

조혜신 한국경쟁법학회 2019 競爭法硏究 Vol.40 No.-

The issue of contract termination and renewal is an important matter in determining the parties' interests in the continuity of the contract, and this becomes more important in the so-called 'distribution contracts'. Distribution contracts are not only one-time or short-term, but are retained on a recurring and long-term basis, in which the nature of these continuing contracts forces the parties to be bound here for a long period of time and rely on the trust of the parties to resolve the various problems arising from the contractual relationship. However, in a distribution contract, it is common to see situations in which asymmetry between parties is structured and solidified due to circumstances in which either party is in a dominant market position or controls accessibility to consumers. This is a situation in which autonomous determination, which is the basis for contract freedom, is infringed, and in this case, the law's intervention is required. Special distribution-related laws, such as the Franchise Act, the Large Retail Business Act, and the Agency Act, can be said to limit the freedom to decide whether a contract is retained or not through regulatory laws based on the principle of good faith. The nature of such contracts in the distribution requires that the various issues arising from the contract relationship be treated differently than in the general contract. Much of it may be left to negotiation and agreement between the parties in a contract of equal standing, but in a major distribution contract in which the symmetry of the status is not guaranteed due to structural conditions, 'the objective legitimacy(das objectiv Richtige)' should be achieved through legislation. At present, since the broadest range of regulations is in Franchise Act of Korea, we could take an approach to examine whether the rules on the termination and renewal of contracts can be extended to the Agency Act or the Large Retail Business Act. Of course, the key to this is to have a review based on an understanding of the nature of each transaction. Recently, there has been discussion on introducing regulations related to contract termination and renewal in other distribution-related laws, especially the Agency Act, and a proposed revision to the law has been prepared to reflect them. This is because it has been pointed out that unfair business practices related to the termination or renewal of contracts are taking place in agency transactions. Meanwhile, the Fair Trade Commission's recently announced measures to prevent unfair practices in dealing with agency transactions said that it will set up at least three years of contract renewal requirements in standard agency contracts considering the proper duration of each transaction. While this is not yet set as a legal amendment, it may be possible to try legislative solutions in the future while looking at the improvement in reality. Of course, the provisions concerning contract termination and renewal under the Franchise Act can be a primary reference. However, it should not be missed that a gradual increase in the level of regulation in terms of 'best regulatory levels' would be desirable. In other words, it is necessary to step up to the legal level, starting from a low level, such as the introduction of standard contracts or the preparation of guidelines, with checking the effectiveness of regulations.

경쟁법의 목적으로서의 ‘효율성(Efficiency)’에 대한 법철학적 검토

조혜신 가천대학교 법학연구소 2014 가천법학 Vol.7 No.3

The objective of competition law has been debated mainly in US and EU, and especially the Chicago School which had emerged as an alternative theoretical framework against traditional Harvard School in 1970s in US has led it arguing that efficiency should be the exclusive goal for all economy-related laws including competition law. Under its powerful influence, efficiency now has become the concept which represents the goal of law, and functions as a criterion for main prohibitive activities in competition laws in many countries including Korea. In oder to see whether efficiency is eligible for the goal of law, we need to throughly examine the definition, assumption, and philosophical implication of it. When efficiency is accepted as the objective of law, issues may arise. The concept of efficiency is grounded on abstract and incomplete presumptions of 'economic men(homo economicus)' and 'perfect competition', so it never considers such facts as on what condition the affected parties are, and whether parties in question have economic capacities to improve their interests, etc. These economic reasoning neither fit well to the essentials of legal reasoning, nor is proper to solely and directly apply to complex realities. Furtuermore, Pareto efficiency, Kaldor-Hicks efficiency, and wealth maximization is not neutral on the problem of initial resource allocation. It is said that efficiency can be obtained regardless of initial resource allocation, but the matter is not only the resulted state of resource allocation depends on the state of initial resource allocation, but also the degree of inequalities in initial resource allocation could be more deepened under certain circumstances. Therefore, enforcement of competition law which aims at maximizing efficiency or wealth, is likely to widen the gap in given conditions of participating players. It is not acceptable ethically or morally, needless to say from the view of legal policy. Rather, looking back the history of competition law, the goals such as fairness or distributive justice, aside from efficiency, have been very important motives in enforcing competition law. 경쟁법의 목적에 관한 논쟁은 주로 미국과 EU을 중심으로 이루어져 왔는데, 특히 미국에서 전통적인 하버드 학파(Harvard School)의 이론체계를 반박하면서 1970년대에 등장한 시카고 학파(Chicago School)는 효율성이 경쟁법을 비롯한 모든 경제 관련 법의 유일한(exclusive) 목적이 되어야 한다고 주장하였다. 그러한 영향 하에, 오늘날 우리나라를 비롯한 여러 주요 경쟁법제에서 ‘효율성’은 법의 목적을 응축해 놓은 개념이자 주요 금지규제의 위법 여부를 판단하는 기준으로 자리잡아 가고 있다. 경쟁법의 목적으로서 유력하게 논의되고 있는 효율성이 과연 법 목적으로서 적절한 개념인지를 판단하기 위해서는, 효율성 개념의 정의와 전제, 그리고 그것이 갖는 함의에 대해서 면밀하게 살펴볼 필요가 있다. 효율성 개념이 법 목적으로 수용된다고 할 때 제기되는 문제점에는 다음과 같은 것들이 있다. 효율성 개념은 ‘경제적 인간’과 ‘완전경쟁’이라는 추상적이고 불완전한 전제에 기반한 것으로서, 일정한 행위 혹은 의사결정으로 인하여 영향을 받게 되는 자가 구체적으로 어떠한 조건에 놓여 있는지, 구체적으로 자신의 의사를 관철할 수 있는 정신적 혹은 경제적 능력이 있는지 등과 같은 사실관계는 전적으로 사상(捨象)되고 있기 때문에, 이러한 논증은 현실에서 제기되는 문제를 ‘구체적으로 타당하게’ 해결한다는 법적 논증의 목적이 맞지 않을 뿐 아니라 복잡한 현실에 단독으로 또한 직접적으로 적용되기에는 부적합하다. 또한 Pareto 효율성, Kaldor-Hicks 효율성, 부의 극대화 모두 자원이나 권리의 배분 문제에 대해서 중립적이지 않다. 최초의 자원배분이 여하하든지 간에 효율성을 달성할 수 있다고 하지만, 문제는 최초의 자원배분 상태에 따라서 효율성 도달 이후의 자원배분 상태가 결정될 뿐 아니라, 경우에 따라서 자원배분의 불평등 정도가 더욱 심화될 수 있다는 것이다. 따라서 효율성 혹은 부의 극대화를 목적으로 하는 경쟁법의 집행은, 경쟁에 참여하는 사업자들간에 존재하는 경쟁조건에 있어서의 차이가 경쟁과정을 통하여 더욱 심화되도록 할 가능성이 크다. 이러한 결과는 법정책적으로도 납득하기 어려울 뿐 아니라 윤리적·도덕적으로도 납득하기 어려운 것이다. 오히려 경쟁법의 역사를 돌이켜보면 실제로 부의 극대화와 같은 효율성 이외에 공정성이나 분배적 정의와 같은 목적들이 중요한 지침이 되어 왔음을 알 수 있다.

온라인 중개 서비스 및 검색엔진 관련 EU 이사회 규칙 개관

조혜신 한국공정경쟁연합회 2020 경쟁저널 Vol.- No.204

경쟁법상 부당한 공동행위의 형사처벌에 따르는 법리적 쟁점

조혜신 한국경쟁법학회 2019 競爭法硏究 Vol.39 No.-

Criminal punishment for cartels began with Article 1 of the U.S. Sherman Act, which has set a strong antipathy against cartels and monopolies at the time of the enactment of the Act. Against this backdrop, the so-called 'conspiracy-centered approach' was adopted. Specifically this approach could be explained as as 'agreement'-oriented components that do not take into account their implementation or the consequences of implementation, a prohibition that is not exceptionally permissible, and strong criminal sanctions that include jail terms for individuals involved. On the other hand, the circumstances behind creating competition laws for the EU community and its members are clearly distinct from those of the United States. That is, in the background of the lack of experience in moral criticism of cartels, the EU Community and Member States Competition Law has adopted an administrative-regulatory approach, which has centered around specialized regulators, to determine whether an agreement is prohibited by combining "effects or consequences" with the agreement itself. Fines, administrative sanctions, have played a major role in enforcement. However, the introduction or reinforcement of criminal sanctions to enhance the effectiveness of cartels' regulations is being noticeable due to the strengthening of awareness of problems with international cartels in the 1990s and the global spread of the leniency program that began successfully operating in the U.S. Currently, 12 countries among EU member states enforce criminal sanctions against cartels, while others, Canada, Australia, Brazil, Israel, Mexico and South Korea, do so. Many of these countries have adopted or strengthened them through legal revisions since the 2000s, showing a distinct tendency toward so-called "criminalization." And in Korea, this trend is felt in the discussion surrounding the abolition of the "exclusive accusation system“. In the case of Korea, the exclusive accusation system could be said to have been an institutional mechanism that allowed criminal sanctions to exist in a coherent manner within the framework of administrative regulation, and thus mitigated legal and procedural problems that followed criminal sanctions to some extent. In other words, an independent regulator with expertise in the Fair Trade Act has been, to some extent, restraining the problems arising from the presence of both administrative and criminal enforcement by leaving the right to decide whether or not to initiate criminal enforcement. In particular, criminal punishment of the individual involved had been supported in the light of strengthening the deterrent effect without due consideration of its legal implications, and it is thought that critical review of it from the criminal law, particularly the question of ambiguity of the subject and the substance of legality, could never be omitted. It can be expected that the recently discussed abolition of the exclusive accusation system will bring about significant changes to the existing cartel's enforcement system, that, among other things, the criminal procedure of administrative procedures cannot rule out the possibility of fundamentally changing the relationship between regulators and undertakings under competitive law, and that the benefits of enhancing the deterrent effect may not be significant due to the increase in regulatory costs associated with criminal procedures.

사회적 경제에 있어서 ‘사회성’의 헌법적 의의 : 사회적 시장경제와의 관계를 중심으로

조혜신 한국경제법학회 2022 경제법연구 Vol.21 No.3

In Germany, the social market economy has been formed as a concept with unique contents in the process of being presented as an ideal and becoming a reality. Here, two meanings of 'social' can be derived: the combination of market principles and social principles, and the binding of market with ethical and cultural values. In the economic order under the Korean constitution, both significances of ‘social’ are found. The clues are ‘economic democratization’ and ‘harmony between economic actors’ in Article 119(2). This can be the constitutional basis of sociality as a legal concept, and, based on the contents of sociality visualized or embodied by legislation and policy, the text of “economic democratization through harmony between economic subjects” can be understood. It is the laws related to social economy that allow us to directly and abundantly grasp the significance of ‘the social’ or ‘sociality’ in the legal order. The social and economic organizations designed by these laws are largely based on the following two essentials in terms of purpose and operation: one is ‘non-profit or limited profitability’ in terms of purpose, and the other is ‘democratic and participatory decision-making’ in terms of operation. The core principles of these two social economic organizations can be said to be the content of sociality implemented in the current social economy-related legislation and policies, which means ’social’ in the social market economy, which is an economic order under the constitution, and the process and result of our community's implementation of “economic democratization through harmony between economic actors.” On the other hand, the two principles of sociality: non-profitability or limited profitability in purpose and democratic and participatory decision-making in operation are to be carried voluntarily. Everyone is free to choose to form or participate in a social economic organization, and can voluntarily participate in the operation by agreeing to the purpose of the organization. This means that the pursuit of profitability is completely or partially abandoned, and the decision-making power according to one’s economic power is limited to the same level as other members. It can be said that it is related to this that the constitutional ground of social economy legislation may be “harmony” between economic actors that implies spontaneity or autonomy. 독일에서 사회적 시장경제는, 먼저 하나의 질서적 이상으로 제시되고 법과 정책으로 현실화되는 과정에서 고유한 내용을 가진 개념으로 형성되어 왔다. 여기에서 ‘사회적’의 두 가지 의의를 도출할 수 있는데, 그 하나는 시장 원리와 사회 원리, 즉 경제적 효율성과 사회적 형평성의 가치적 결합이고, 다른 하나는 윤리적·문화적 가치에 대한 시장의 결속이다. 우리 헌법상 경제질서에도 ‘사회적’의 첫 번째 의의인 시장 원리와 사회 원리의 결합 뿐 아니라 두 번째 의의인 일정한 가치지향성이 발견된다. 그 단서는 바로 ‘경제민주화’와 ‘경제주체간의 조화’이다. 이는 법 개념으로서 사회성의 헌법적 근거가 될 수 있을 것이고, 반대로 입법과 정책으로 가시화(可視化) 혹은 실체화 된 사회성의 내용을 바탕으로 “경제주체간의 조화를 통한 경제의 민주화”라는 텍스트를 이해해 볼 수도 있을 것이다. 우리 법질서에 있어서 ‘사회적인 것’ 혹은 ‘사회성’의 의의를 직접적이고도 풍부하게 파악하도록 해 주는 것은 바로 사회적 경제 관련 법률들이다. 이들 법률에서 설계하고 있는 사회적 경제조직은 크게 ‘목적’과 ‘운영’의 차원에서 다음의 두 가지를 본질로 한다고 할 수 있는데, 하나는 목적 차원에서의 ‘비영리성 혹은 제한적 영리성’이고 다른 하나는 운영 차원에서의 ‘민주적·참여적 의사결정’이다. 이 두 가지 사회적 경제조직의 핵심 원리는 현행 사회적 경제 관련 입법과 정책에서 구현된 사회성의 내용이라 할 수 있을 것이며, 이는 우리 헌법상 경제질서인 사회적 시장경제에서 ‘사회적’인 것이 의미하는 바이자, 우리 공동체가 헌법 제119조 제2항 ‘경제주체간 조화를 통한 경제민주화’를 추구하는 과정이자 결과라 할 수 있다. 한편 사회적 경제 입법의 고유하고도 독특한 성격은 그러한 정치·사회 원리에 의한 경제·시장 원리의 수정이 자발적으로 수행된다는 점에 있다. 사회성의 두 가지 원리, 즉 목적에 있어서의 비영리성 혹은 제한적 영리성과 운영에 있어서의 민주적·참여적 의사결정은 구속성과 강제성을 전제로 하지 않는다. 모든 사람은 사회적 경제조직을 결성하거나 이에 가담할 것을 자유롭게 선택할 수 있으며, 사회성을 추구하는 조직의 목적에 동의하여 자발적으로 그 운영에 참여할 수 있는 것이다. 이는 영리성의 추구를 전면적으로 혹은 부분적으로 포기하고, 자신의 경제력에 따른 의사결정권을 다른 구성원과 동일한 수준까지 제약한다는 것을 의미한다. 사회적 경제 입법의 헌법적 근거가 자발성 혹은 자율성을 암시하는 경제주체간의 ‘조화’일 수 있는 것도 이와 관련되어 있다고 할 것이다.

경쟁법상 ‘지속가능성(Sustainability)’ 문제에 관한 EU 및 회원국 경쟁당국의 동향

조혜신 한국경쟁법학회 2023 競爭法硏究 Vol.47 No.-

It will be difficult to disagree that environmental, social, and economic sustainability has now become a goal for mankind that cannot be delayed any longer. However, it is true that the new demand for sustainability raises several difficult problems in the competition law, which has basically distinguished economic and non-economic aspects. And it seems to be a problem that has not yet appeared in Korea. However, each country's economic activities are bound to be closely influenced by each other, which leads to interaction among norms. In this respect, looking at the discussions and trends in the EU and Member States, which are dealing with sustainability issues under competition law, will mean looking ahead to our problems. On the other hand, in the case of the Korean Competition Act, it is also worth paying attention to the aspect that sustainability issues may highlight the limitations of the system of prohibiting cartel in Article 40. If there is an issue in Korea where environmental public interest is greatly highlighted, such as agreement to achieve sustainability purposes, it will be reviewed in the requirement of unreasonableness, and in light of previous precedents, unreasonableness is possible to be denied. There is no choice but to say that there is considerable uncertainty as of now for both competition authorities and undertakings. For EU and member competition authorities, the sustainability issue is, after all, a task to alleviate or resolve the uncertainty of law enforcement, which seems to be greater for our KFTC or operators, but never less. Overall, looking at how the EU and its Member States address the issue of environmental sustainability, we can see that they are taking a very careful approach to maintaining consistency with the ultimate objectives and systems of competition law, while boldly embracing the challenges of the new era. The question of to what extent to consider non-economic goals or interests in competition law has long been a controversial topic, and the degree of acceptance will inevitably vary depending on the country. In the EU, values from various economic and non-economic aspects have had some role in interpreting and enforcing competition laws, so there was a context to deal with sustainability issues, but this context is relatively weak in other competition legislation, such as the United States and Korea. Nevertheless, sustainability issues are expected to provide an opportunity for in-depth discussions by visualizing issues latent in the existing normative system, such as cartels, merger, and abuse of market dominant position in Korea.

한국의 경제개발과 외자 및 외국인투자 관련 법제

조혜신 梨花女子大學校 法學硏究所 2013 法學論集 Vol.17 No.3

‘경제개발(Economic Development)’을 추진하는 국가에 있어서 가장 시급하고도 우선적인 과제는 바로 경제개발에 소요되는 자본을 조달하는 것이라 할 수 있을 것이다. 하지만 역사적으로 보았을 때 외자의 도입을 통하여 장기적이고도 지속적인 경제발전이라는 소기의 목적을 달성하는데 실패한 사례도 없지 않다. 1960년대부터 80년대에 이르는 경제개발기 한국의 외자 운용 방식은 라틴아메리카 개발도상국들의 그것과 비교하여 성공적이었다는 평가를 받을 수 있을 것이다. 개발도상에 있는 국가의 외자 관련 법제에 있어서 가장 핵심이 되는 것은 경제발전이라는 국가적 목표에 부합하도록 외자를 활용할 수 있는 기제를 마련하는 것이라 할 수 있을 것이다. 경제발전에 있어서 국가의 역할과 관련하여 많은 논의가 있을 수 있지만, 한국의 외자 및 외국인투자 관련 법제가 경제발전 과정에서 담당하였던 기능과 그 특징은 경제개발을 위하여 국가가 할 수 있는, 혹은 하여야 하는 역할의 일면을 보여주는 것이다. 경제개발기 한국의 외자 및 외국인투자 관련 법제가 보여주는 몇 가지 특징, 즉 ‘중앙 집중적인 의사결정 및 감독’과 ‘권한당국의 재량적․실질적 판단’ 그리고 ‘외자기업 및 생산수단에 대한 소유권의 국내 유보’ 등은 최대한 국민경제에 유리한 방향으로 외자를 활용하기 위한 효과적인 기제가 될 수 있었다는 점에서, 경제개발을 위한 국가의 적극적인 역할이 어떠한 방식으로 이루어질 수 있는지를 보여주는 좋은 예가 될 수 있을 것이다. 뿐만 아니라 그러한 특징은 오늘날까지 한국의 경제시스템이 운용되는 기제의 일부를 이루고 있기 때문에, 여전히 외국인투자 관련 법제의 기본적인 성격을 규정하고 있다고 보아도 크게 틀리지 않을 것이다. It is the most urgent and primary task for developing countries to raise capital. However, history proves that not all developing countries have succeeded in obtaining the sustainable economic development. Korea has managed foreign capital with better results, when comparing developing countries in Latin America in 80’s and 90’s. The core objective in foreign capital-related laws and institutions in developing countries is to have the mechanism which enables to use foreign capital according to the national goal, i.e. economic development. While there might be controversies regarding the role of state in economic development, Korean case partly shows what the state can and must do in the course of economic development. The characteristics of Korean laws on foreign capital and investment, which are ‘centralized decision making and monitoring’, ‘discretionary and substantial judgement by authority in charge’ and ‘national reserves of ownership of foreign enterprise and means of production’, would be the effective mechanism to use foreign capital in the best way for the national economy. It could be a good example which can show the proper and active role of state in economic development. Furthermore, those features form a part of the Korean economic system until today, so it can be said that they still define the basic nature of current laws and institutions of foreign investment.

원격의료 확대의 의의 및 조건에 대한 법정책적 연구: 헬스케어 산업 발전의 관점에서

조혜신 경북대학교 IT와 법연구소 2017 IT와 법 연구 Vol.0 No.15

Recently the adoption of new technology in health and medial field has generated a great deal of controversy and resistance, which comes from the sensitivity of that filed related to human’s life and body. Specifically, telemedicine in Korean Health Law has been firstly introduced in 2002, however, the further expansion is stopped due to the failure in compromising between pros and cons. If we can agree on that the essences of medical practice are ‘professionalism’ and ‘face-to-face’, it is because of the ‘morality’ and ‘responsibility’ as a conduct dealing with ‘human’. It is not enough to take functional approach. Therefore, even if the most advanced technology is going to emerge in the future, medical personnels have to take the ultimate responsibility and the technology ought to remain in complementary position. The two core characteristics of medical practices suggest us the limitation that the technology should not take place of medical personnel. In this sense, we should try to find a way to institute the more advanced telemedicine without distorting and damaging the existing heath care delivery system. It is possible to have the advanced telemedicine to strengthen the ‘regionalization’ of health care delivery system that is said to be in danger of destruction. If we promote health care industry which focuses on the prevention of disease and management of health on the basis of local government and society, we may be able to vitalize the first-level medical institutions. The primary goal of health and medical policy is to serve all people with a substantial level of health care anywhere in the country, and to prevent the concentration of profits and patients into certain large hospitals. From this point of view, in deciding priority of policies, an aim of establishing the health care system with ‘publicness’ as universal service which can treat all people in need in relatively cheap price, rather than maximizing profits and upgrading services through the development of health care industry, should take the lead.

논문 검색을 통한 피부 부작용 사례 고찰

조혜신,송아련,서형식,Cho, Hye-Sin,Song, Ah-Ryun,Seo, Hyung-Sik 대한한방안이비인후피부과학회 2018 한방안이비인후피부과학회지 Vol.31 No.3

Objectives : The aim of this review is to investigate studies on skin adverse reactions and to demonstrate subjects related to the adverse effects in dermatology. Methods : Electric searches were performed with KISS(Korean studies Information Search System) and the key words were combination of 'skin' and 'adverse effect'. 87 literatures investigated in this review were issued from 1900 to 2016. Results : Among the 87 papers, dermatologic adverse reactions were reported in 83 papers in medicine, accounting for 95.4%. Of the adverse effects seen on the skin, 84 discoloration such as erythema, pigmentation and hemotelangiosis were the most common, accounting for 21%. Among the medical adverse reactions not seen on the skin, 21 infection were the most common, accounting for 25%. Among the subjective adverse reactions, of which 32 pruritus were the most common, accounting for 43%. Among the 87 papers, there were 3 cases with underlying diabetes and 3 cases with underlying hypertension, followed by 2 cases with chronic renal failure, HBV, atopic dermatitis and respectively 1 case with alcoholism, depression addiction, multiple myeloma, arthritis and psoriasis. The most frequent period until adverse reactions appeared was within 2 weeks, accounting for 13 papers. And 4 were the most frequent adverse reactions lasting less than 1 month, and 4 were more than 3 months and less than 6 months. There were 48 cases where adverse reactions were caused by nonmedical practioner's treatment. The adverse reactions by the pharmacist were the highest at 11 cases (23%). There were 17 cases of adverse reactions due to medical treatment, among which dermatologists and nondermatologists accounted for the majority of 5 cases, 29%. The most common cause of adverse reactions was the application of external medicine (41 cases), followed by 36 cases of foreign body implantation, eyebrow tattooing, ear piercing, etc. Conclusions : In this report, we demonstrated patterns of adverse reactions in the medical field of dermatology caused by non-medical personnel than medical personnel. We suggest that more effort should be followed by medical personnel to establish clear awareness of skin disease and by patients to be aware of the risks of the illegal medical treatment by non-medical personnel.