• 의료법학
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• 제17권1호
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• pp.139-168
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• 2016

독일은 의료분쟁에 대하여 주의사협회를 중심으로 설립된 두 가지 방식의 대체적 분쟁해결방식을 두고 있는데, 첫째는 하노버를 중심으로 한 북독일 지역의 의료조정원이고, 다른 하나는 노트라인 지역을 중심으로 한 감정위원회 방식이다. 두 조직은 의사협회를 중심으로 구성되어 있지만, 북독일의료조정원은 법조인과 의사가 각각 1인 포함된 조정위원회를 구성하고, 감정위원회는 법조인 1인을 감정위원장으로 임명하고 그 이하에 4명의 의사 감정위원을 둠으로써, 조정위원 또는 감정위원들이 가진 고도의 의학적 지식에 법률적 중립성을 부여하려고 노력하고 있다. 현재 우리나라에서 의료사고 피해 구제 및 의료분쟁 조정 등에 관한 법률에 의하여 설립된 한국의료분쟁조정중재원에 의한 대체적 분쟁 해결 방식은 감정과 조정 중재라는 두 단계를 거쳐야 하기 때문에 독일의 감정위원회 절차와 조정위원회 절차가 참고가 될 수 있다. 의료 분쟁 조정제도가 의료인 중심으로 운영되면, 환자 측으로부터 불신을 받을 것이지만, 현재 우리의 제도는 의사측이 의료중재원 절차에서 소외될 수 있다는 우려 역시 주요한 문제점으로 나타나고 있다. 또한 법 개정에 의하여 사망자와 중상자에 대한 조정 자동개시가 도입되면서, 의료분쟁조정중재원의 중립성과 효율적 운영이 중요한 문제점이 되었다. 독일의 조정원과 감정위원회의 구성에 비추어 보면, 조정원 구성은 법조인과 의사가 동등하게 참여하여 구성하는 것과 감정위원회 구성은 위원장을 법조인이 하고, 감정 위원들을 의사들로 구성하는 것과 같이 전문가들의 협조와 견제를 고려하고 있다. 현재 의료분쟁 조정법에서 조정과 감정은 하나의 절차처럼 운영되고 있는데, 적절한 협력을 고려하면서 의료인 중심의 감정 분야와 법조인 중심의 조정 분야를 독립적으로 운영 발전할 필요가 있다.

• 의료법학
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• 제13권2호
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• pp.309-334
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• 2012

Although the number of foreign patients visiting Korea for medical treatments or plastic surgery is rapidly increasing, countermeasures against unforeseen medical disputes involving foreign patients are adequate. To date, the record shows that most foreign patients have visited doctors at the departments of family medicine, internal medicine, dermatology (incl. plastic surgery), and healthcare centers, which, fortunately, indicates that there are not many severe, high risk patients. However, if the current growth rate continues to rise and the number of foreign patients visiting each department continues to grow, more diverse medical practices will be likely to take place in the future, and consequently, it is expected that the possibilities of medical malpractice and the costs of dispute resolution will also rise dramatically. When a medical dispute occurs, in general, a lawsuit is ultimately settled by the court. However, since this can damage the creditworthiness of medical institutions and also incur significant litigation costs, which is a typical characteristic of a medical lawsuit, medical professionals or institutions will be heavily burdened. Furthermore, an adequate policy or countermeasure against a medical dispute with a foreign patient has not yet been established, and it would be difficult to resolve a dispute by finding the middle ground, due to relative standards and policies between countries. Now, we need to improve the existing policies and prepare for countermeasures that will allow us to precisely predict the nature of such disputes, which have been increasing, and resolve them peacefully. Based on such knowledge, this study aims to establish countermeasures against medical disputes with foreign patients, and examine ways to promptly and reasonably resolve them at an early stage.

• 의료법학
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• 제7권2호
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• pp.271-310
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• 2006

In the situation of bringing out of social problem about the medical accident and medical dispute, from 1988 the enactment activity for a legislative bill on conciliation of dispute has promoted, a legislative bill on prevention and relief of medical accident was again proposed in December, 2005. This bill has been faced rough going in review process of National Assembly. Because the purpose of this legislative bill is the conciliation of interest of between medical service consumer and medical service supplier, an item of issues of law is no-fault compensation scheme. However, as no-fault compensation scheme runs counter to the principle liability with fault in our civil law, as expected, whether the inducement is valid or, if induced, the problem is not must be totally reviewed. First of all, the general of principle liability without fault and especially the medical system in foreign countries are reviewed, by reviewing an issue and the pros and cons of the inducement of no-fault compensation scheme, this article draws the conclusion. After all, considering that the necessity adapting Gefahrdungschftung in medical accident as much as other industrial fields exists, the many provisions of the principle liability without fault exists in civil law and special law of our law system, and no-fault compensation scheme let legislative purpose be, to what extent, achieved by conciliating patient and doctor, the inducement of principle liability without fault in medical field is reasonable in the aspect of politic and legal system.

• 의료법학
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• 제7권2호
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• pp.113-136
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• 2006

In recent years, as well as the other countries, medical dispute cases increase continuously in China. one of the reason that medical cases increase rapidly like this is after reformation and opening people's sense of independence, law and right come to be high, but a theoretical study about medical malpractice liability is insufficient and there is deficiency at legislation from 1986 civil law general rule is carried out in Chinese. but it is difficulty to deal with those more and more complicated medical dispute only according to the law above. so in 2001 The Chinese Supreme Court established the judicial construction about civil litigation evidence which regulated the shift of the burden of proof of medical malpractice and the relation of cause and effect from the plaintiffs to the defendants. in 2002 the State Council made out Incident of Malpractice Processing Rule. but many scholar pointed out the problem in it. on the other side, according to Chinese Contract Law parties could choose contractual or tort liability to prosecute. but because of the judicial construction above majority of people asked tort liability. of course there are some cases asking contractual liability. then this paper aim at analysis of the Chinese medical malpractice liability, especially of the problems about the subject of responsibility, burden of proof and scope of responsibility.

• 대한한의학회지
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• 제36권3호
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• pp.111-125
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• 2015

Objectives: The purpose of this study was to analyze the current cases of oriental medical injury relief data from Korea Consumer Agency (KCA), and to report the current change of oriental medical disputes pattern. Methods: Oriental medical injury relief cases processed by KCA from January 2010 to February 2015 were collected and analyzed. Results: 149 Oriental medical injury relief cases from KCA were analyzed for the study. The highest number that had been relieved was 43 in 2014. In monthly status, 18 case in September was The highest. According to the record, the bigger city had the bigger amount of relief cases which was 53(Seoul), 43(Gyeng-gi), 11(Busan) and so on. In age categories, 30s had the highest number of injury relief cases. The injury relief cases of package program had been rapidly increasing since 2013. Cancellation was the dominant claims cause of package program and consumer required the refund of prepayment. Breast augmentation was the majority treatment type of injury relief cases of package program. Average prepayment of package program was \3,166,085. Conclusions: This study finded that the major cause of oriental medical dispute was changed from side effect of clinical treatment to patient's satisfaction of medical service.

• 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.

• 한국응급구조학회지
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• 제13권1호
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• pp.19-33
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• 2009

Purpose : To check the legal relation between rescue team and patient as well as legal responsibility for patient's damage intentionally or erroneously caused by rescue member, a public official, in the performance of relevant job ; to prevent legal dispute over rescue team and to present program for fair settlement of dispute and equitable and feasible burden of damage. Method : First, the legal principle of Civil Law, Criminal Law and Administrative Law related to the theme of this research will be investigated around research by literature. Second, the case of dispute related to rescue team will be introduced. Result: 1. If 119 rescue members as a public official intentionally or erroneously cause damage to patient in the performance of job, they shall bear civil, criminal and administrative responsibility. They shall bear civil responsibility for indemnity for damage due to default or tort. The typical criminal responsibility includes accidental homicide arising out of duty, preparing falsified official document, dereliction of duty, etc. In the administrative side, the state is responsible for indemnity for peculiar status of the rescue member, public official. 2. Though raising civil petition or legal dispute over unsatisfactory rescue service may be reasonable to guarantee the right of nation, such action may cause stress to rescue member as well as may lead to mental shrinking and defensive attitude only to take the basic first aid treatment which has low possibility of mistake instead of active first aid treatment so as to avoid legal responsibility. 3. The program that may prevent legal dispute over 119 rescue team includes expansion of manpower specialized in first aid treatment, enhancement of education on legal environment, development and application of standard job guideline, formation of mutual trust with patient, detailed explanation, preparing and keeping minute record, improvement of the rescue members' ability of first aid treatment and development of medical instruction mode. Conclusion : The best policy is to prevent legal dispute. If it is impossible to basically exclude the possibility of dispute, however, we need to make effort to minimize the occurrence, settle fairly and divide damage equitably and feasibly. To improve the preventible death rate of our first aid system to the level of advanced country, 119 rescue team which is in charge of the stage before hospital needs to positively enforce special first aid by improving the qualitative level of rescue service and to strive to prevent legal dispute that may occur in the process.

• 보건행정학회지
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• 제31권3호
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• pp.280-291
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• 2021

Background: Based on the fact that the Korea Medical Dispute Mediation and Arbitration Agency is a public institution established by social demands for medical disputes, this study reviews the publicness of public organization and discusses its policy implications. Methods: Through Moore's strategic triangle, which consists of legitimacy and support, public value and operational capacity, the process of creating public value is examined. For the analysis, case studies were conducted using related literature data from 2012, when the agency was established, to the present. Results: As a result of the analysis, first, the related law examined in the operational capability has been revised dozens of times, but the revised law has its own contradictions and limitations. The human resource system is also being improved, but there is a problem with the fairness and reliability of the arbitration process, especially due to the limitations of the appraiser system. Second, in terms of legitimacy and support, a regional gap occurred despite efforts to improve accessibility through the expansion of the organization. And the arbitration agency failed to reconcile conflicts caused by stakeholders' perception of each other as a trade-off relationship. Third, the public value result shows that, despite many explicit (statistical) achievements, citizens' use of the past dispute resolution means (litigation) has not decreased. Likewise, the perception of value makers (citizens) is important for creating public value as an invisible result, but it has not yet been formally investigated, so the performance can not be recognized. Conclusion: While the organization's efforts for continuous change and improvement are encouraging, it is not perceived as a better means of resolving disputes and improving quality of services. Therefore, it is necessary to reconsider the institutional design centered on value creators.

• 의료법학
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• 제11권1호
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• pp.11-52
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• 2010

Medical Dispute Arbitration Law had been debated on its legislation several times since Korean Medical Association's submission of the bill to the National Assembly in 1988, eventually in December, 2009, passed the National Assembly Standing Committee and was laid before the Legislation and Judiciary Committee, and thus its legislation is now near at hand. During the long process, it has provided a hot issue with our society. And yet, Medical Dispute Arbitration Law has differed considerably in legislative content depending on the main body of proceeding the enactment, which subsequently was given the mixed comments of 'Act on Malpractice-related Damage Relief' or 'Medical Indemnity Act', and this legislative bill also cannot be free from this debate. It is desirable that medical disputes between doctors and patients be resolved through conciliation between the parties concerned. But, because reaching a compromise is difficult owing to deep emotional conflicts between the parties, difficulties in investigating a cause and requiring a high amount of settlement money, etc., it is inevitable to seek a resolution by third party intervention. By the way, such an arbitration by third party is based on the compromise of the interested parties and thus has a limitation of not being able to satisfy both parties completely. Therefore, the legislative bill made for arbitration of medical disputes between the parties will have to prepare an institutional system for the parties to easily understand and accept. Also, problems occurred in the legislative bill will have to be corrected through an in-depth discussion in order for the legislative bill to work as an effective system.

• 한국중재학회지:중재연구
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• 제27권4호
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• pp.61-72
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• 2017

In this study, the Commission proposed the mitigation of remedies by improving the role of medical disputes and preventing medical disputes. Medical disputes include a comprehensive description of medical malpractice, medical negligence, medical malpractice, and medical malpractice. Medical negligence refers to the neglect of medical care due to careless medical care in the treatment of patients, leading to patient injury and death. An inappropriate response in the process of international treatment could result in international trials and a decline in international credibility. In cases where medical disputes arise, health care is strictly necessary to determine the truth or absence of medical malpractice, and these expertise and experience are usually provided by emotion. With the neutral and objective emotions provided fairly and impartially, medical care expertise and experience can be fair, and the medical disputes can be resolved peacefully if the parties are trustworthy. The Health Care Dispute Mediation Committee should focus on enhancing the professionalism, objectivity, and reliability of medical care.