• Title/Summary/Keyword: 불가항력 의료사고

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Constitutional Issue Review of Compensation for Inevitable Medical Accidents During Delivery (불가항력 의료사고 보상사업에 대한 헌법적 쟁점 검토)

  • JUN, HYUN JUNG
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.153-185
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    • 2020
  • In principle, even if serious consequences such as death or serious injury of a patient occur as a result of a medical accident, if the medical malpractice of a health care worker is not recognized, the health care worker is not held liable for said consequences. However, with the opening of the Korea Medical Dispute Mediation and Arbitration Agency on April 7, 2012, a system was established to compensate health care personnel for their medical malpractices only in the case of "injuries caused by medical accidents in the course of childbirth" (hereinafter referred to as "program for compensation of medical accidents"). Article 46 paragraph 1 of the current Medical Dispute Mediation Act, which is the basis of the Force Majeure Medical Accident Compensation System, stipulates that "medical accidents under delivery" claims are to be determined by the Medical Accident Compensation Review Committee are subject to the compensation project. And the details of the compensation, ratio of sharing financial resources for compensation, scope of compensation, and the guidelines and procedure for the payment of compensations are prescribed by Presidential Decree. In other words, the Presidential Decree requires the state to pay 70 percent of the compensation funds, and 30 percent of the above funds among health care providers. The Constitutional Court has decided on the 2015Hun-Ga13 that the scope of the health care institution's founders and the share of the compensation funds cannot be directly determined by the law, and that the portion delegated by the Presidential decree does not violate the Principle of Legal Protection nor Comprehensive Nondelegation Doctrine. However, this can be seen as an exclusion of accountability for force-induced delivery accidents even if there is no negligence of the medical staff. If the nature of the system is a type of social security system with a social compensatory nature, it could consider eliminating the health care innovator's cost-sharing provisions, leaving the full cost to the state. However, it is also necessary to review institutional protocols that strengthen the efforts of medical institutions in areas such as analysis of the causes of medical accidents and measures to prevent their recurrence. In addition, I think that the conclusion of the Act is in line with the purpose of the Comprehensive Wage Support Regulations that at minimum the law sets an upper limit of the compensation funds that are to be paid by health and medical institutions. Moreover, it is reasonable for the Medical Accident Compensation Review Committee to specify gestational age and weight of births, which are the criteria for compensation, under the Enforcement Decree of the Medical Dispute Mediation Act, in relation to the criteria for payment of contributions by the Medical Accident Compensation Review Committee, and to set the detailed criteria.

의료분쟁조정 신청절차에서의 입법적 개선방안에 대한 소고(小考) - 의료사고 피해구제 및 의료분쟁 조정 등에 관한 법률 제27조를 중심으로 -

  • Baek, Gyeong-Hui
    • Journal of Legislation Research
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    • no.44
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    • pp.435-464
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    • 2013
  • 의료민사소송은 그동안 의료행위가 지니고 있는 전문성, 밀실성, 폐쇄성 등의 여러 가지의 특수성으로 인하여 소송이 장기화되고 경제적 비용이 상당하게 소모되었다. 또한 법원의 판결이 이루어지더라도 당사자들이 이를 신뢰하지 못하는 등의 이유로 신속성과 공정성에 문제점이 지적되었다. 이 때문에 소송 대체적 분쟁해결제도로서 의료사고 피해구제 및 의료분쟁 조정 등에 관한 법률상의 의료분쟁조정 및 중재 절차가 탄생하게 되었다. 그러나 의료분쟁조정법 제27조 제8항에서 피신청인이 14일 동안 의사를 표명하지 않는 경우 거부의사로 간주되고, 이 경우 한국의료분쟁조정중재원장이 각하결정을 하여야 한다고 규율함으로써, 조정의 개시 조차 순탄치 않은 것이 현실이다. 본고에서는 우리나라 의료분쟁의 최근 현황을 확인해 본 후, 의료분쟁조정법상 조정의 신청에 관한 조문인 제27조에 대한 입법안을 비교 점검한 후 다른 ADR 관련 법률이나 민사소송법상의 조문과 비교하여 불합리한 점이 있는지를 검토하고, 동조의 개선방안을 제시하고자 한다. 또한 2013. 4. 8.부터 시행이 되고 있는 불가항력적 산과 사고에 대한 무과실보상제도와 관련하여 동조가 미치는 영향 등에 대해서도 논의하고자 한다.

A Study on Imposing Contribution in the Compensation for Uncontrollable Medical Malpractice during Delivery (분만관련 불가항력적 의료사고 보상제도에 있어 분담금부과에 관한 연구 -헌법재판소 2018. 4. 26. 선고 2015헌가13 사건을 중심으로-)

  • Beom, Kyung Chul
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.139-171
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    • 2018
  • The 「Act on Remedies for Injuries from Medical Malpractice and Mediation of Medical Disputes」(hereinafter referred to as 'the Act on Mediation of Medical Disputes') provides that the state should compensate the victims of medical accidents occurred irresistibly in childbirth despite that health and medical service personnel fulfilled their duty of care for their damage within the range of its budget(Article 46 of the Act on Mediation of Medical Disputes). Given that victims of medical accidents could expect demage recovery only through lawsuits thus far, this act can be said to be a groundbreaking act. However, However, as 30% of the costs for such medical accident compensation projects are borne by those who have records of childbirth among the founders of health and medical institutions (Article 21 of the Act on Mediation of Medical Disputes), there has been a question about whether doctors are held responsible despite that the accidents such as the deaths of mothers and newborn babies occurred irresistibly without doctors' fault. However, recently, the Constitutional Court ruled that 'the range of founders of health and medical institutions' and 'share ratios of finances for compensation' in Article 46 (3) of the Act on Mediation of Medical Disputes' related to the imposition of the share of costs are institutional (Constitutional Court ruling dated April 26, 2018, 2015Heonga13, hereinafter referred to as 'the ruling in the case'). Although the ruling in the case was made based on only the principle of statutory reservation and the principle of ban on comprehensive authorization, this paper added a practical judgment. This paper proved that the share of costs in this case has the nature of burden charges in pursuit of study and does not infringe on the property rights of the founders of health medical institutions even in light of the principle of proportionality because there is a legitimate reason for imposing the burden charge. The imposition of the share of costs in the system for compensation for medical accidents occurred irresistibly is against the principle of liability with fault in part. However, the medical accident compensation projects are rational a national policy for the victims of medical accidents and the medical world clearly gains some benefits from the effect to terminate medical disputes. The expansion of finances for compensation through the payments of the share of costs will reduce the suffering and misunderstanding of victims of medical accidents occurred in the process of childbirth and will be very helpful to the construction of stable treatment environments of medical workers by quickly establishing the medical accident compensation projects as such.

Problems in the Medical Dispute Medication System and Improvement Plan (의료분쟁조정제도 운영상의 문제점 및 개선방안)

  • Choi, Jang Seop
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.91-122
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    • 2014
  • For a variety of reasons, the number of medical disputes is continuously rising. Due to the intrinsic qualities of medical treatments, one would find it more apt to subject medical disputes to general conflict resolution procedures rather than to once-for-all decisions under legal suits. To address the increasing medical disputes with greater professionalism and efficiency, the Medical Disputes Mediation Act was enacted and a medical dispute mediation system put in place, while drawbacks have been blamed to both. The current mediation procedures require the respondent's agreement as a disclosure requirement. A reasonable improvement to this would be to amend the regulation of agreement supposition, or to enforce procedural participation only to public health facilities managed by the national or regional government. Furthermore, small claims cases of 20 million KRW or less in claim may be considered for conciliation-prepositive principle. The concentration on small claim medical disputes is a phenomenon that can be addressed by carrying out maximum authentication commissions or similar measures, one of the solutions by enhancing the public trust in the Korea Medical Dispute Mediation and Arbitration Agency. The proper management of medical authentication teams is one way to address the existing problems in the authentication system. For this, the number of team members shall be increased under more flexible authentication procedures. All indemnity resources for medical accidents of force majeure must be borne by the Government, for it is the body principally responsible for social compensation. Placing this cost on the establisher of the subject medical facility holds the possibility of violating fundamental rights. While the costs for subrogation payment system for damages may be borne by the healthcare facility establisher, a deposit-based system must be created for cases in which the facility shuts down, without holding the responsibility for accident cause. Such change to a deposit-based system will evade the controversies of unconstitutionality, etc.

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A Study on Compensation for Damage in Civil Litigation of Japanese Long-term Care Facilities (개호사고에서 손해배상책임에 관한 연구 -일본의 판례를 중심으로-)

  • Jeong, Da-Young
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.173-207
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    • 2018
  • Japan is a super-aged society where the proportion of the people aged over 65 is exceeded 20%. Therefore, there are many accidents that occur in long-term care facilities in Japan, and there are many civil litigations. The Japanese court has acknowledged in many cases that the long-term facility is responsible for the damage to the elderly who is injured in the facility. The cases can be divided into ① tumbling down, ② wandering, ③ suffocation, ④ bedsore, and ⑤ accidents among the facility-users. In most cases, the court found that the facility violated its obligation to protect their users. This is not only the case where the manager or the employee of the facility violates the obligation to watch and care for the elderly, but in some cases, the failure to maintain the human and material system itself is recognized. The basis for such judgment is whether the facility can predict the possibility of an accident and whether the facility has taken measures to prevent accidents. Also, the Japanese court recognizes the transfer of burden of proof in order to expedite the victims' rights. However, the liability of the facility for damages should not be so heavy that it would be hesitant to allow a person to enter the facility and make a contract.

Eine kritische Betrachtung $\ddot{u}$ber das Kompensations-Zusicherungsgesch$\ddot{a}$ft und die Typenanalyse f$\ddot{u}$r die medizinische Geburtsbehandlungsfehler (분만 의료사고에 대한 보상사업 -의료사고 피해구제 및 분쟁조정 등에 관한 법률 제46조에 관하여-)

  • Baek, Kyoung-Hee;Ahn, Bup-Young
    • The Korean Society of Law and Medicine
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    • v.12 no.2
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    • pp.11-61
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    • 2011
  • In dieser Arbeit ist zum ersten allgemeiner $\ddot{U}$berblick auf die Verschuldensprinzip, das grunds$\ddot{a}$tzlich f$\ddot{u}$r die Unfalls-Haftung im Bereich der medizinischen Behandlungsfehler noch immerhin gelten, in aller K$\ddot{u}$rze angef$\ddot{u}$hrt und zugleich in rechtsvergleichender Weise auf die sozialrechtliche Typenentwicklung in Bezug auf die haftungsrechtlich motivierte Entsch$\ddot{a}$digung. Gem$\ddot{a}{\ss}$ dem ${\S}$ 46 Gesetzes zur Abhilfe f$\ddot{u}$r medizinische Besch$\ddot{a}$digungenund auf die Mediation-Schlichtung f$\ddot{u}$r medizinische Streitigkeiten ist die rechtssystematische Bedeutung des Kompensations-Zusicherungsgeschafts als eine Art institutioneller Fremdversorgung zu erfassen. Demzufolge geht es h$\ddot{a}$uptsachlich um die Problematik von tatbest$\ddot{a}$ndlichen Merkmalen der Kompensation im ${\S}$ 46 obigen Gesetzes (unten 1) und im Bezug auf die im voraus von GF-Ministerium bekanntgegebene AO (provisorische Fassung) von 8. 11. 2011. um die Analyse einer Reihe von KHG-Entscheidungen $\ddot{u}$ber $\ddot{a}$rztliche Geburtsbehandlungsfehler (unten 2). Dabei ist noch die Geltungsbereich mit entsprechendem Kompensationssystem in Japan zu vergleichen (unten 3). 1. Der terminologische Sinn von "h$\ddot{o}$here Gewalt" ist sowohl semantisch wie auch juristisch-rechtstechnisch eine negative Vorausaussetzung f$\ddot{u}$r haftbar machende Gef$\ddot{a}$hrdungstatbestand. Nicht nur im Inhalt und Umfang vertr$\ddot{a}$gt dieser Rechtsbegriff sich nicht mit dem anderen tatbest$\ddot{a}$ndlich parallell zu erf$\ddot{u}$llenden Merkmal, also "die Besch$\ddot{a}$digung aus unverschuldeter $\ddot{a}$rztlicher Geburtsvorsorge", weil die jene enger als die diese auf dem Begriffsfeld ist, sondern auch im dogmengeschichtlichen, auch doch rechtstechnichen Sinne ist die Terminologie von "h$\ddot{o}$here Gewalt" ungeeignet, f$\ddot{u}$r den kompensatorischen Tatbetand als ein positives Merkmal, zu sein, statt derer, m. E. sollte der Begriff von "unkontrollierbarer Zuf$\ddot{a}$lligkeit" als L$\ddot{o}$sungsansatz verwendet werden. Dazu ist auch die ratio legis zur institutionellen Einf$\ddot{u}$hrung des obigen Kompensations-Zusicherungsgesch$\ddot{a}$fts, das sich auf die Entsch$\ddot{a}$digung des f$\ddot{u}$r Patienten unertr$\ddot{a}$glichen Verlustes gerichtet, d. h. gerade die Augabe des nachteilsausgleichenden Einstehens f$\ddot{u}$r Ungl$\ddot{u}$ck, nicht f$\ddot{u}$r Unrecht, zu ber$\ddot{u}$cksichtigen. 2. Die Typen der KHG-Entscheidungsf$\ddot{a}$llen im Bereich von Gyn$\ddot{u}$kologie k$\ddot{o}$nnten diagnostisch bzw. therapeutisch im folgenden differenziert sein werden; je nach der Kriterien von der Weise und dem Zeitpunkt zur Geburtshilfe, technischen Behandlungsfehlern beim Geburtsvorgang, und Besorgungsfehlern nach dem Geburt u. dgl. 3. Die japanische verschuldensunabh$\ddot{a}$ngige Kompensation ist eigentlich eine Art institutionelle Vorsorge, die anders als koreanische Versorgungssystem auf Grund privatsicherungsfinaler Vorleistung gew$\ddot{a}$rleistet wird. Der kompensatorische Bereich beschr$\ddot{a}$nkt sich auf die schwere infantile Zerebralparese (Cerebralparese) beim medizinischen Geburtsbehandlung. Schlie${\ss}$lich w$\ddot{u}$rde diese Arbeit erw$\ddot{u}$nscht sein, zur Konkretisierung des Voraussetzungen f$\ddot{u}$r die Kompensation nach ${\S}$ 46 Abs. 1 u. 4 des obigen Gesetzes beitragen zu k$\ddot{o}$nnen, welcher spatestens am 8. 4. 2013. zur Geltung gebracht sein sollte.

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