• Title/Summary/Keyword: 의료계약

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Legal issues on HAI (병원감염에서의 법적쟁점)

  • Lee, Soo kyoung;Yoon, Seok chan
    • The Korean Society of Law and Medicine
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    • v.20 no.1
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    • pp.133-162
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    • 2019
  • Due to the nature of medical malpractice lawsuits, it is difficult for medical consumers, who are weak in getting information when it comes to health care problem, to secure all information inside the hospital. Even if you are confident about the hospital infection, it is true that people have difficult to obtain medical testimony by expert. It is seen as no easy task to testify to the malpractice of colleagues who work in the same field not only in our country but also abroad, when a doctor gives negative testimony to another doctor in a medical malpractice lawsuit. Although few health care providers will be motivated to take medical care from the outset, testimony or statements from a medical practitioner can have a significant impact on the outcome of a lawsuit, as it is impossible for the patient to control or be aware of the whole process of medical conduct, especially in the event of a hospital infection and the victim. If the hospital can prove the causality of damages caused by negligence of the employees or supervision of the hospital itself in a medical suit caused by the infection, the level of protection of the victim could be raised further. We sought to find a solution to these problems by looking at the provisions of other laws related to hospital infection. In particular, as the comparative legal review regarding hospital infection, Germany's legislative precedent sets a medical contract as a typical civil law contract, so it is thought that looking at German civil law regulations also has implications for Korean law. We also tried to improve the French Special Act 'rights of patients' and we can look at the consequent changes in court cases. Finally, the content of the U.S. case's and the theory of 'the doctrine of res ipsa loquitur' in relation to it show that doctors and hospitals have been forced to shift the burden of proof through this theory. This paper tried to find out the implications of mitigating the burden of proof by reviewing various issues that might be related to medical litigation of hospital infection from a comparative point of view.

Review of 2022 Major Medicla Decisions (2022년 주요 의료판결 분석)

  • Lee Jeongmin;Yoo Hyunjung;Park Taeshin;Jeong Heyseung;Cho Woosun;Park Nohmin
    • The Korean Society of Law and Medicine
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    • v.24 no.2
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    • pp.79-117
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    • 2023
  • Among the healthcare-related judgments handed down in 2002, there was a significant ruling on the timing of the duty of explanation, stating that, in order to ensure the exercise of the patient's right to self-determination, the patient must be given time to consider and decide on the risks and side effects of a medical procedure in specific circumstances. In addition, in a case where an insurance company claimed unjust enrichment against a medical institution on behalf of its insureds, the court provided a clear standard by distinguishing between active and passive requirements regarding the need to preserve the right of subrogation of creditors. In the area of medical administration, there was a ruling that clarified that a medical institution's business suspension under the National Health Insurance Act is directed against the medical institution, a ruling that broadly recognized causation in a case of compensation for side effects of corona vaccination, and a ruling on the scope of a medical practitioner's license, such as the use of ultrasound devices by an oriental medicine practitioner. In a case involving a patient's claim for eviction from a medical institution, the court reviewed a ruling on just cause for termination of a hospitalization contract in relation to Article 15(1) of the Medical law.

Criminal Liabilities of Ghost Surgery (유령수술행위의 형사책임 - 미용성형수술을 중심으로 -)

  • Hwang, Manseong
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.27-53
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    • 2015
  • Recently, a plastic surgery hospital in Seoul, has been raided following suspicions that ghost surgery was performed by an unauthorized substitute surgeon on a chinese woman who lapsed into a death. Following the incident, an organization to eradicate ghost surgery was created in March by Consumers Korea, founded to protect consumer rights, and the Korea Alliance of Patients Organization. The organization has received reports of illegal medical practices. To substitute another physician without the patient's consent and without his knowledge of the substitution is fraud and deceit and a violation of a basic ethical concept. The patient as a human being is entitled to choose his own physician and he should be permitted to acquiesce in or refuse to accept the substitution. It should be noted that it is the operating surgeon to whom the patient grants his consent to perform the operation. The patient is entitled to the services of the particular surgeon with whom he contracts. The surgeon, in accepting the patient, obligates himself to utilize his personal talents in the performance of the operation to the extent required by the agreement creating the physician-patient relationship. He cannot properly delegate to another the duties which the patient authorizes him to perform personally. 'Ghost surgery' comes under Article 257(Inflicting Bodily Injury on Other or on Lineal Ascendant) of the Criminal Code. Substitution another physician without the patient's consent and without his knowledge of the substitution shall be performed Inflicting Bodily Injury. This is a controversial issue that'ghost surgery' comes under Article 347(Fraud) of the Criminal Code. It maybe controversial that operation substituted by another physician without the patient's consent and without his knowledge of the substitution becomes the component of Fraud. Also, Ghost surgery' comes under Article 27 (Prohibition of Unlicensed Medical Practice, etc.), Article 22 (Medical Records, etc.), Article 33 (Establishment) of the Medical Service Act. The surgeon's obligation to the patient requires him to perform the surgical operation: (1) within the scope of authority granted him by the consent to the operation; (2) in accordance with the terms of the contractual relationship; (3) with complete disclosure of all facts relevant to the need and the performance of the operation; and (4) to utilize his best skill in performing the operation.

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Material Transfer Agreement for Human Material (인체 유래 물질과 관련된 계약)

  • Kim, Jang-Han
    • The Korean Society of Law and Medicine
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    • v.8 no.1
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    • pp.9-34
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    • 2007
  • Human material is considered as an independent object after departing from human body. But unlike other materials, that is not allowed for the trading because of the nature of personality. According to the present legal system, the human material is only permitted to donate to the researcher or biobank for scientific study. Bur after the collection, the human materials are regarded as a valuable assets and the collectors want to get more economic gains. If the neutral modulators serve for the justifiable circulation. The economic motivations could be prevented within material transfer processes. In real life, the neutral modulator is hard to find and most of partipants are involved in the economic interests. In this situation, it may be justifiable to permit the person who donate his body material to pursue reach through right on his material. The problem is how to measure the value of human material and how to treat the informed consent. If the essential portion of human personality is contributed to the value of human material and if only his material can be served for the invention, the tissue donator can get economic interests on his body material as his property. That is based on the rule of processing of human efforts on civil law.

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Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.299-346
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    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

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Review of 2013 Major Medical Decisions (2013년 주요 의료 판결 분석)

  • Lee, Dong Pil;Jeong, Hye Seung;Lee, Jung Sun;Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.263-302
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    • 2014
  • The court handed down meaningful rulings related to medical sectors in 2013. This paper presents the ruling that the care workers could be the performance assistants of the care-giving service although the duties of care worker are not included in the liability stipulated in the medical contract signed with the hospital for reason of clear distinction of duties between care workers and nurses within the hospital in connection with the contract which was entered into between the hospital and patients. In relation to negligence and causal relationship, the court recognized medical negligence associated with the failure to detect the brain tumor due to the negligent interpretation of MRI findings while rejecting the causal relationship with consequential cerebral hemorrhage. The court also recognized negligence based on the observation on the grounds of inadequate medical records in a case involving the hypoxic brain damage caused during the cosmetic surgery. In terms of the scope of compensation for damages, this paper presents the ruling that the compensation should be estimated based on causal relationship only in case the breach of the 'obligation of explanation' is recognized, however rejecting the reparation for de factor property damages in the form of compensation, and the ruling that the lawsuit could be instituted in case that the damages exceeded the agreed scope despite the agreement that the hospital would not be held responsible for any aftereffects of surgery from the standpoint of lawsuit, along with the ruling that recognized the daily net income by reflecting the unique circumstances faced by individual students of Korean National Police University and artists of Western painting. Many rulings were handed down with respect to medical certificate, prescription, etc., in 2013. This paper introduced the ruling which mentioned the scope of medical certificate, the ruling that related to whether the diagnosis over the phone at the issuance of prescription could constitute the direct diagnosis of patient, along with the ruling that required the medical certificate to be generated in the name of doctor who diagnosed the patients, and the ruling which proclaimed that it would constitute the breach of Medical Act if the prescription was issued to the patients who were not diagnosed. Moreover, this paper also introduced the ruling that related to whether the National Health Insurance Service could make claim to the hospitals for the reimbursement of the health insurance money paid to pharmacies based on the prescription in the event that the hospitals provided prescription of drugs to outpatients in violation of the laws and regulations.

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A Study on the relations between change of productivity and conversion factor of the Accredited Hospitals based on Malmquist index (Malmquist 지수에 기초한 의료기관평가 대상 병원의 생산성 변동과 환산지수 변동에 관한 연구)

  • O, Dong-Il
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.125-137
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    • 2011
  • This study aims to know whether the Accreditation of Hospitals can help to improve productivity of hospital and affect the conversion factor. Based on the Malmquist productivity Index, the productivity of accredited hospital improves. There exists an tendency that as the scores of Accreditation rises, productivity increases. Also the higher the productivity, the lower the conversion factors in the rigid statistical evidence. This evidence is independent of hospital classification, geographical distribution, grouping. This evidence supports the productivity index can be included in the fee negotiations. It also means that rather than static efficiency, the multi-year change of productivity information can be usefully combined to set a conversion factor in Korean National Insurance Contract especially in the discussion of the structural change of payment system.

현장탐방 - 이라크 비스마야 신도시 건설 PC플랜트 및 아파트 기계.소방설비공사 윤창기공(주)

  • 대한설비건설협회
    • 월간 기계설비
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    • s.295
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    • pp.57-68
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    • 2015
  • 내전 후 전쟁 상처를 복구 중에 있는 이라크는 주택, 인프라, 사회 서비스망 구축의 필요에 따라 지난 2010년 이라크 기획청(Ministry of Planning, MOP)이 이라크의 삶의 질 개선을 위한 국가개발계획(Iraq National Development Plan, 2010 ~ 2014)을 수립하고 15개 주정부와 쿠르드 자치정부 지역에 100만호 주거 시설 제공을 위한 국가 주택 프로그램을 발표했다. 이에 따라 2017년까지 주택과 교통인프라, 에너지, IT, 의료, 보안 등에 걸쳐 총 2,750억불(약 300조원)을 이라크 재건사업에 투자할 계획이다. 또 2030년까지는 에너지 분야에 5,000억불 투자 등 정유공장, 발전소, 도로, 인프라, 공공시설 및 군시설 등 다양한 분야에 최소 7,000억불에 달하는 예산을 투입할 예정이다. 한화건설은 지난 2012년 80억 달러 규모의 이라크 비스마야 신도시 건설공사를 수주해 우리나라 해외건설 역사상 최대 규모의 프로젝트 기록을 세웠다. 또한 이 계약으로 우리나라 해외건설 누적 수주액 5,000억 달러 돌파에 크게 기여했다. 윤창기공(주)(대표 백종윤)는 비스마야 현장에서 PC 플랜트 현장의 기계설치공사와 하우징 현장의 기계설비 및 소방공사를 담당하고 있다. 본지는 이라크 현장에 있는 윤창기공(주) 정몽준 소장과 김용우 소장을 이메일로 만나 보았다.

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Review of 2016 Major Medical Decisions (2016년 주요 의료판결 분석)

  • Park, Tae Shin;Yoo, Hyun Jung;Jeong, Hye Seung;Lee, Dong Pil;Lee, Jung Sun
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.297-341
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    • 2017
  • We searched out court rulings on medical affairs through court library search sites and specialized articles on medically relevant judgments sentenced in 2016. And we selected and analyzed the judgements of the court we considered important as follows. In relation to the medical civil judgements, (1) In the case of applying surgery for female infertility during cesarean section operation but it has not been done, we expressed the regret for the lack of judgment in the process of entering the medical contract, introducing the rights infringed and the scope of compensation, (2) We pointed out that the ruling on the medical malpractice estimation goes out of limit of negligence estimation doctrine, and that the court asked very high degree duty of the traditional Korean medicine doctors to cooperate with Western medicine doctors. (3) In the case of admitting hospital's 100% responsibility, we pointed out the court overlooked the uncertainty and good intention of the medical practice. (4) Additionally, We introduced the cases admitted the hospital's responsibility in the accident related to the psychiatric patients in closed ward. Relating to a medical criminal ruling, we analyzed the supreme court decision about whether the dentist's Botox injection on the patient's face is a medical practice within the scope of the license from the viewpoint whether it is within the possible range of the word. And, concerning decisions on healthcare administration, (1) we analyzed the case about when medical personnel operate multiple medical institutions, whether it is possible to get back medical care costs under the National Health Insurance Law, (2) We commented on the ruling regarding explanation obligation in terms of object, degree, subject of explanation as a prerequisite for permissible arbitrary uninsured benefits. Finally, we reviewed the decision of the Constitutional Court about the Article 24 of the Mental Health Law, which it had allowed for a mental patient to be hospitalized forcibly by the consent of two guardians and a diagnosis of a psychiatrist. Also we indicated the problems of the revised Mental Health Law.

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A Study on the design of the outpatient and inpatient conversion factors based on the medical expenditure budget system (진료비 예산에 기초한 외래 및 입원 환산지수 설계에 관한 연구)

  • O, Dongil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.2
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    • pp.470-478
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    • 2020
  • In this paper, a theoretical model that separates one single conversion factor into two conversion factors for both outpatients and inpatients is introduced. By using hypothetical numbers, two conversion factors and an adjustment factor were calculated. The major implications are as follows. Firstly, by introducing two conversion factors, a minimum incentive mechanism for admitting outpatients to a clinic and high risk inpatients to a hospital was installed. Secondly, the introduction of two conversion factors decreased the drive to admit outpatients to a hospital by reducing the economic benefits for the hospital. Thirdly, it is possible to make explicit contracts for several factors rather than a single conversion factor, so that it can be used as an appropriate management tool for rapidly increasing medical expenses. Finally, this research can be used to set up policy tools to establish a proper healthcare delivery system in Korea by inducing behavioral changes in healthcare institutions.