• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.57-81
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• 2016

It can determine the outcome of the lawsuit whether or not there is a causality between the medical malpractice of a physician and the patient's injury when the patient is filing a lawsuit against the physician in order to pursue civil liability for a medical accident. In medical malpractice lawsuits, it is not easy to judge causality between different civil cases because of the special nature of medical care. Also, information such as medical records is concentrated on doctors and the medical knowledge of the patient is relatively insufficient compared with the doctor. Therefore, it is recognized through medical malpractice lawsuits that the burden of proof of the causality burdened by the plaintiff patient is relaxed. In this paper, I examine the legal theory on how to recognize causality in medical civil liability and then concern the attitude of the case in Korea, which is divided into the types of the causality - such as the case of general medical practice, explanation duty, no causality with medical malpractice.

• The Korean Society of Law and Medicine
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• v.16 no.2
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• pp.159-193
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• 2015

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.

• The Korean Society of Law and Medicine
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• v.15 no.2
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• pp.123-163
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• 2014

As results of analyzing judicial precedents about infection in hospitals in connection with mistakes and causality in medical litigations shows that the Mitigation of Law Principles To Prove responsibility in medical litigation has not been able to play its role compared to its intended purposes. And Major sentiment from those judgments is that a mistake can't be proved only by the fact that certain infection in hospital occurred in connection with hospital infection. Therefore, the number of indirect facts to deny estimation is overwhelmingly high. Like this, especially for hospital infection which is difficult to prove indirect facts themselves to estimate mistake, major sentiment from those judgments have a problem that impute sharing of losses caused by hospital infection to patient. In accordance with the Principles of equitable and proper sharing of losses, it's required to prepare legal interpretation and theoretical methods to largely mitigate patient's responsibility to prove medical mistakes compared to other medical litigations in connection with existing Mitigation of Law Principles To Prove responsibility and conventional theory of estimation. In connection with this, the results of review that duty of safety management in hospital infection cases can be the base of conversion of proving responsibility, the duty that prevent hospital infection, corresponding the duty of safety management in hospital infection is not conventional duty of safety management based on duty of good faith but secondary obligation of medical contract. The breach of duty preventing hospital infection is the violation of medical contract, but there is no logical necessity that convert proving responsibility from the obligation of contract itself. Therefore, the duty of preventing hospital infection from the obligation of medical contract, corresponding the duty of safety management in hospital infection cases cannot be the base of conversion of proving responsibility alone. But, it's still required to conversion of proving responsibility in hospital infection, we need further studies on cases of Germany which applies legal estimation of proving responsibilities in hospital infection.

• The Korean Society of Law and Medicine
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• v.17 no.2
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• pp.29-56
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• 2016

$F{\ddot{u}}r$ den Schadensersatzhaftung des Arztes, sog. die Arzthaftung, ist es vornehmlich vorauszusetzen: die $Sch{\ddot{a}}digungsbehandlung$ des Arztes, die Rechtswidrigkeit und das Verschulden. Zur Problematik der $Fahrl{\ddot{a}}ssigkeit$ in der Stufe des Verschuldens handelt sich es in dieser Beitrag um die Kritisierung der Rechtsprechung. $F{\ddot{u}}r$ die Entscheidung des Verschulden im medizinischen Fehler kommt es darauf an, ob die Sorgfaltspflicht des Arztes verletzt wird. $Daf{\ddot{u}}r$ wird der medizinische Standard rekurriert, den die Rechtsprechung nicht aus materieller, sondern aus normativer Sicht begreift. Erstaunlich $un{\ddot{u}}bereinstimmend$ mit deren Leitsatz wird der medizinische Standard als $Ma{\ss}stab$ der Sorgfaltspflicht materiell - zutreffend nur im Ergebnis - behandelt. Die Sorgfaltspflicht in der Medizin bedeutet nicht die natur-wissenschaftliche Erkenntnisse, sondern eine "Best-$M{\ddot{u}}ssen$" Pflicht. Demnach ist der Standpunkt der Rechtsprechung, wonach den med. Standard normativ bewertet und die Sorgfaltspflicht darduch wieder normativ entscheidet, nicht anders als eine $w{\ddot{o}}rtliche$ Wiederholung. Die Arzthaftung in der Rechtsprechung ist aufgrund mit der Verneinung von der Sorgfaltspflichtverletzung nicht angenommen, welche in der Tat jedoch aus verschiedenen $Gr{\ddot{u}}nden$, wie die Rechtswidrigkeit, die $Fahrl{\ddot{a}}ssigkeit$ oder $Kausalit{\ddot{a}}t$, nicht angenommen. Der $Fahrl{\ddot{a}}ssigkeitsbeweis$ in der Rechtsprechung entwickelt sich mit dem Beweis nach objektivem $Ma{\ss}stab$, der Vermutung nach Anschein-Beweis und der $Beschr{\ddot{a}}nkung$ mit der Wahrscheinlichkeit. Bei Letzterem $geh{\ddot{o}}rt$ es $schlie{\ss}lich$ zum medizinischen Bereich. Ein Eintritt in den fachliche Bereich im Rahmen der Beweislast stellt der Beweiserleichterung $gegen{\ddot{u}}ber$. Aus diesem Hintergrund ist ${\S}630$ h Abs. 5 BGB bemerkenswert, wonach das Vorliegen eines groben Behandlungsfehler $regelm{\ddot{a}}{\ss}ig$ zur Vermutung von der $Kausalit{\ddot{a}}tszusammenhang$ $f{\ddot{u}}hrt$. Dieser Paragraph ist inhaltlich als Beweislastumkehr angesehen. Damit ist es von Nutzen im Fall des groben Fehler, der beim - elementaren - kunstgerechten Verhalten nicht entstanden $h{\ddot{a}}tte$, wie $Hygienem{\ddot{a}}ngel$, ${\ddot{U}}berdosierung$ des Narkotikum.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.3-36
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• 2023

The main issue in medical malpractice civil litigation is medical negligence and the causal relationship between medical negligence and damages. Regarding the presumption of causality in cases where medical negligence is proven, there is a previous Supreme Court decision 93da52402 on February 10, 1995, but it is difficult to find a case that satisfies the textual requirements of the above decision, and yet, in practice, the above decision is cited. In many cases, causal relationships were assumed, and criticism was consistently raised that it was inconsistent with the text of the above judgment. In its ruling, the Supreme Court reorganized and presented a new legal principle regarding the presumption of causality when medical negligence is proven in a civil lawsuit. According to this, If the patient proves ① the existence of an act that is assessed as a medical negligence, that is, a violation of the duty of care required of an ordinary medical professional at the level of medical care practiced in the field of clinical medicine at the time of medical practice, and ② that the negligence is likely to cause damages to the patient, the burden of proving the causal relationship is alleviated by presuming a causal relationship between medical negligence and damage. Here, the probability of occurrence of damage does not need to be proven beyond doubt from a natural scientific or medical perspective, but if recognizing the causal relationship between the negligence and the damage does not comply with medical principles or if there is a vague possibility that the negligence will cause damage, causality cannot be considered proven. Meanwhile, even if a causal relationship between medical negligence and damage is presumed, the party that performed the medical treatment can overturn the presumption by proving that the patient's damage was not caused by medical negligence. Meanwhile, unlike civil cases, the standard is 'proof beyond reasonable doubt' in criminal cases, and the legal principle of presuming causality does not apply. Accordingly, in a criminal case of professional negligence manslaughter that was decided on the same day regarding the same medical accident, the case was overturned and remanded for not guilty due to lack of proof of a causal relationship between medical negligence and death. The above criminal ruling is a ruling that states that even if 'professional negligence' is recognized in a criminal case related to medical malpractice, the person should not be judged guilty if there is a lack of clear proof of 'causal relationship'.

• Korea Trade Review
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• v.43 no.3
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• pp.101-124
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• 2018

After the establishment of the Korean Product Liability Act, a new clause on the burden of proof has been added and is being revised to meet the purpose of consumer protection. Article 3(2) of the new clause stipulates a provision for estimating a causal relationship when proving indirect facts to alleviate burden of proof. While consumer rights are increasing and public attention is drawn to consumer issues, problems are still emerging. In order to solve the problem, the U.S. Product Liability Act, which has strong consumer rights, was examined to describe the direction in which Korea's Product Liability Act should proceed in terms of consumer protection. The results of the comparative analysis show that the US has expanded the concept of strict liability in terms of rigorous liability, consumer dispute resolution, provable possibility, and litigation accessibility, The consumer dispute settlement system has thoroughly protected consumers by operating educational and systemic consumer ADR system. As for the possibility of proving, Korea has three provenances, and the United States has one. In the United States, where consumer lawsuits are frequent, lawsuits are more accessible than those in Korea, where the party responsible for proving is turned into a manufacturer and responsible for proving the case. This study focuses on consumer protection and provides implications for Korean product liability law.

• The Journal of the Korea Contents Association
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• v.17 no.10
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• pp.559-566
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• 2017

Despite the government operating various preventive programs to ward off accidents and diseases on business sites, diseases rates are not decreasing, unlike accident rates. In many cases, diseases caused by work have a latent period before symptoms appear or progress over a longer term, making it difficult for workers to prove the causal relation between their work and the diseases. Moreover, data related to the business site are mostly owned by the employer. Even if the employee has access to parts of such data, his lack of medical expertise limits his ability to identify the characteristics of the diseases and how it appears. In August, 2017 the Supreme Court did an about-face with its ruling on the case involving diseases caused by exposure to harmful substances in work environments, by easing the burden of proof on the employees. As such, this study focuses on the case to analyze cases involving diseases that have occurred in work environments and present their implications. In doing so, the study seeks to provide a basic set of data that can help secure the employees' labor rights and rights to health by complementing the current law in relation to recognizing industrial incidents caused by rare diseases and making work environments safer for employees.

• The Korean Society of Law and Medicine
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• v.15 no.2
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• pp.435-459
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• 2014

Supreme Court of Korea has been mitigating the burden of proof on the malpractice and causal relation by a patient in accordance with the practical transfer of such burden of proof on causal relation as well as relieving a doctor's burden of proof on mistake in the civil damage claim suits on the malpractice. However, a prosecutor shall strictly prove the causal relation between malpractice and unfavorable results as well as a doctor's mistake in the criminal cases for making a doctor accept the professional negligence resulting in death or injury in accordance with In Dubio Pro Reo principles. Furthermore, it shall not be allowed to relieve the burden of proof on malpractice and causal relation which has been frequently applied in the civil proceedings. Nevertheless, it was widely known that the front-line courts accepted the malpractice and causal relation by quoting the legal principles on relieving the burden of proof on malpractice and causal relation applied in the civil cases even in criminal cases with no or insufficient proof on malpractice or causal relation. However, the latest precedents in Supreme Court explicitly declared the opinion that there was no reason to apply the legal principle to relieve the burden of proof on the malpractice and causal relation in the criminal cases requiring the proof 'which doesn't cause any reasonable doubt' on malpractice and causal relation in accordance with the legal principles 'favorable judgment for a defendant in case of any doubt' on the basis of the strict principle of 'nulla poena sine lege.' Accordingly, Supreme court definitely clarified that there would be no reason to relieve the burden of proof on malpractice and causal relation in criminal cases by reversing several original judgments accepting malpractice and causal relation even though there were no strict evidence.

• 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.