병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 -

Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch -

병원감염 사례에 관한 판결의 주류적 태도는 병원감염 발생으로 인한 손해의 분담을 사실상 환자 측에 전가하는 문제가 있다고 판단되므로, 손해의 공평 타당한 분담을 그 지도 원리로 하는 손해배상제도의 이념에 비추어 환자 측의 증명책임을 대폭 완화하기 위한 방법을 강구할 필요성이 있다. 이와 관련하여 진료계약을 민법상 전형계약으로 규정하고, 병원감염과 같은 의료 측이 전적으로 지배할 수 있었던 경우에는 일반적 진료상 위험이 실현된 때 진료자의 오류가 추정된다고 명문으로 과실추정규정을 둔 독일민법을 검토하였다. 진료계약은 매우 빈번하고 광범위하게 일반 국민의 실생활에서 체결되고 있으며, 그로 인한 분쟁도 다양하게 발생하고 있으므로, 진료계약을 독일과 같이 민법의 전형계약으로 규정함으로써 계약 내용과 분쟁 발생 시 증명책임 등에 관해 규율할 필요성이 있다. 병원감염 사건의 경우 법률에 의해 과실을 추정하고, 병원감염 예방을 위한 노력을 철저히 시행한 기관에 한하여 병원감염 사고로 인한 손해가 발생한 경우 그 비용을 지원하도록 사회보험을 통한 제도적 보완이 필요하다고 생각되며, 향후 이에 관한 면밀한 연구와 검토가 요구된다.

Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.