In current law, the premium medical treatment system gives patients the right of choice between normal medical treatment service and premium medical treatment service. Only the doctors having a career more than a certain period of time fixed in the law are eligible for providing the premium medical treatment service. So, the premium medical treatment system is highly related to the patients' right to know and the right of self-determination. The system is also relevant to the so-called 'economic explanation' notion because patients should pay additional fee when they want to use this system. Meanwhile, the situation as follows is problematic as to this system. Although a patient applied for using the premium medical treatment system and the patient also chose his or her own doctor specifically, another doctor who was not selected as premium doctor could make a medical accident. Then, is the another doctor liable for damages because the accident was a medical malpractice or a breach of medical contract? In this study, we are going to examine the problems related with the premium medical treatment system. First, we examine the current law related to the system. Second, we look into the economic explanation duty and its application to the premium medical treatment system. Finally, we examine a real judgment case about a medical practice against the premium medical treatment system and we propose our solution to this case.
NHIS claimed for damages to doctors that by doing the treatment breaching medical insurance criteria caused by doctors, NHIS paid for medicine cost to pharmacy; as a result, the doctors caused the tort to NHIS. Following consecutive rulings afterwards, NHIS also argued that the medicine cost violating medical law or medical treatment expense paid to medical organizations are both the tort in civil law. NHIS claimed for all the damages, and the Supreme Court confirmed this judgment. However, within our national health insurance system, the subject of insurance payment is NHIS and the subject of medical treatment expense are also NHIS since the treatment expense is also insurance payment by asking the treatment to medical organizations. Further, national health insurance law is not made to control the violation of medical treatment cases; therefore, the breach of medical law cannot be covered by illegality of tort in civil law regarding NHIS. If that is the case, in the case that if the patients are treated according to treatment criteria via the doctors delegated the doctors' permission by Health and Welfare minister, NHIS acquired the benefits to remove the duty to give treatment payment to doctors in civil law; thus, even though the doctors have breached the medical law, NHIS does not have any damages. The fact that supreme court confirmed the ruling that the treatment is the tort in civil law towards NHIS is the judgment not counting the benefits of insurance payment as the subject but only considering the fact that NHIS paid to the doctors and this ruling have gone against the principle under civil code section 750. If the doctors have breached the medical law, the case should be sanctioned by medical law not national health insurance law, and the ruling of supreme court is assumed that they have confused both with the principle of national health insurance law and civil law.
Traditionally, the Supreme Court has held that medical treatment agreements covered by national health insurance should be distinguished from other medical treatment agreements which are viewed as a consummation of the autonomous free will between doctor and patient. Namely, the Supreme Court views medical treatment agreements covered by national health insurance to be bound by the National Health Insurance Law with the intent to promote the applicability and comprehensiveness of the national health insurance scheme. Yet, issues of voluntary non-reimbursable treatments are triggered not only by the mistakes or moral hazard of medical care institutions but also by systemic limitations of national health insurance coverage criteria. Thus, there is a need for legislative measures that allow certain medical treatments to be included or reflected in the national health insurance coverage system so that patients may receive prompt and flexible medical treatments. To reflect such concerns, the Supreme Court made an exception for voluntary non-reimbursable treatments and developed a strict test to be applied in such cases in Supreme Court Judgment 2010 Doo 27639, 27646 (ruled on June 8, 2012 by the Grand Bench). Such judgment, however, is not a fundamental overturn of the Supreme Court's prior rulings that voluntary non-reimbursable treatments are not allowed under the law. It is only a slight revision of its previous stance for cases in which there is a lack of legislative measures to make coverage of a new yet valid medical treatment possible under the current national health insurance coverage system.
This study is a paper reviewed legal status of medical personnel and issues of law on recently discovered medical records. As the increase of medical personnel who have gone through the administrative disposal in regards to the medical records, it is needed to examine the legal issue or dispute on the medical records under the current law. Medical records are the statement on patient's medical conditions made by the medical personnel. This records are used as important source for patient's further treatment. This becomes the communication route between the patients and the other medical personnel, and it provides the patients a right to find out their medical information. According to the Medical Service Act (Article 21), a medical personnel shall prepare respectively a record book of medical examination and treatment. And medical personnel shall make a signature. Furthermore, the medical personnel or the opener of the medical institutions must preserve the record book (including an electronic medical record). Meanwhile, the issues of a ban on false entry, additional record, revision or manipulation on the medical record have been recently on the rise. This paper briefly examined the major issues in regards to the medical records. It especially clarified the legal duty on medical records and its major-contentious-issues. At the same time, it pointed out the problems of the unreasonable over interpretation of the law. Furthermore, this suggested the guidelines for the further discussion and review.
The right to self-determination in regard to one's body is a key element of human dignity, privacy and freedom. It is constitutionally enshrined in the guarantee of human dignity, in the general right of personality and, most concretely of all, in the right to physical integrity. In principle No-one may trespass another person's body against his will, whether this act improves his physical condition or not. This right of self-determination applies equally to healthy and to sick people. Hence everyone has the right either to permit or to refuse a medical treatment, unless he can not make a rational decision. If the person does not consent himself, for whatever reason, another one must do for him as guardian. Representation in consent to medical treatment is therefore the exception of self-determination rule. This article explored, 1. who can consent to the medical treatment in the case of the mentally incapacitated adult and the infant, 2. what kind of consent to the medical treatment can the deputy determinate for the mentally incapacitated adult and the infant, 3. when the deputy can not determinate without permission of the court, and 4. what can the doctor do in the case of conflict between minors and guardians.
This study examined the levels of satisfaction from medical staff and patients by analyzing 691 Supreme Court precedents on medical practice from legal disputes in Korea, which are developing into a dual medical system. In addition, the issues that can be prevented in the medical field through the flow and judgment of legal disputes in medical practice after the revision of the medical law are discussed. The concept of medical practice not specified in the Medical Law was examined and compared with the medical-legal systems of Germany, Japan, and the USA through international comparative analysis to assess the illegal factors occurring in the medical field by analyzing the legal approach, medical practice, and medical personnel qualifications of each country. An analysis of the Supreme Court's case law revealed the timing analysis of issues in legal disputes related to medical practice, the incidence rate among the subjects of the cases, and medical personnel to be significant. The meaning was studied by finding the law that applied to it. Important cases were identified, and their meaning was reviewed. The legal issues of medical practice in orthopedics were divided into five sections based on precedents, such as problems in consent to information at the start of treatment, problems in prior radiography before treatment, explanation of the consent process for surgical treatment, problems related to the qualification of operators in the operating room, and the responsibility for postoperative results. In the wake of the recent major crisis in the government's medical reform policy (Essential medical package), procedural problems and legal reviews of illegal medical practices and their qualifications in the medical field were conducted because of the lack of medical personnel.
In providing general medical treatments, the medical service contract between the patient and the doctor is the mutually responsible onerous contract. However, the nature of the mutually assumed contract standings of the patient and the doctor has been changing since the implementation of the national health insurance program. For instance, besides the cases of beyond excessive medical charges and medical negligence, if the doctor charged for his/her medical treatments violating the post-treatment/nursing cover criteria, the overpaid medical charge, regardless of being collected with the patient's consent, has to be refunded back to the patient. Medically needed aspects, treatment results, and unfair benefits favoring the patient are not at all taken into consideration in the health insurance scheme. This makes it easier for patients to get refunds for their share of the medical payments by involving the Health Insurance Review & Assessment Service or the National Health Insurance Corporation, without engaging in civil law suits (for reimbursement claim) against doctors. In other words, the doctor's responsibility to provide medical treatments and the patient's responsibility to pay for the medical treatment provided within the contractual realm are being demolished by the administrational arbitration of the National Health Insurance system. The basic rights of medical service providers, and the patient's right to choose are as important constitutional rights, as the National Health Insurance program, which is essential in the social welfare system. Furthermore, the development of the medical fields should not be prevented by the National Health Insurance system. If the medical treatment services can be divided into necessary treatments, general treatments, and high quality treatments, the National Health Insurance is supposed to guarantee the necessary and general treatments to provide medical treatments equally to all the insured with limited financial resources. However, for the high quality treatments, it is recommended that they should not be interfered by the National Health Insurance system, and that they should be left to the private contract between the patient and the doctor.
The concept of expectation rights considers 'the expectation' that the patient should be given proper medical treatment as the benefit and protection of the law, so it would be the benefit and protection of the law due to personal rights different from 'the legal principle that has the possibility to a considerable extent' being in an extension of life and body. However, the problem how the patient's expectation of medical service sets up in order to make it the benefit and protection of the law would be still left in the vague concept of the patient's 'expectation', thus, in the first place, the medical practice following formed medical standard in every particular medical institutes should be the standard because these medical services are normally within a range of the patients' expectations. In addition, it should be naturally constituted as mental profit to get the subjective circumstances such as 'the patient's expectation' to be an object, and also, different from the profit and protection of the law such as life and body that should be absolutely protected, the origin of violation behavior should be regarded simultaneously to define the denotation of expectation rights. Therefore, the expectation rights violations would be problematic in case it fails to reach the medical standard that is expected for common doctors to practice properly. This is the concept of expectation rights that gets subjective matters such as the patient's expectation to be objectivity as medical practices that can be expected by generalized abstract doctors. This standard should be defined as the minimum standard that is naturally expected for doctors to practice, different from medical standard that decides the level of doctors.
The right to live is the most valuable benefit and protection of the law. And Medical science is the study considering value of life as the top priority. As modern medical science has progressed and expanding lifespan skills have developed, the number of symptom, called a human vegetable, has been also increased. As a result, people concerns whether euthanasia should be permitted. (1) Active euthanasia is prohibited and a doctor who conduct it is punished. (2) Indirect euthanasia can be permitted unless it is against a patient's intention. (3) Permission of passive euthanasia depends on intention of a patient. In other words, when a patient accepts, a doctor respects the right of self determination of patient and irreversible situation such as brain death happens, treatment stop is permitted. Even a patient who is in the last stage of cancer has a right to die in the dignity and elegance. Solutions for ceasing medical treatment are as follows; First, establishment of 'Bioethics Committee'. Second, setting procedures to empower a court a right to decide whether medical treatment is ceased. Third, setting procedure a government to assist treatment fees. In this paper, direction for social agreement of legal policy regarding the ceasing treatment is provided.
In connection to the civil liability of the medical malpractice, plaintiff and courts are solving the medical disputes with theory of the liability based on tort law. because contract law does not enact the right of claim of solatium and a plaintiff's lawyer and courts hesitate to use contract law. Medical treatment of doctor is main debt in medical contract and its in-complete performance gives rise to the violations of human's life, body and health. Consequently a breach of medical contract leads to violations of person-al rights. These violations spring from liability of contract as well as tort and damages from them are recognized based on medical contract law. A duty of explanation of doctor is a independent and appendant debt to the treatment debt. However its breach provokes violations of human's life, body and health as well as a right self-determination. Therefore consolation money claim should be recognized. In case of the violation of patient's life, body and health, patient's family al-so can demand consolation money due to the violation of their's own mental pain. However in case of the violation of only patient's self-determination without informed concent, they can not demand it by reason of the violation of patient's self-determination. But by reason of the violation of patient's life, body and health that were recognized by proximate causal relation between violation of duty of explanation and abd execution, they can do.
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