산업재해보상보험법상 업무상 자살의 인정범위 및 인정기준

황규식,이승길 아주대학교 법학연구소 2018 아주법학 Vol.12 No.3

In Korea, according to the Industrial Accident Compensation Act, the requirements admitted for occupational injuries are very strict and difficult, because an occupational injury related to suicide proves to be a mental abnormality, which has caused very low rate of accepting suicide as work-related accidents. However, since suicide is already intrinsic to the victim employee’s intention, it is not reasonable to judge the causal relationship between suicide and work. Therefore, stress and fatigue causing the employee to commit suicide should be related to work and work-related issues. On the other hand, judging the causal relationship is based on the common causes of the suicide when the mental illness develops due to the business reason. When the suicide is committed due to disease not related to mental illness, it is appropriate to judge the causal relationship as the suicide is caused based upon the relatively strong causes that were made due to considerable work or stress. In addition, it is reasonable to judge the subject by evaluating the degree of psychological load leading to suicide based on the individual characteristics, just like judging the physical load due to work stress or stress based on personal characteristics. In the event of a disaster, the burden of proving the causal relationship between the disaster and the victim should be transferred to the responsibility of the employer in case of suicide at work time in the workplace. If the suicide is committed without mental illness, it is also required to have the psychiatric autopsy to be able to find reasons for committing suicides. 현행 산업재해보험보상법상 업무상 재해 인정요건은 원칙적으로 고의에 의한 자살은 업무상 재해로 인정하지 않고. 예외적으로 정상적인 인식능력이 뚜렷하게 저하된 정신적 이상 상태라는 것이 입증된 자살에 대해서만 업무상 재해로 인정하고 있다. 이에 정신적 이상상태를 입증하지 못한 과로자살은 업무상 재해로 인정받기 어려웠다. 하지만 자살의 개념에 원천적으로 고의성을 내포하고 있어, 자살과 업무 사이의 인과관계를 자살행위의 고의성 유무 기준으로 업무상 재해를 판단하는 것은 타당하지 않으며, 자살자가 자살 의지를 가지게 된 원인이 과로나 스트레스 등의 업무상 문제인 지를 판단해야 한다. 한편, 상당인과관계의 판단은 업무상 사유로 정신질환이 발병해 악화되어 자살시 ‘공동원인설’에 의한 인과관계의 판단이 타당하고, 정신질환에 기초하지 않고 자살한 경우 상대적으로 업무상 과로나 스트레스가 유력한 원인으로 판단하는 ‘상대적 유력원 인설’에 의한 인과관계의 판단이 규범적으로 타당하다. 또한 자살하게 된 심리적 부하의 정도를 판단하는 주체 문제는 업무상 과로나 스트 레스로 인한 신체적 부하를 개인적 특성을 기준으로 판단하는 것처럼 ‘재해자 본인’의 개체적 특성을 기준으로 판단하는 것이 타당하다. 그리고 산재 발생시 재해자 또는 유족의 인과관계 입증책임은 사업장에서 업무시간에 자살한 경우 업무상 재해로 추정해 사용자가 업무와의 연관을 부인하는 반증책임으로 전환하고, 자살 원인이 불분명한 경우 심리부검으로 규명하도록 제도화할 필요가 있다.

부천시 일반 성인 인구의 자살에 대한 태도에 영향을 미치는 변인

김용기,이소영,김혜진,이아름,문경선,김신겸,정한용 대한신경정신의학회 2016 신경정신의학 Vol.55 No.4

ObjectivesZZThe goal of this study was to investigate variables affecting attitudes toward suicide among the general adult population in the city of Bucheon, Korea. MethodsZZStudy participants included 1000 subjects over 18 years old who visited public offices in Bucheon, Gyeonggi Province, South Korea. Subjects completed a series of questionnaires covering demographic characteristics, clinical characteristics, and prior suicidal ideation and attempts. The Attitudes Toward Suicide-20 and the Center for Epidemiologic Studies-Depression Scales were used to assess attitudes toward suicide and the severity of depression, respectively. Exploratory factor analysis of the responses was performed. ResultsZZAnalysis of responses on the Attitudes Toward Suicide-20 Scale revealed four important factors : permissiveness and unpredictability, attitudes toward suicide prevention, relationship between suicide causes and processes, and lack of comprehension of suicide. We assessed relationships among clinical and demographic variables by assessing scores on the Attitudes toward Suicide scale. Demographic characteristics (sex, age, marital status, education, economic status, and religion), clinical characteristics (physical and psychological health), and prior suicidal ideation and attempts affected respondents attitudes toward suicide. ConclusionZZThe variables identified as affecting attitudes toward suicide in this study were similar to those reported in previous studies (i.e., sex, age, religion, education, physical, and psychological health, prior suicidal ideation and attempts). In support of previous research results, we suggest that identifying groups that exhibit variables associated with attitudes toward suicide is an important step in suicide prevention, as such attitudes may influence subsequent behavior. Educational campaigns aimed at suicide prevention can be enhanced by focusing on attitudes toward suicide.

Comparison of Families with and without a Suicide Prevention Plan Following a Suicidal Attempt by a Family Member

Cho, Heung-Don,Kim, Nam-Young,Gil, Hyo-wook,Jeong, Du-shin,Hong, Sae-yong The Korean Academy of Medical Sciences 2015 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.30 No.7

<P>The frequency and extent of the existence of a familial suicide prevention plan may differ across cultures. The aim of this work was, therefore, to determine how common it was for families to develop a suicide prevention plan and to compare the main measures used by families with and without such a plan, after an attempt to commit suicide was made by a member of a family living in a rural area of Korea. On the basis of the presence or absence of a familial suicide prevention plan, we compared 50 recruited families that were divided into 2 groups, with Group A (31 families) employing a familial suicide prevention plan after a suicide attempt by a family member, and Group B (19 families) not doing so. The strategy that was employed most frequently to prevent a reoccurrence among both populations was promoting communication among family members, followed by seeking psychological counseling and/or psychiatric treatment. Contrary to our expectation, the economic burden from medical treatment after a suicide attempt did not influence the establishment of a familial suicide prevention plan. It is a pressing social issue that 38% (19 of 50) of families in this study did not employ a familial suicide prevention plan, even after a family member had attempted suicide. Regional suicide prevention centers and/or health authorities should pay particular attention to these patients and their families.</P>

자살 완료자 중 성별과 연령에 따른 자살률, 자살방법 및 동기에 대한 분석

박재영(Jae Young Park),정상혁(Sang Hyuk Jung),김진학(Jin Hak Kim),채유미(Yoo Mi Chae) 대한사회정신의학회 2007 사회정신의학 Vol.12 No.2

연구목적: 2004년 한 해 동안 우리나라에서 발생한 자살자를 대상으로 성별과 연령에 따른 자살률과 자살방법 그리고 자살동기를 알아보 고자 하였다. 방 법: 2004년 자살자에 대한 통계청 자료와 경찰청 자료를 분석하였다. 자살방법은‘한국표준질병·사인분류’의 X-code에 따라 11 개로 분류하였다. 자살동기는 경찰청 수사기록지의 사건개요를 분석하여 10개로 분류하였다. 결 과: 2004년 우리나라 자살자수는 11,523명으로 인구 10만당 25.4이었다. 여자보다 남자가 2.2배 더 자살하였으며, 전체적으로는 45~49세에서 가장 많이 자살하였다. 자살률은 연령이 증가할수록 증가하는 경향을 보였다. 가장 흔한 자살방법은 의사, 음독, 투신 등이었으며 자살동기는 경제적 이유, 육체적 질병, 정신과적 질병 등이었다. 성별에 따른 자살방법은 남자는 의사(40.8%), 여자는 음독(41.7%)이 가장 많았으며, 자살동기로는 남녀 모두에서 육체적 질환(23.5%,30.7%)이 가장 많았다. 결 론: 2004년도 우리나라의 자살률은 OECD 국가 중에서 가장 높았다. 이 연구의 결과는 자살에 관련된 기본적인 역학 자료를 제공할 것이며 자살예방을 위한 사회적 중재의 근거가 될 것이다. Objectives:This study was designed to identify the incidence, methods and reasons for committing suicide according to age and sex in South Korea. Methods:We analyzed suicide data from the National Statistical Office and the National Police Agency from January 1, 2004 to December 31, 2004. The suicide methods were classified according to X-code from the Korean Standard Classification of Diseases in 2002. We classified the reasons for committing suicide into 11 groups. Results:The number of suicide cases in Korea was 11,523 in 2004, translating to 25.4 per 100,000 persons. The suicide rate among males was 2.2 times higher than among females. The highest incidence of suicide occurred among those aged 45-49 years. The rate of suicide increases with age. The most common methods of committing suicide were hanging, poison intake, and death leap. The major reasons for committing suicide were economic, physical, and psychiatric reasons. The most frequent method of suicide was by hanging (40.8%) among males, and poison intake (41.7%) among females. The most frequent reason for committing suicide was physical (23.5%) among males, and physical (30.7%) among females. Conclusion:The suicide rate in Korea was highest in the OECD. Results of this study will serve as basic epidemiologic data about suicide in South Korea and provide support for the need to facilitate social intervention for preventing suicide.

일 지역사회의 자살기도자와 자살사망자에 대한임상적 특성 비교

황지희,기선완,이기환,김지웅,이태용 대한우울조울병학회 2010 우울조울병 Vol.8 No.2

Objectives:Suicide is an important public health problem and one of the leading causes of death worldwide. The purpose of this study was to examine the differences in clinical and sociodemographic characteristics between suicide attempters and completers in Chungcheongnam-Do Community. Methods:This study was a part of the Mental Health Survey of Chungcheongnam-Do. 73 subjects (33 attempters, 40 completers) were investigated with a questionnaire about suicide related factors. Basic sociodemographic and clinical datas were compared between suicide attempters and suicide completers. Results:The suicide completers were characterized by male preponderance,lower rates of previous suicide attempt and psychiatric treatment. In both groups, depression were strongly related to suicide. The most common method of suicide in both groups wasagricultural chemicalsoverdose. In addition, the suicide completers used the lethal methods such as Hanging, drowning, neck fastened and jumping compare to attempters. Howeverthe suicide attempters used the non-severe methods such as psychotropics overdose and cutting. Economic problems were a leading cause of suicide in both groups. Also, impulsivity and despair were most common psychological state at the time of suicide. Conclusion:There were significant differences between suicide attempters and completers in gender, distressful disease, method of suicides, previous suicide attempts. This result emphasis the need for further investigation on high risk group for suicide.

자살예방에 대한 사회정신의학적 접근

김성완,전민,김미나,백종우,김재민,윤진상 대한의사협회 2019 대한의사협회지 Vol.62 No.2

Suicide is the fifth-leading cause of death in Korea, accounting for 4.4% of all deaths. Therefore, suicide is a serious medical problem, as well as a social problem. In this paper, we provide a social psychiatric perspective on suicide and recommend suicide prevention strategies based on programs with roots in the Gwangju mental health pilot project and an analysis of suicide patterns in Seoul. First, early intervention and active case management are mandatory to prevent suicide among individuals with mental illnesses such as depression, schizophrenia, and alcohol use disorder. To this end, mental health and welfare centers, addiction management centers, suicide prevention centers, and care program after a suicide attempt in the emergency department of general hospitals should collaborate via a multidisciplinary approach. Second, crisis intervention should be provided in collaboration with the police, government officials, and mental health agencies to people who are at immediate risk of suicide. Additionally, case management services should be expanded for individuals who are treated at hospitals for psychiatric illness. Third, social welfare services should be offered to low-income individuals at risk of suicide. Fourth, the mass media should restrict reporting about suicide and follow the relevant reporting guidelines. Finally, access to methods of committing suicide, such as charcoal for burning and agrichemical poisoning, should be regulated by the government. Proactive psychosocial strategies implemented with government support will prevent suicide-related deaths and decrease the suicide rate in Korea.

의학적 측면의 자살방지 대책: 외국 사례를 중심으로

배상빈,우종민 대한의사협회 2011 대한의사협회지 Vol.54 No.4

Even though suicide ranks as the fourth cause of death and is causing a significant loss in Korea, it seems that the conventional notion regarding suicide as a feasible way of solving a troublesome life situation hinders early recognition and proper management of suicide. This article reviews suicide prevention strategies recommended based on robust experience and scientific understanding of the characteristics of the suicide problem. In the UK, a suicide prevention strategy was formed at the national level suggesting significant goals to reduce the rate of suicide. In the US, the Institute of Medicine study committee examined the state of the science base, gaps in knowledge, strategies for prevention, and research designs for the study of suicide. This recommendation includes more science-based, coherent and well-coordinated multidisciplinary approaches, and thus suggests important practical recommendations for a suicide prevention strategy of Korea. The author concludes that suicide should be defined as a treatable and even preventable medical condition. Constructing a national network of suicide research, data surveillance, developing tools for suicide prevention including early detection and safety planning, and comprehensive insurance coverage are recommended.

자살 생각에 따른 자살 시도 고위험군 규명

한명희(Myeunghee Han) 한국산학기술학회 2023 한국산학기술학회논문지 Vol.24 No.4

본 연구는 2021 지역사회건강조사 자료를 활용하여 자살 생각 경험이 있는 대상자 중 자살 고위험군을 예측하는 모델을 구축하였다. 본 연구는 자살생각 경험이 있는 총 대상자(N=16,070명)를 자살 시도 경험군(n=699명)과 비경험군 (n=15,371명)으로 나누어 의사결정나무분석을 통해 자살시도 고위험군을 파악하였다. 본 연구의 전체 대상자를 중심으로 한 예측 모형에서는 우울증상이 있고, 흡연을 하며 삶의 만족도가 4점 이하로 낮은 경우가 자살 시도율 20.0%로 자살 고위험군으로 확인되었다. 연령을 기준으로 한 자살 고위험군 예측 모형에서는 연령 군 19-29세에 해당하면서, 흡연자이고, 삶의 만족도가 낮은 경우 자살 시도율 30.9%로 가장 높았다. 성별을 고려한 자살 시도 모델에서는 여성이면서 우울하고 흡연하는 경우가 21.3%로 고위험군이었다. 자살은 자살생각, 자살 계획 그리고 자살 시도의 일련의 과정으로 일어날 가능성이 크다. 따라서 자살 생각 경험이 있는 대상자를 중심으로 정기적인 자살 관련 검진을 실시하고 다양한 프로그램을 적용하여 자살을 예방할 수 있도록 지역사회가 노력해야 할 것으로 사료된다. This study used the 2021 Community Health Survey data to build a model that predicts the high-risk suicide group among subjects with suicidal thoughts. To predict the high-risk group, the total number of subjects identified with suicidal ideation (N=16,070) was divided into a group that had experienced a suicide attempt (n=699) and a non-experienced group (n=15,371). Decision tree analysis was applied to identify the high-risk group. Subjects with depressive symptoms, smoking, and low life satisfaction were identified as the high suicide risk group and were determined to have a suicide attempt rate of 20.0%. In the age-based suicide risk group prediction model, the highest suicide attempt rate at 30.9% was in the age group of 19-29 years old, smoker, and with low life satisfaction. In the suicide attempt model considering gender, the high-risk group included 21.3% of women, depression, and smoking. Since suicide is likely to occur as a series of suicidal thoughts, suicide plans, and suicide attempts, it is necessary to conduct regular suicide-related checkups for people experiencing suicidal thoughts. Also, the community should make efforts in the prevention of suicides by employing various programs.

2020년 자살 관련 지표들과 추이

허경덕,김승훈,이두웅,박은철,장성인 한국보건행정학회 2022 보건행정학회지 Vol.32 No.2

The aim of this study was updating suicide-related indicators, including the number of suicidal deaths, suicide rate, and theprevalence of suicidal ideation and suicide attempts. We observed trends in suicide-related indicators based on up-to-dateinformation. This study used five data sources to evaluate the trends of suicide-related indicators: Statistics Korea (1983–2020),Korean Wealth Panel Study (KOWEPS, 2012–2020), and Korea Health Panel Survey (KHP, 2010–2013, 2016–2018), Korean NationalHealth and Nutrition Examination (KNHANES, 2007–2013, 2015–2020), and Korean Community Health Survey (KCHS, 2008–2009, 2013,2017). The suicide rate per 100,000 population decrease from 26.9 in 2019 to 25.7 in 2020. Based on recently available data, the ratesof suicidal ideation were 1.48% (KOWEPS, 2020), 2.61% (KHP, 2018), 4.62% (KNHANES, 2019), and 6.96% (KCHS, 2017). Those ofsuicide attempt as were 0.07% (KOWEPS, 2020), 0.44% (KNHANES, 2020), and 0.32% (KCHS, 2017). Annual percentage change (APC)of suicide rate was -1.87% (Statistics Korea, 2011–2020). APC of suicidal ideation was -10.7% (KOWEPS, 2012–2020), -11.5% (KHP,2010–2013, 2016–2018), -14.7% (KNHANES, 2007–2013, 2015, 2017, 2019), and -2.5% (KCHS, 2008–2009, 2013, 2017). APC of suicideattempt was -11.3% (KOWEPS, 2012–2019), -5.2% (KNHANES, 2007–2013, 2015–2020), and -4.4% (KCHS, 2008–2009, 2013, 2017). Although the suicide rate in Korea has decreased compared to 10 years ago, it is still at a high level. Thus, continuous observationand appropriate suicide prevention policies are needed.

대중매체의 자살보도 및 사회적 지지가 대학생의 자살생각에 미치는 영향

한수미,Han, Su-Mi 한국학교보건학회 2012 韓國學校保健學會誌 Vol.25 No.1

Purpose: The purpose of this study is to identify the effects of suicide reports by mass media and social support on suicide ideation for college students. Methods: Participants are 350 undergraduate students in one university. This study uses three questionnaires: Perception and Attitude toward Suicide Reports, Social Support, and Suicidal Ideation. The SPSS/WIN 12.0 program is used to analyze the data. In particular, the participants' biographical data are analyzed into frequency and percentage. The degrees of suicide reports, social support, and suicide ideation are calculated into Mean and SD. Moreover, the suicide ideation by suicide report and social support are analyzed by the two-way analysis of variance (ANOVA). Results: This study reveals that college students have an average of 30 minutes to one hour news time a day (38.9%) and have at least one suicide report in a month (30.3%). 79.7% participants believe that the suicide report of mass media results in the cause of the copycat suicide. In terms of suicide report and suicide ideation, the types of mass media (F (4,340)=2.41, p<.05) and suicidal urge (F (1,340)=31.23, p<.01), respectively, have significant influences on suicide ideation. On the other hand, the social support and suicide ideation, whether college students have their mentors (F (1,328)=13.26, p<.001) and/or careres (F (1,328)=26.84, p<.001) have significant influences on suicide ideation. Conclusion: College students have higher suicide ideation at news by internet site rather than by radio, TV, and so on. Moreover, college students who have a suicide feeling in the last one year, have more suicide ideation than who have not. On the other hand, college students who have a mentor and carer tend to have less suicide ideation.