• 의료법학
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• 제13권1호
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• pp.125-153
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• 2012

The adult guardianship system has been introduced through amendments of Korean Civil Code for the first time in the March 2011(Act No. 10429, 7. 1. 2013. enforcement). The adult guardianship system has the main purposes to provide a lot of help vulnerable adults and elderly, and protect them on the welfare related with property act, treatment, care, etc. There could be a controversy about whether the protection Legal Guardian's consent(formerly known as the Mental Health Act) or permission of the Family Court(revised Civil Code) are required to, or the Mental Health Act should be revised, when mental patient will be hospitalized forcibly. The author proposes that mental patient with Adult guardians should be determined by Legal Guardian's consent and approval of the Family Court, but mental patient without Adult guardians could be determined by Legal Guardian's consent. The issue of Withdrawing of life-sustaining treatment could be occurred due to the aging society and the development of modern medicine, and this has provided difficult, various problems to mankind in Legal, ethical, and social welfare aspects. The need of Death with dignity law or Natural death law has been reduced for a revision of the Civil Code. Therefore, on the issue of Withdrawing of life-sustaining treatment, in the future, intervention of the court is necessary in accordance with the revised Civil Code Section, and Organ Transplantation Act and the brain death criteria may serve as an important criterion.

• 의료법학
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• 제21권2호
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• pp.75-103
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• 2020

의료기술의 발전과 환자 진료 향상 등을 목적으로 빅데이터나 인공지능에 의료정보를 분석·활용하면 유전적 질병이나 암 등 특이 질병 등에 대비할 수 있어 의료정보가 공유되어야 한다는 목소리가 높아지고 있다. 환자의 개인정보에 관한 활용과 보호는 동전의 양면과 같다. 의료기관 또는 의료인은 일반 정보처리자와 다른 환경적 특수성과 민감도가 높은 개인정보를 처리함에 있어 신중하여야 한다. 대체적으로 환자의 개인정보는 의료인이나 의료기관에서 수집·생성부터 파기까지 개인정보를 처리하고 있으나 의료법의 개인정보에 관한 용어 사용의 혼재되어 있거나 적용 범위가 명확하지 않아 판례의 해석에 의존하고 있다. 의료법 제23조의 전자의무기록에 저장·보관된 개인정보는 고유식별정보만을 의미하는 것이 아니라 진료기록부 등 의무기록의 개인정보와 동일하며, 그 내용은 인적 정보, 고유식별정보, 진료정보, 재산정보 등을 포함한다. 의료인이나 의료기관 개설자는 의료법 제24조의4 진료정보가 침해된 경우 제23조의 개인정보와 동일하게 취급하여야 하는지에 대해 전자의무기록에 환자의 민감정보가 기록·저장·보관되어 있으므로 특별히 개인정보 중 진료정보만을 의미한다고 볼 수 없다. 의료법 제19조의 정보 누설 금지는 업무상 알게 된 '비밀'에서 '정보'로 개정되었으나 명칭만 바뀌었을 뿐 보호법익은 형법상의 비밀과 동일하여 환자의 개인정보자기결정권을 보호하고 있지 못하다. 개인정보보호법과 지역보건법은 '업무상 알게 된 정보'에서의 보호법익을 개인정보자기결정권으로 보아 누출, 위조, 변조, 훼손 등 개인정보 침해 행위에 대하여 동일하게 벌칙을 규정하고 있다. 의료법의 개인정보 보호 규정은 용어의 정의가 불명확하여 정보주체 및 정보처리자, 국민에게 적용 범위 등 혼란을 일으킬 수 있어 용어가 통일적으로 정비되어야 할 필요가 있으며, 개인정보 보호에 관한 특별법인 의료법과 일반법인 개인정보보호법의 규정 내용이나 범위가 일치하지 않아 해석상 혼란이 생길 수 있어 개인정보 보호에 대하여 일정한 한계를 보인다. 환자의 개인정보는 민감정보로서 그 활용과 처리에 있어 안전하게 보호되어야 한다. 개인정보 보호 원칙에 따라 개인정보를 처리하여야 하며, 정보주체인 환자나 보호자의 권리인 사생활의 비밀과 자유, 인격권, 개인정보자기결정권을 보장하여야 할 것이다.

• 의료법학
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• 제13권1호
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• pp.199-247
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• 2012

According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

• 대한물리치료과학회지
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• 제9권1호
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• pp.69-80
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• 2002

The objective of research provides the physical therapy of good quality to the patients to search for the problem pant against a physical therapy accident and it simultaneously respects physical therapy company law, the possibility of preparing a system defensive ability in order to be. The data were collected from 2000 October 1 to December 30th, and analyzed by a frequency and a percentage, oneway ANOVA, Scheffe method, $x^2$ official approvals. Conclusion (1) the accident where the patient falls from inside the treatment 'room is many and occasionally' 29.3% (63 people) with was many most. (2) Because of a mistake by a part-time therapist in holiday or a colleague therapist to do, the fracture or bum accident happens 12.5% (27 people), by a assist nurse due to more showed 12.1% (26 people) experience degree in the patient. (3) From physical therapy process breakdown of the medical treatment machinery and tools or it is in malfunction to do and the experience which has a failure to physical therapy is one enemy 68.1% (147 people) was in item. Also it treats and the patient or in the protector it sends an explanation in advance not to be, the experience which it enforces 50% (108 people), of service hour treatment equipment the medical treatment directives broad way of the doctor is accurate in insufficiency and does not enforce the experience is 45.4% (98 people), the patient whom I am treating Hot Pack (electricity has pack inclusion) with to do, the art dealer (over at 1 buffoonery) the experience which it puts on 27.1% (58 people), The patient whom I am treating is the electrotherapy flag (electricity has pack exclusion) with to do, the art dealer (1 degree art dealer over) the experience which it puts on 16.3% (35 people), the experience boat song the patient against a fracture from physical therapy process 9 person (4.2%) was visible an experience degree. (4) With hospital infection to do, from the patient the experience and the therapist which receive a problem proposal were caused by with hospital infection and the answer back regarding the experience which tries to receive a treatment appeared 6% (13 people), 42% (9 people) with each. (5) It listened to the treatment hour patient or the appeal of the protector and especially it does not appear to be being important it was not and and the management which is special it did not take, also the experience where the condition of the patient is deteriorated after that was 10.3% (22 people). (6) The condition or state of the patient does not agree with the medical treatment instruction of the doctor not to be, amendment one experience was 67.5% (145 people). (7) The experience degree of the physical therapy accident which relates with physical therapy recording and a secret maintenance 59.7% (129 people) 'is many and occasionally it is,' it showed an answer back and e it showed a most high accident experience degree. (8) The business overweight of physical therapy company 43.3% (93 people) with was high most from recognition degree of the physical therapy company against a physical therapy accident. (9) Against the question which asks the responsibility subject matter of physical therapy accident the whole answer back volition 42.8% did it is a joint responsibility where the multi person relates. (10) The accident occurs most the hour unit which plentifully in the afternoon 64.3% (133 people) with appeared from the recognition degree against the frequency hour unit of physical therapy accident. (11) Physical therapy it bought and after the various medical treatment accident which relates against the attitude of the, patient side against the physical therapy company it understood and trillion it was many most with 33.3% to be finished. (12) After physical therapy accident the management against the physical therapy company of the hospital authorities concerned above all do not experience 70.6% (149 people), from event right and wrong submission 22.7% (48 people), warning management 2.8% (6 people), the event report requirement and money compensation were each 0.5% (1 person). (13) As the prevention book of physical therapy accident most it is important, the fact which it thinks that, the persons supplement of physical therapy company 58.8% (127 people) with was high most. (14) It related with a physical therapy accident and the medical law 43.5%, civil law 23.9%, was visible the answer back ratio of the criminal law 13.7% from the degree which probably is a relation law.

• 의료법학
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• 제23권1호
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• pp.37-80
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• 2022

이 논문에서는 현행 응급의료에 관한 법률이 규정하고 있는 응급의료에서의 설명·동의의 원칙과 응급의료거부죄를 검토함으로써 응급의료종사자의 환자에 대한 생명보호 의무가 환자의 자기결정권 보장보다 중요한 경우에 한하여 응급의료거부죄가 성립함을 제시한다. 응급의료에서도 일반 의료상황과 마찬가지로 의료행위 시행 전 환자에게 응급의료의 필요성이나 방법 등에 관하여 설명하고 동의를 받아야 함이 원칙이다. 다만, 설명·동의 절차를 예외적 방법으로 이행하거나 생략할 수 있음에도 그 절차 준수를 이유로 응급의료를 거부·기피한 응급의료종사자는 응급의료거부금지에 따른 행정처분과 행정벌을 부담하게 된다. 즉, 설명·동의 절차 생략 가능성에 관한 판단에 따라 응급의료거부죄가 성립할 수도 있는 것이다. 환자가 미성년이거나 의사결정능력이 없는 경우 그 법정대리인이 환자의 의학적 이익에 반하는 결정을 하더라도 법정대리인의 의견이 무조건적으로 존중되는 것은 아니다. 미성년 환자도 원칙적으로 자신의 신체에 관하여 결정할 권리가 있고, 법정대리인의 결정 역시 환자의 최선의 이익을 위한 것일 때 유효하기 때문이다. 환자가 치료를 거부하는 상황에서도 원칙적으로 응급의료종사자의 생명보호의무가 더 우선한다. 그러나 현행법은 여러 예외 상황에 대해 명문의 규정을 두고 있지 않아 응급의료 현장에서 그 해석에 어려움이 있다. 한편, 우리 대법원 및 하급심 판례는 응급의료종사자의 응급의료의무와 설명의무 사이의 이익형량이 불가피한 상황에서 환자의 생명상실이 문제되는 경우 설명의무보다 응급의료를 시행하여 환자의 생명을 보호하여야 할 의무가 우선이고, 예외적으로 사전에 치료 여부·방법에 대해 환자의 진지한 숙고가 있었던 경우 환자의 자기결정권이 응급의료의무와 대등하게 고려될 수 있다는 취지로 설시하고 있으므로, 이를 체계적으로 정리하고자 한다. 나아가 현행법의 해석만으로 해결이 어려운 부분에 대하여는 1) 미성년자에 대한 응급의료의무 조항 신설, 2) 응급환자의 의사결정능력 판단 기준을 의학적 내용을 중심으로 수정·보완, 3) 응급처치시 의료인의 추가 동의가 불요함을 명시, 4) 복수의 의견 충돌이 있는 경우에 대한 제도적 보완, 5) 응급의료 중단시 벌칙조항 신설 등 입법 과제를 제시한다.

• 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.

• 의료법학
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• 제22권2호
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• pp.49-79
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• 2021

피고의 잘못된 임플란트 시술로 인하여 원고는 임플란트 보철물 도재 파절 및 역미소선, 치주염 등의 심각한 손상을 입은 사건에서 피고는 원고에게 불법행위 또는 채무불이행으로 인한 손해배상으로 향후 치료비와 위자료를 지급하라는 판결이 나왔다. 이번 대상판결에서는 치과치료에 관한 사안으로서 일반적인 의료과오소송과 마찬가지로 고도의 전문적 지식을 필요로 하는 분야로서 비전문가인 일반인으로서는 치과의사가 의료행위 과정에서 주의의무 위반이 있었는지 여부나 환자에게 발생한 손해 사이의 인과관계가 있었는지 여부를 밝혀내기 극히 어려우므로 증명책임을 경감하는 것으로 구성한 것이다. 대상판결의 사안에서처럼 수술 도중이나 수술 후에 환자에게 중한 결과의 원인이 된 증상이 발생한 경우에 그 증상의 발생에 관하여 의료상의 과실 이외의 다른 원인이 있다고 보기 어려운 간접사실들이 증명된 경우에는 그와 같은 증상이 의료상의 과실에 기한 것이라고 추정할 수 있다고 판시하였다. 특히 대상판결에서는 일반적인 수술적 치료의 사안이 아닌 임플란트의 시술의 사례로서 수단채무로서 치과진료의 의료과오소송에서 치과의사의 과실에 관한 환자의 입증책임을 소위 '사실상 추정론'에 근거하여 대폭 경감함으로써 의료기술의 발달과 증가하는 현대 의료과오소송에서 세계적 입법추세인 입증책임의 전환에 더욱 가까이 접근하였다는 점에서 큰 의미를 부여할 수 있다. 이러한 점은 대상판결에서 치과의사의 '과실'의 판단에 있어 "그 증상이나 발생에 관하여 의료상의 과실 이외의 다른 원인이 있다고 보기 어려운 간접사실이 증명되면 그와 같은 증상이 의료상의 과실에 기한 것이라고 추정할 수 있다"고 판시한 점에서 명확히 확인된다.

• 의료법학
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• 제18권2호
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• pp.139-161
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• 2017

이 글은 대법원 2016.1.28. 선고 2015다9769 판결의 검토를 목적으로 한다. 이 사건 연명의료 중단에 관한 이전의 판례에서 대법원은 객관적 요건으로 회생불가능한 사망의 단계와 주관적 요건으로 환자의 동의가 충족되면 의료계약이 해지된다고 보았다. 그러나 환자의 동의는 의료계약 해지에 관한 동의가 아니다. 환자의 의료행위에 대한 동의는 법률행위가 아니다. 그것은 사실행위이다. 만약 연명 의료의 중단에 관한 환자의 추정적 의사가 의료계약의 해지의 의사라면, 의료계약은 연명의료 중단에 관한 소 제기시에 종료하여야 한다. 그런데 대상판결은 의료계약이 일부 해지되었다고 하면서도 진료비채무는 연명의료 허용에 관한 판결이 확정된 때부터 면제된다고 하였다. 이는 논리적으로 맞지 않다. 연명의료의 중단이 허용되면 의료급부 제공이 불가능해지기 때문에 그 부분 진료채무가 면제된다. 급부의 불능은 연명치료 중단에 관한 확정판결이 있는 때에 확정된다. 따라서 연명의료 중단에 관한 확정판결이 있은 때부터 연명의료에 대한 진료비채무가 면제된다고 한 대상판결의 결론은 타당하다. 다만 그 근거는 의료계약의 일부해지가 아니라 일부불능이다.

• 의료법학
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• 제25권1호
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• pp.3-58
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• 2024

It has become a general idea today that the characteristics of medicine should be considered as a basis when discussing a medical personnel's duty of care and whether or not it has been violated, and when discussing its duty of explanation and whether or not it has been fulfilled in medical practice. However, in the discussion of its characteristics, some shortcomings still exist, so the need for a re-discussion has been raised. Firstly, existing discussions on characteristics have failed to comprehensively grasp and explain the characteristics of medical practice. Secondly, in some researchers' arguments, there are discrepancies between the terms used to express characteristics and their conceptual definitions or content. Thirdly, the lack of exemplified cases that reflect the characteristics of medicine - especially Supreme Court precedents - has led some to think negatively about the recognition and reflection of certain characteristics. In my early writings, I have described five characteristics of medical practice: 'conflict in medical goals', 'initiating appropriate medical actions (progression of illness)', 'dynamics of medical intervention (diversity of symptoms)', 'diversity of medical effects', 'inherent risk of medical treatment (invasiveness)'. In this paper, keeping in mind the reasons for the need for reconsideration, I aim to analyze the characteristics of medicine in detail and cite key parts of representative Korean Supreme Court precedents that reflect each characteristic. The characteristics of medicine extracted from this paper are; There are ten factors, including the legitimacy of the essence of medical practice, timeliness of medical execution, dynamics of medical progress, diversity of medical effects, risk of medical invasion, non-uniformity of medical methods, limitations of medical capabilities, intervention of the medical subject, high degree of medical standards, and maldistribution of medical data.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권3호
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• pp.29-39
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• 2013

Purpose: As emergency medical service fund is further expanded due to amendment of the law on emergency medical services in 2008, Korean government has prepared to intervene in a comprehensive manner to strengthen a trauma treatment system. As a result, it announced a master plan to establish a serious trauma treatment center in 16 areas across the nation. Therefore, this study has attempted to investigate the current status of the serious trauma treatment centers and suggest the goal and improvement plan of future serious trauma treatment centers. Methods: As of 2011, Korea operates 23 emergency cerebrovascular service centers, 23 emergency heart disease centers and 35 severe trauma treatment centers across the country. 12 emergency medical service centers have been chosen among the serious trauma treatment centers. Then, top six (6) centers chosen at Emergency Medical Institute Assessment 2011 by Ministry of Health and Welfare have been selected, and floor layout and spatial allocation by usage have been reviewed and analyzed. Results: Consequently, this study has investigated the spatial components, circulation layout and spatial allocation of a serious trauma treatment. For construction planning in consideration of the fundamental objectives and goal of emergency medical services, it is essential to allot spaces and select exact spatial components. It appears that it is necessary to design spaces for emergency medical services and come up with construction planning through appropriate spatial allocation.