• 의료법학
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• 제15권1호
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• pp.239-262
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• 2014

The conventional medical appraisal which was done in the process of medical lawsuit was requested from the court to the designated hospital and was delivered as a pattern of one question and one answer in each. However, the comprehensiveness of medical appraisal which was pursued, for example, in Korea Medical Dispute Mediation and Arbitration Agency, could be guaranteed in terms of in-depth medical analysis as well as the broader capacity of the causality estimation besides. The comprehensiveness of appraisal would also include how well organized hospital system of medical care is and how well correlated job system among medical staffs, when medical dispute was happened at the hospital. This comprehensiveness will exert a big contribution on making a demonstrative medical care to prevent from the medical dispute and it could achieve the national plan of building the patient safety net which is effective in restoring the worsened quality of contemporary medical service. Therefore, the comprehensiveness of medical appraisal has to be designed to go forward interdisciplinary fused speciality rather than one division of medicine, which is also aiming at the reliable and consistent appraisal with the supreme dignity from one window. In addition to that, the objective and concrete frame of comprehensive appraisal under the computed connection has to be deliberated to make itself possible in collaboration with positive participation of medical community. The comprehensiveness of medical appraisal would serve to expand not only the capacity of speciality but also the ability of influence on a restorative justice, so that it give effect to an increased number of mediation and arbitration rather than medical lawsuit as well as a decreased number of the social cost and social conflict.

• 의료법학
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• 제21권1호
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• pp.153-185
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• 2020

불가항력 의료사고 보상사업의 근거 법률인 현행 「의료사고 피해구제 및 의료분쟁 조정 등에 관한 법률」 제46조제1항에서는, 보건의료인이 충분한 주의의무를 다하였음에도 불구하고 불가항력적으로 발생한 '분만에 따른 의료사고'를 사업의 대상으로 정하고 있다. 또한, 동법 시행령에서 보건의료기관개설자 중 분만실적이 있는 자가 보상재원의 30%를 부담하게 규정하고 있는바, 이에 대하여 헌법재판소에서는 2015헌가13 결정을 통해 의료분쟁조정법에서 위 사업의 분담금 납부의무자의 범위와 보상재원의 분담비율을 시행령에 위임하였다고 하여 헌법에 위반되지 않는다고 결정한 바 있다. 그러나 이는 의료진으로 하여금 의료과실이 없는 분만사고에 대하여 금전적으로 보상하게 하는 것으로 과실책임주의를 배제한 것인바, 이 제도의 본질이 사회보상적 성격을 갖는 사회보장제도의 일종이라면, 보건의료개설자의 비용분담 규정을 삭제하고 국가가 비용 전부를 부담하는 방법을 고려할 수 있을 것이다. 다만, 이와 더불어 의료사고 원인분석 및 재발방지 조치 등 의료기관의 노력을 강화하기 위한 제도적 장치를 함께 검토할 필요가 있다. 더불어, 의료분쟁조정법상 보건의료개설자가 부담하여야 할 보상재원의 분담비율의 상한을 정하는 것이 포괄위임금지원칙의 취지에 부합할 것이다. 한편, 의료사고 보상심의위원회의 분담금 지급기준과 관련하여, 시행령에서 보상의 기준이 되는 재태주수, 출생체중 등을 적시하고, 그 세부기준을 의료사고 보상심의위원회에서 정함이 타당하다. 마지막으로 불가항력 의료사고 보상사업에서 보상의 회색지대를 방지하기 위함은 물론, 의료'과실'이 규범적 판단임을 고려할 때 위 동법 제48조 제1항의 규정에서 '보건의료인의 과실이 인정되지 않는다는 취지의 감정서가 제출되고'의 요건은 삭제하는 것이 바람직하며, 반드시 의료중재원 조정·중재절차가 선행되어야 하는 현행의 규정을 개선할 필요가 있을 것이다.

• 한국중재학회지:중재연구
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• 제32권4호
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• pp.3-31
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• 2022

In the past, there has not been a law with the main purpose of preventing or preventing a risk in advance in order to protect the safety of patients in relation to medical services. It is evaluated that the enactment of the Patient Safety Act has a very important meaning in protecting patient safety as the top priority and further improving the quality of medical care. However, looking at the status of patient safety accidents reported to the Patient Safety Reporting System after the Patient Safety Act was enacted and implemented, various types of risk factors for patient safety still exist in the medical field. Meanwhile, Korea Consumer Agency and Korea Medical Dispute Mediation and Arbitration Agency, the existing domestic ADR specialized agencies, have been operating reasonable damage relief procedures such as recommendation of settlement, mediation, and arbitration according to the purpose of their establishment. Therefore, with the aimof broadening the choice of compensation system for patients, we propose the establishment and revision of ADR-related laws to apply the damage relief procedures of both institutions.

• 의료법학
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• 제7권2호
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• pp.219-268
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• 2006

In July 1989, Korea had achieved the national medical insurance system comprehensively covering the whole population since its inception of 12 years before, and subsequently the plural medical insurers had integrated to the unique health insurer system in July 2000. But there yet remain some problems to be improved under low contributions rates and poor benefit packages, especially the shortage of assuring beneficiaries' rights. The Health Insurance Appeal System is composed of a two-tiered system of committee. The Formal Objection Committees built in the National Health Insurance Corporation and in the Health Insurance Review Agency respectively examine the formal objections to the decisions of the Corporation, or the Review Agency. And the Dispute Mediation Committee built under the command of the Minister of Health and Welfare reviews the protests against the decisions on the formal objections by each Formal Objection Committee. To cope with the appellant in relation to the administration on the qualification of the insureds, contributions, and insurance benefits etc, is found to be unsatisfactory. There's the reason of poor function on right-relief caused by the loose composition of the Appeal Committee, the deficit of people's recognition and P.R., the lack of professional manpower and the Committee's independency, and time lag in making decisions and so on. Consequently the Appeal System should be improved to secure the rights-relief function, to empower the professionalism of the Appeal Committee, to strengthen P.R. for the beneficiaries, to build up the staff's proficiency through training, and to develop the quality of administrative services.

• 한국병원경영학회지
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• 제11권1호
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• pp.1-30
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• 2006

According to the available data, in these days, the number of medical accidents and disputes have significantly increased since 1990 in Korea. From this aspect, a variety of approaches and efforts to solve these problems is needed before it is too late. This study intended to identify the thoughts of patients who are directly connected with medical accidents and disputes and then to consider reasonable settlement methods of the increasing disputes. For achieving the purpose of this study, the self-administerd questionnaire was conducted with 450 out-patients who visited three university hospitals, five small and medium-sized hospitals, and ten clinics in Seoul from June 13 to 17, 2005. Incomplete questionnaires were omitted and 410 respondents(91%) were included for the analysis of this study. Each section of the survey was composed of six categories such as the recognition of malpractice, a compensation system about no-fault medical accidents, the recognition of the judgement of medical accidents in court, reasonable settlement of medical accidents, reasons of lawsuit, and the need of the medical dispute settlement organization. The major results of this study were as follows. First, more than half of the respondents, 51.9 percent, worry about malpractice. And many respondents think malpractice causes their symptoms to persist or become worse, and also some respondents think that the doctor's prescription changed too frequently. Second, as for a compensation system about no-fault medical accident, 55.7 percent of the respondents insist that a proper compensation for suffering patients or their families should be provided. And also as for the responsibility of compensation, respondents think joint compensation of both the medical institution and the government is needed foremost, followed by the medical insurance company and finally by the medical institution. The government as well as the related institutions should take responsibility for malpractice accidents for which the doctor is not responsible. Third, as for the acknowledgment of medical accident judgements by the court, 32.8 percent of respondents think that it is best to compromise with a medical institution, followed by lawsuit(26.2%), the assistance of civil organization(23.2%), and a powerful physical protest(7.6%). Fourth, as for the lawsuit of medical accidents, 62.9 percent of respondents think that patients and their families would be in a disadvantageous position in relation to medical institutions and doctors mentioning the lack of professional medical and lawful knowledge, experience and know-how as the reason. So many people have given up appeals owing to the difficulties involved in defending themselves through evidence. Fifth, about a half share of the respondents indicated that the medical institution's neglect of the responsibility of medical accidents is one of the most important reasons of lawsuit. And next respondents mentioned the lack of the medical dispute settlement organization and a general distrust of medical institutions and doctors. Sixth, a majority of respondents consented to the introduction of the need of the medical dispute settlement organization, And about a half of the respondents mentioned a readiness to accept the mediation of the organization, but the rest did not express a clear opinion. It seems that conflict among the parties concerned have existed in relation to the medical dispute settlement organization and related legislation for many years. But as this study has shown, the needs of the medical dispute settlement organization is in desperate demand. Therefore, more negotiation efforts from all interest groups should be considered for the birth of the medical dispute settlement organization and related legislation.

• Journal of Oral Medicine and Pain
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• 제31권4호
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• pp.283-296
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• 2006

과학기술의 발전과 더불어 보건의료분야는 괄목할 성장을 가져왔고 국민생활 수준의 향상과 건강에 대한 관심이 고조됨에 따라 의료서비스의 수요가 급증하고 있다. 이 과정에서 국민의 권리의식의 신장, 의료행위의 본질에 대한 이해부족, 의료기술에 대한 지나친 기대, 상업화된 의료공급체계, 의사의 윤리의식 저하 및 의료법리에 대한 무지 그리고 사회적 불신풍조의 만연, 분쟁해결을 위한 제도적 장치의 결여 등이 요인으로 작용하여 의료사고 및 분쟁이 급증하는 추세이다. 본 연구는 치과관련 단체에서 보유하고 있는 소송과 관련된 자료 및 연세대학교 치과대학병원 구강내과에서 신체감정을 시행한 재판기록을 중심으로 하여 판결전문을 확보할 수 있는 치과 의료사고 판례 중 1994년부터 2004년까지의 민사소송 30례의 판례를 분석하여 다음과 같은 결과를 얻었다. 1. 소송의 연도별 분포에서 2000년 이후 급증하는 추세를 보였다. 2. 소송의 유형별 분포에서 발치와 관련된 소송이 전체의 36.7% 이었다. 3. 소송의 원인을 분석한 결과 불편감, 치료불만족과 관련된 것이 전체의 36.7%, 사망 및 영구손상이 각각 16.7% 이었다. 4. 원고의 소송결과 승소 및 강제조정, 화해권고결정이 60.0% 이었다. 5. 소송에 관련된 병원유형은 치과의원이 60.0%로 가장 높게 나타났다. 6. 소송의 심급별 구성비율에서 2,3심 이상 진행된 경우가 전체의 30.0% 이었다. 7. 손해배상 청구금액은 5천만원 이상 1억원 미만이 36.7%, 1억원 이상이 13.3% 이었고 손해배상 판결금액은 1천만원 이상 3천만원 미만이 40.0%, 1억원 이상이 6.7% 이었다. 8. 소송과 관련된 치과의사수는 2명 이상이 26.7%이었다. 9. 판결까지의 소요기간은 11개월에서 20개월이 46.7%, 21개월에서 30개월이 36.7% 이었다. 10. 의료과실 유무에서는 과실을 판정한 경우가 46.7% 이었고 소송과정에서 신체감정이나 사실조회가 이루어진 경우는 70.0% 이었다. 11. 의사패소 판례(18건)에서 판결의 주안점은 주의의무위반이 72.2% 이었고, 설명의무위반이 16.7% 이었다. 치과 의료분쟁의 경우 치료의 긴급성이 상대적으로 적어 의사의 설명의무 중요성이 폭넓게 요구되며, 주관적인 치료 만족도가 중요시되는 분야이기 때문에 결국 분쟁을 줄이는 방법으로 기술적인 과실도 줄여야 하지만 치과의사와 환자와의 신뢰 관계를 개선하는 것과 의사집단의 자율성(autonomy)의 회복이 중요하다. 그리고 불합리하게 시행되고 있는 의료배상책임보험의 보완과 함께 치과의사단체와 학계가 주도하는 교육 및 의료분쟁시 자문을 구할 수 있는 체계의 확립으로 의료분쟁에 대한 대처가 이루어져야 할 것이다.

• 한국콘텐츠학회논문지
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• 제20권4호
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• pp.571-581
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• 2020

의료통역전문인력의 검정시험 평가항목으로는 대항목, 중항목, 소항목이 있으며, 그 기준 및 수준이 명확하지 않아 시험을 준비하는 자로 하여금 혼란이 야기될 수 있다. 이에 의료통역능력 검정시험 자격요건과 평가항목의 출제기준을 우리나라의 의료체계와 부합할 수 있도록 제안하고자 한다. 시행되고 있는 의료통역능력 검정시험에 대한 조사는 국내·외 자료를 수집하였으며, 유사검정시험과 비교 및 국외 시험과 비교하였다. 또한 의료통역능력 검정시험 문항개발, 출제경험이 있는 전문가들에게 검정시험에 대한 인식을 조사 하였다. 그 결과 국제문화 평가항목에 대하여 언어권문화는 의료권문화로 통역윤리는 의료통역윤리로 수정하였다. 병원시스템 평가항목은 대항목의 「의료관련법」에서 중항목인 「의료분쟁조정법」을 「의료사고피해구제 및 의료분쟁조정등에 관한법률」로 「의료관광관련법」 4개 항목을 2개로 축소하고, 「의료해외진출 및 외국인환자유치지원에 관한법률」을 추가하였다. 우리나라 의료문화와 부합되게 의료통역능력 검정시험이 마련된다면, 검정시험에 합격한 전문인력에게 전문가로서 활동할 수 있는 안정적인 기회가 마련될 것으로 판단된다.

• 의료법학
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• 제20권1호
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• pp.83-107
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• 2019

의료사고에 대한 분쟁의 해결을 위해, 법원은 통상 진료기록에 대하여 의학전문가에게 그의 의학에 관한 전문적 지식이나 그 지식을 이용한 판단을 보고하게 하는 감정(鑑定) 절차를 진행하고 있다. 의료사고에 대한 감정의 결과는 전문가에 대한 참고 의견으로 증거방법의 하나에 불과하다. 그러므로 원칙적으로 법원이 그 결과에 대하여 기속되어야 하는 것은 아니지만, 법원이 의료사고의 구체적 경위를 비롯하여 의료과실과 인과관계가 존재하는지 여부에 관하여 의학적 판단인 감정결과를 온전히 배제할 수는 없다. 따라서 의료사고에 대한 분쟁에서 진료기록감정이 차지하는 비중은 높고 법원 등의 심증 형성에 중요한 영향을 미치고 있다. 본고에서는 의료사고에서 감정의 의의와 기능을 살펴본 뒤, 현행법상 진료기록감정의 양상으로 이루어지고 있는 법원에서의 진료기록감정절차와 한국의료분쟁조정중재원의 의료사고에 대한 감정절차를 각각 유형별로 고찰한다. 또한 우리나라 판례에서 진료기록감정회신에 대하여 어떠한 태도를 취하고 있는지, 외국의 제도로 일본의 경우를 살펴보아 우리나라에의 시사점을 알아보고자 한다. 특히 우리나라의 진료기록감정절차가 지니고 있는 진료기록감정회신의 공정성에 관한 문제, 진료기록감정절차의 지연으로 인한 소송의 지연에 관한 문제 등에 대한 개선점을 제시하고자 한다.

• 한국중재학회지:중재연구
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• 제28권4호
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• pp.43-59
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• 2018

This study aims to review various efforts required by medical institutions to prevent medical accidents in advance and to suggest the necessity of introducing liability insurance for medical accidents based on cases abroad and compulsory professional indemnity insurance at home. Over the past five years between 2013 and 2017, the number of inquiries regarding medical accidents and medical disputes has increased by 11.1 percent from 36,099 to 54,929, and the number of mediation and arbitration for medical disputes has increased by 14.3 percent from 1,304 to 2,225. Since some medical accidents even cause social problems, a compulsory insurance system for the liability of medical institutions for damages need to be introduced to promptly compensate the victims of medical accidents and to ensure compensation by medical personnel. In Korea, a system is in place to provide compensation for a client who suffers an accidental damage after receiving professional services, regardless of whether or not the professional service provider can provide compensation. In major foreign countries, a medical liability system is in place that is applied either by the principle of liability with fault, or the principle of liability without fault. In this study, the cases of compulsory insurance and semi-compulsory insurance in the US and Japan to which the principle of liability with fault is applied, as well as the case of New Zealand to which the principle of liability without fault is applied, were examined. It is necessary to urgently introduce the compulsory insurance system for the liability of compensation to prevent medical disputes and to compensate for the life and physical damages of the victims of medical accidents in domestic medical institutions. Doing so is expected to ensure fair compensation for the victims of medical malpractice and compensation by medical personnel, thereby improving medical practice.

• 한국중재학회지:중재연구
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• 제30권1호
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• pp.199-215
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• 2020

Compared to Korea's recently expanding art distribution market, the difficulty of securing the authenticity of art is hindering the healthy development and growth of the market. In this regard, the current situation of the emotional system in the UK and France's art distribution process are examined as excellent cases in foreign countries. In the UK, there is a full autonomous appraisal system by art experts without state intervention. In France, the judiciary and the administration of art have an appraisal system for art works, so the appraisal work has reliability and objectivity. Through the above system, this study suggests measures to strengthen transparency in art trade and to break unfair practices in order to secure the authenticity of the domestic art distribution market. In addition, this study proposes the establishment of a professional appraisal system and the improvement of administrative law regulations to explore the possibility of ensuring fairness through mediation through the example of an international arbitration body.