• The Korean Journal of Pain
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• 제29권1호
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• pp.62-62
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• 2016

• 의료법학
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• 제19권1호
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• pp.143-163
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• 2018

임플란트 시술은 소위 상업화된 의료에 속하고 상대적으로 시술자체가 단순 명료하며 그 시술이 성공가능성은 거의 100%에 달한다. 또한 환자에게 건강을 위한 불가피한 수단이기 보다는 선택적 수단의 의미를 지니는바 자기결정권의 보호를 위한 설명의무의 중요성이 특히 강조되기도 한다. 이러한 특성에 비추어 임플란트 시술 계약에 대하여는 도급의 성격이 강조되어 경우에 따라서는 식립 자체의 실패만으로도 의사의 과실이 존재한다고 할 수 있을 것이다. 또한 임플란트 시술은 상업화된 의료로서 단순 명료한 의료행위인바 과실여부는 직업적 평균인이 아닌 일반인의 상식을 기준으로 판단되어야 할 것이므로, 임플란트 시술 후 악결과가 발생한 환자는 예를 들어, 시술 중 과도한 통증과 출혈이 발생하였음에도 의사가 별 다른 조치를 취하지 않았다는 등을 입증하면 충분하고 그 전문가의 입장에서 의료행위가 적절치 못하였다는 점까지 밝혀야 하는 것은 아니다. 한편, 임플란트 의료과오 판결들을 살펴보건대 법원은 명시적으로 임플란트 시술계약을 도급이라고 판단하고 있지는 않더라도, 식립 자체의 성공여부로 의사의 과실을 판단하고 있어 일의 완성을 목적으로 하는 도급계약과 유사한 특성을 어느 정도 인정하는 듯 보인다. 또한 제시하고 있는 의료과실의 구체적 내용들에 비추어 의료과실의 판단도 일반인의 상식에 기초한 것으로 보인다.

• 의료법학
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• 제9권1호
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• pp.57-127
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• 2008

In medical malpractice lawsuits, negligence is generally defined as conduct that is culpable because it falls short of what a reasonable person would do to protect another individual from a foreseeable risks of harm. Thus, the essence of negligence is a breach of obligations to be attentive, and the breach of obligations to be is negligence. However, whether negligence is or not depends on time, place, litigation forms and the judge since the meaning of negligence is wavering on the basis of abstract and normative judgment. In this thesis, what is medical negligence, a breach of obligations of attention for a doctor in medical malpractice lawsuits, would be it further enacted that doctors have the responsibility to protect the patients as a subordinate duty due to a principle of faith and sincerity besides the main duty for medical contract-performance since the suit is a litigation form to be based on responsibilities of experts, especially doctors, though having factors that are non-contractual as a trait for medical treatment. Further on the concept, when the plaintiff asserts and proves a specific fact from the recent moderation of the burden of proof about medical malpractices, whether the court should find a true bill in medical malpractice actually or not has been discussed.

• 의료법학
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• 제15권1호
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• pp.83-122
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• 2014

Compared with medical cases and health care law from other countries there has been a lot of progress on medical law, especially on medical precedents in Korea. However, in recent years, medical precedents tend to reflect a realistic position of health care providers, rather than normative position of the victim. The burden of proof to prove strict liability is given to patients in civil law suits by courts, patients generally has the burden of proof. The rate of claims to prove the negligence of medical malpractice is falling significantly. Even if the error is acknowledged, it is not enough to get right to be relief for patients by increasing limitations of liability or ratio of patient's own negligence. Compensation fee is included in medical fees and risk of medical malpractice actions contributes ultimately to a health care consumer. In conclusion, author represents a major the new upgrade of above mentioned problem. By advising that court should assess actively for the perspective of victim for medical negligence we will be able to exercise remedies of patients' rights and to prevent recurring medical accidents and also contribute to medical advances.

• 치위생과학회지
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• 제8권1호
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• pp.13-20
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• 2008

본 연구는 치과위생사의 의료사고 및 분쟁에 대한 경험을 파악하여 치과위생사의 권익보호차원 및 조정을 통한 의료분쟁 해결방안의 기초자료로 삼고자 실시되었으며, 다음과 같은 결론을 얻었다. 1. 응답자의 32.5%가 의료분쟁 경험이 있는 것으로 나타났고, 이 중 55%는 치과위생사와 관련된 의료분쟁 경험이 있는 것으로 나타났다. 또한 일반적인 특성과 의료분쟁 경험 차이를 검정해 본 결과 나이, 임상경력, 근무지에 따라 유의한 것으로 나타났다. 2. 치과위생사와 관련된 의료사고 및 분쟁 유형은 환자 상담 및 예약이 27.3%로 가장 빈도가 높았다. 3. 의료분쟁시 치과위생사의 책임여부를 조사한 결과 전체 응답자 중 66.3%가 치과위생사에게 책임이 있다고 응답하였고, 책임이 있다고 응답한 대상자에게 책임 비율을 조사한 결과 응답자의 57.1%가 11-30%라고 하였다. 4. 치료전 관련 질환과 치료에 대해 모든 환자에게 충분히 설명한다는 경우는 55.3%였고, 모든 치과진료에 있어서 사전 동의를 구한 후 치료를 시행한 경우는 84.1%였다. 또한 의료분쟁 발생시 진료에 대한 설명이나 동의여부가 매우 중요한 역할을 한다는 경우는 78.0%로 나타났다. 5. 모든 환자의 진료기록을 충실히 작성하고 보관하는 경우가 82.1%로 나타났고, 의료분쟁 발생시 의무기록 관련 자료가 매우 중요한 역할을 한다고 생각하는 경우가 86.6%로 나타났다. 6. 향후 의료사고나 분쟁에 대한 의구심 정도를 조사한 결과 가끔 그렇다는 72.4%로 나타났고, 치과위생사의 업무 중 의료분쟁 및 의료사고가 우려되는 항목으로 교정용 브라켓 장착이라는 경우가 45.1%로 가장 높게 나타났다. 7. 의료분쟁에 대한 예방 및 대책과 관련된 교육이 필요하고 시급하다고 응답한 경우가 64.2%로 나타났고, 의료분쟁에 대한 예방 및 대책과 관련된 교육 시행시기에 대해 학교 교육과정과 보수교육 및 종합학술대회 모두라고 응답한 경우가 40.7% 였다. 본 연구의 결과를 통해 치과에서의 의료사고와 분쟁을 예방하기 위한 진료시 주의의무, 설명 및 동의의무 등 의무를 다할 수 있도록 하며 가장 기본적인 의무기록부 작성에 관심을 갖도록 한다. 또한 의료법에 따른 직무범위를 정확하게 인식하고 의료분쟁 예방과 대책에 관한 교육의 필요성을 인식시켜 앞으로 정규교과과정은 물론 대한치과위생사협회를 중심으로 학회 및 세미나를 통한 보수교육시 일정시간을 의료분쟁에 관련한 사항을 접할 수 있는 기회가 만들어져야 할 것으로 사료된다.

• 의료법학
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• 제15권2호
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• pp.195-223
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• 2014

Nurses are medical care providers most closely associated with the national health. Their works are subdivided and specialized, and it is such a factor making nurse's role more important, and with the appearance of specialized nurses, they have secured a position as an independent medical care provider. As the domain of nurse's service becomes broader, there are more accidents and disputes related to nurses. However, there are not many studies conducted on such problems, and even when medical disputes take place related to nurses, the court does not make consistent judgments as a matter of fact. Besides, as the ambiguity of nurse's range of service and the lack of nursing workforce work as a factor causing nurse's medical malpractice, more legal discussions and studies are required to seek proper solutions to such problems. Thus, as a plan to clarify legal issues likely to occur due to nurse's medical practice, this study classified nurse's work into medical assistance practice and other jobs based on their own independent judgments, and proposed establishing concrete regulations on the range of their work, while reviewing common problems extracted from precedents related nurse's medical malpractice. Moreover, while examining Japanese precedents related to the Act of Medical Service Personnel, Nurses and Midwives, which is the sole act of nurses in Japan, this study reviewed the necessity of revising the present nurse-related regulations in Medical Service Act, or enacting a sole act of nurses.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2000년도 제52차 추계학술대회 연제집
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• pp.195-196
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• 2000

• The Korean Journal of Pain
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• 제28권4호
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• pp.254-264
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• 2015

Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

• 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.

• 의료법학
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• 제9권1호
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• pp.9-56
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• 2008

The medical practice does not always get a satisfatory result since the disease progress of patients are depended on patients' physical constitution and the doctors cannot control the outcomes about patients' physiological and biological reaction after the treatment. Moreover, the medical practice may bring wrong result fatalistically because of the unpredictablility of life. To demand for compensation of the damage to the doctors about these wrong result, the patient side holds the burden of proof that is between medical practice and demage, and there is damage from doctor's malpractice according to the accepted theory about the fundamental principle of distribution of the burden of proof. This falls not only under the liability of Tort Law, but also liability of Contract Law. However, the patient may be in difficult situation to prove the malpractice of doctors since he or she cannot recognize the facts because he or she was in unconscious while the medical practice was conducted, or they cannot judge precisely even though they recognize the facts. Nevertheless, the lawsuits against medical malpractice are the field that never achieves the equality of arms since the most of the evidence belong to the doctor's side. Hence, to maintain the principle of the equality of arms under the constitution, the theory leads to alleviate the burden of proof that patients hold. However, the doctors cannot be asked for the burden of proof that they conduct medical practice without errors. Because the doctors may experience difficulty to prove their innocence as the patients because of the unique characteristic that medical practices have. Therefore, the methods of the alleviation of the patient's burden of proof should have the equality of arms and the equal opportunity between the patients and the doctors with the evaluation of the justifiable interest from both the patients and the doctors. As the methods of the alleviation of the burden of proof, the alleviation of the demands and the degree of the burden of proof or resolutely the conversion of the burden may be considered. However, Recognizing the exception from general principle with converting the burden of proof is not proper in principle because the doctors may experience difficulty of the proof as the patients may have. If the difficulty of proof can be resolved by alleviating of the demands and the degree of the burden of proof, it is more desirable resolution rather than converting the burden of proof.