• 의료법학
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• 제9권1호
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• pp.285-317
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• 2008

To accept the doctor's professional negligence in the medical malpractice, the mistakes, by which the doctor did not foresee the production of the results in spite of the possibility of foresight and did not avoid the production of the results in spite of the possibility of avoidance, must be considered, and to decide the presence of the doctor's professional negligence, the standard must be the attention standard of general-common doctor engaged in the same business and the same function, and the medical enviornments, the conditions, the extraordinary nature of medical behavior, and etc should be considered by the general level of medical science at the time of accident. This principlel must be applied to the medical malpractice case occurred being on duty without exception. But, because of the extraordinary nature of duty work, it is difficult for any doctor to do one's best technical practice by making all diagnosis, medical treatment with all the equipment on the same plane as the ordinary times. That cannot be also expected for any doctor to do one's best technical practice in the terms of a social idea. From this point of view looking into The Precedent case related to Medical-service person being on duty sentenced by The Supreme Court, unlike the general medical malpractice case, the presence of the professional negligence in the medical malpractice occurred being on duty seems to be decided with more consideration on the general level of medical science, the medical enviornments and the conditions, particularities of medical practice at the time of accident. Especially, the extraordinary nature of medical behavior of the medical service person being on duty in the emergency room seems to be admitted compared to that of the medical service person being on duty in ward.

• 의료법학
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• 제13권1호
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• pp.295-329
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• 2012

A medical malpractice case requires special legal protection, considering its characteristics, such as seriousness and long term effects of its damages, medical information asymmetry between practitioners and patients, and difficulties in realization of liability. Taking the points above into consideration, Medical Malpractice Arbitration Act of 2012(MAA) has legislative intent to protect the rights of the injured from medical malpractice, while protecting the stability of medical practice by providing arbitration as an alternative dispute resolution. However, constitutional review is required for one new scheme of compensation for medical injuries during delivery, which is implemented in MAA of 2012, especially with regard to freedom to exercise occupation, property, equality under the Constitution. Two important aspects are 1. according to the law, absolute liability applies to compensation for damages during delivery without negligence of practitioners; and 2. the practitioner bears some portion of the cost, 30% in the law above. This article aims to analyze this new institution in various aspects of the Constitution, and, as a result, it does not comply with constitutional criteria.

• 의료법학
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• 제23권2호
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• pp.171-209
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• 2022

2021년에도 의료와 관련된 많은 판결들이 있었는데, 그 중 본 논문에서 검토한 판결들은 다음과 같다. 먼저 진료기록 부실기재 및 변조 등과 주의의무위반 관련 판결은 의료과실 유무 등에 관한 일차적 판단자료인 진료기록이 사후에 수정된 사례에 관한 것으로 그 수정내용 및 수정시기에 비추어 사후에 수정된 진료기록 내용은 고려하지 않고 최초 작성된 진료기록을 토대로 과실 유무 판단을 하였다. 다음으로 비만치료약 처방 등에 대한 손해배상책임을 묻는 사례에 관한 판결은 처방과 관련한 과실을 인정하였으나 상당인과관계를 부정하여 재산상 손해배상책임을 부정하고, 설명의무위반에 따른 위자료만 인정하였다. 또한, 환자의 가해자에 대한 기왕치료비 손해배상채권을 대위하는 국민건강보험공단의 대위범위에 관한 전원합의체판결은 '과실상계 후 공제방식'을 취해온 기존 판례를 변경하여 '공제 후 과실상계방식'으로 대위 범위를 판단하여 피해자 보호를 도모하였다. 그리고 과실 유무에 관해 진료기록감정회신결과와 달리 판단한 판결은 과실유무 판단을 함에 있어 진료기록감정결과에 구속되는 것은 아니고 자유심증에 따라 판단한다는 입장에 따라 규범적으로 판단하였다. 마지막으로 국민건강보험공단의 요양급여비용환수처분과 관련해서는 비의료인이 개설한 의료기관에 대한 환수처분을 함에 있어서도 재량권을 행사해야 한다는 판결과 시설 및 인력을 공동이용한 의료기관에 대한 환수처분의 경우 그 환수범위를 세부적으로 판단해야 한다는 판결을 검토하였다.

• 의료법학
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• 제15권1호
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• pp.263-302
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• 2014

The court handed down meaningful rulings related to medical sectors in 2013. This paper presents the ruling that the care workers could be the performance assistants of the care-giving service although the duties of care worker are not included in the liability stipulated in the medical contract signed with the hospital for reason of clear distinction of duties between care workers and nurses within the hospital in connection with the contract which was entered into between the hospital and patients. In relation to negligence and causal relationship, the court recognized medical negligence associated with the failure to detect the brain tumor due to the negligent interpretation of MRI findings while rejecting the causal relationship with consequential cerebral hemorrhage. The court also recognized negligence based on the observation on the grounds of inadequate medical records in a case involving the hypoxic brain damage caused during the cosmetic surgery. In terms of the scope of compensation for damages, this paper presents the ruling that the compensation should be estimated based on causal relationship only in case the breach of the 'obligation of explanation' is recognized, however rejecting the reparation for de factor property damages in the form of compensation, and the ruling that the lawsuit could be instituted in case that the damages exceeded the agreed scope despite the agreement that the hospital would not be held responsible for any aftereffects of surgery from the standpoint of lawsuit, along with the ruling that recognized the daily net income by reflecting the unique circumstances faced by individual students of Korean National Police University and artists of Western painting. Many rulings were handed down with respect to medical certificate, prescription, etc., in 2013. This paper introduced the ruling which mentioned the scope of medical certificate, the ruling that related to whether the diagnosis over the phone at the issuance of prescription could constitute the direct diagnosis of patient, along with the ruling that required the medical certificate to be generated in the name of doctor who diagnosed the patients, and the ruling which proclaimed that it would constitute the breach of Medical Act if the prescription was issued to the patients who were not diagnosed. Moreover, this paper also introduced the ruling that related to whether the National Health Insurance Service could make claim to the hospitals for the reimbursement of the health insurance money paid to pharmacies based on the prescription in the event that the hospitals provided prescription of drugs to outpatients in violation of the laws and regulations.

• 의료법학
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• 제14권1호
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• pp.303-354
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• 2013

In 2012, the major jurisdictions regarding medical cases caused the controversial issues towards medical and legal fields by getting the judgments from the Supreme Court, which admitted the exceptional admissibility on discretionary grant. By regarding the serial negligence of medical organizations as a separate tort, the sentences which made up irrationality, were spoken by the court. As a result, if the treatment was made, which did not follow the entered matters in medical documents attached, the court announced the jurisdiction that presumes the negligence, which provided the evidence of negligence; on the other hand, this gave had the burden to medical branch to take great care for medicinal treatment. To be applicable for the Principle of Trust, the doctors have to give and take the necessary information for the treatment process and symptom decisions, which also commented in the court. Thus, this case made it difficult to apply the Principle of Trust and considered all the conditions as tough ones, which eventually induced lesser faults for patients' care. Moreover, the court confirmed that the medical ads sending the emails to the members belong to the internet portal sites, are not the inducing behavior by considering that the actions are only medical ads. Furthermore, in the case of Namsu Kim, the court's interpretation was rather limited the definition for medical practice that announced limited Erweiterung der Strafbarkeit cases by lower courts. As a consequence, it is very interesting whether the Supreme Court may change their position and concerning the duty of explanation, the trend to expand the contents and scopes for the duty of explanation continues by admitting instruction explanation obligation and all the compensations and so on.

• 의료법학
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• 제8권2호
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• pp.195-204
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• 2007

It is a general principle that the plaintiff takes burden of proof about negligence and causation in a civil compensation litigation. And it is the same in a medical malpractice lawsuit. Korean courts have made diverse efforts to mitigate the plaintiff's duty to prove in medical malpractice lawsuits under the name of justice and impartiality. One of those theoretical attempt is 'presumption of causation'. The Supreme Court, since 1995, has developed a new logic for the theory of 'presumption of causation' which is characterized by a phrase "layman's common sense". The Court presumes the defendant's negligence and causation when the plaintiff alleges and proves the facts which can be pointed out and expressed by a layman with common sense. And if the defendant fails to prove that the result was caused by other fact than own medical activities, the defendant shall be defeated. I realize that this theory has problem for justice and impartiality. I would say that two fators should be considered and added to this logic. First,are defendant's acts generally belonging to gross negligence which would cause that kind of bad result? Second, is it recognized that there would be the causation generally and statistically between the cause and the result?

• 의료법학
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• 제24권4호
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• pp.3-36
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• 2023

의료과오 민사소송의 주된 쟁점은, 과실, 과실과 손해 사이의 인과관계이다. 진료 상 과실이 증명된 경우 인과관계 추정과 관련하여 종래 대법원 1995. 2. 10. 선고93다52402 판결이 있으나, 위 판결 문언 상 요건을 충족하는 사안은 찾기 어렵고, 그럼에도 실무는 위 판결을 인용하면서 인과관계를 추정하는 경우가 많아 위 판결 문언과 정합성이 없다는 비판이 꾸준히 제기되었다. 대법원은 대상 민사판결에서, 민사소송에서 진료 상 과실이 증명된 경우 인과관계 추정에 관한 법리를 정비하여 새롭게 제시하였다. 이에 의하면, 환자 측이 의료행위 당시 임상의학 분야에서 실천되고 있는 의료수준에서 통상의 의료인에게 요구되는 주의의무의 위반 즉 진료 상 과실로 평가되는 행위의 존재를 증명하고, 그 과실이 환자 측의 손해를 발생시킬 개연성이 있다는 점을 증명한 경우에는, 진료 상 과실과 손해 사이의 인과관계를 추정하여 인과관계 증명책임을 완화한다. 여기서 손해 발생의 개연성은 자연과학적, 의학적 측면에서 의심이 없을 정도로 증명될 필요는 없으나, 해당 과실과 손해 사이의 인과관계를 인정하는 것이 의학적 원리 등에 부합하지 않거나 해당 과실이 손해를 발생시킬 막연한 가능성이 있는 정도에 그치는 경우에는 증명되었다고 볼 수 없다. 한편 진료 상 과실과 손해 사이의 인과관계가 추정되는 경우에도 의료행위를 한 측에서는 환자 측의 손해가 진료 상 과실로 인하여 발생한 것이 아니라는 것을 증명하여 추정을 번복시킬 수 있다. 한편 민사사건과 달리 형사사건에서는 '합리적 의심이 없을 정도의 증명'이 기준이고, 인과관계 추정 법리가 적용되지 않는다. 이에 따라 동일한 의료사고에 관하여 같은 날 동일한 재판부에서 선고된 업무상과실치사 형사사건에서는 진료 상 과실과 사망 사이 인과관계에 대한 증명 부족을 이유로 무죄 취지로 파기환송하였다. 대상 형사판결은, 의료과오 관련 형사 사건에서 '업무상 과실'이 인정되더라도 '인과관계'에 대한 확실한 증명이 부족하면 유죄로 판단하지 말라는 취지의 판결이다.

• 대한예방한의학회지
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• 제18권3호
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• pp.105-115
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• 2014

Objective : Traditional medicine (TM) has been playing its role in national healthcare system and it is taken as complementary and alternative medicine (CAM) from the viewpoint of modern Western medicine. In the UK, not a few practitioners of Traditional Chinese Medicine (TCM) are working as CAM practitioners using herbal medicine and acupuncture therapy. Cases of dispute in the TCM practice are not rare these days because patients who take TCM service are increasing by year. Method : In the UK, dispute cases of the Traditional Medicine of East Asia can be found these days, however, it is hard to find a reported court case. A medical dispute case of TCM will be analysed to see the legal management and the resolving principle in the alternative medicine practice with some cases of Korean Medicine (KM) being discussed. Results : The usual pattern of clinical negligence can be discussed from the points of a duty of care, breach of that duty by negligence, and the harm to the patient from that breach of duty. The judge followed this procedure In this case to discuss the claims. The department of health proposed to introduce regulation to provide the reasonable quality in TCM practice, and the governmental system would be essential to regulate both the TCM practice and practitioners. Conclusion : The dispute case of traditional Chinese herbal medicine (TCHM) practice is important for the clinical negligence in TCHM practice. Judging the negligence of a TCHM practitioner involves the conventional negligence principle in tort law, and the TCHM practitioners are required to keep up with the up-to-date information on the related medical specialty. The reasoning is almost the same as that shown in the court case of Korea. The TCHM practice in the UK needs to be under the regulation by the government. The standard of care we expect of a TCHM practitioner is a further matter to discuss from the healthcare and social viewpoints.

• 의료법학
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• 제9권2호
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• pp.311-338
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• 2008

This paper aims to introduce an overview of the regime of expert witness in the medical malpractice litigation, and to provide a plan of how to make it improved. In regard with medical expert witness, several problems, such as time-consuming procedure, non-neural and unclear opinion without reasons provided, have been pointed out for several years. Lack of skill of the court and plaintiff/defender to question the expert is one of many cause to lead to the above problems. What is questioned to the expert? Because expert witness is used in determining probability of negligence, questions to the expert should be selected on the grounds of whether or not to obtain opinions or facts sufficient to let the judge infer negligence in view of the theory of proof burden established by the Supreme Court. In addition, to avoid non-neutral and unclear opinion, it is necessary to question the expert clearly, specifically and scientifically.

• 의료법학
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• 제10권2호
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• pp.287-307
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• 2009

A person is injured in car accident caused by his/her slight negligence except he / she causes accident by his / her willfulness or gross negligence. Because the National Health Insurance Corporation (hereinafter called "Corporation") shall not provide any insurance benefit "when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident" referred to in Article 48 (1) 1 of the National Health Insurance Act. So, if he / she is insured by his / her own bodily injury coverage, he / she can be compensated for his / her medical expenses. The injured have the rights to file either National Health Insurance claim and Automobile Insurance claim but there is no clear and definite adjustment clause. The claim disputes between National Health Insurance (hereinafter called "NHI") and Automobile Insurance (hereinafter called "AI") in the own bodily injury coverage makes some problems. Firstly, there are some differences in co-payments which he / she chooses between NHI and AI. Profit per a patient is higher in the NHI than in the AI. Secondly, it can provoke criticism that people shall unnecessarily pay double contributions. Lastly, it can raise moral hazards. For example, if he / she can cover the compensations when the insured receives the compensations from his / her insurer, the Corporation can be claimed by medical care institution payment of the health care benefit costs. In conclusion, first of all, to improve the national health and preserve the insured's rights the Corporation shall keep notice these facts.