• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.37-63
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• 2023

In medical litigation, there are various cases where a doctor's 'explanation' of a patient becomes problematic. Medical explanations and guidance are required from the doctor, starting from the beginning of diagnosis, through treatment processes such as surgery, when hospitalization is necessary for treatment, during hospitalization, upon discharge, and after discharge. Furthermore, notification from the doctor or medical institution may be requested regarding the economic costs that will be incurred due to medical treatment. South Korea's judiciary has been developing legal principles regarding such doctor's explanations by distinguishing between explanations for obtaining consent for medical treatment and medical explanations related to guidance on patient treatment methods, taking into account related laws such as the stage of treatment and the Medical Service Act. Additionally, the Constitutional Court recently ruled on the non-benefit cost notification system linked to the explanation of economic costs. However, holding a doctor accountable solely because the doctor's explanation was insufficient has aspects that do not correspond to the actual situation in clinical reality, and may have a reflexive disadvantage that results in a decline in legal rights. Therefore, the doctor's explanation needs to be examined from both perspectives: guaranteeing the patient's right to self-determination and protecting his or her right to decision.

• Archives of Plastic Surgery
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• v.43 no.5
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• pp.402-410
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• 2016

Background In an increasing number of lawsuits doctors lose, despite providing preoperative patient education, because of failure to prove informed consent. We analyzed judicial precedents associated with insufficient informed consent to identify judicial factors and trends related to aesthetic surgery medical litigation. Methods We collected data from civil trials between 1995 and 2015 that were related to aesthetic surgery and resulted in findings of insufficient informed consent. Based on these data, we analyzed the lawsuits, including the distribution of surgeries, dissatisfactions, litigation expenses, and relationship to informed consent. Results Cases were found involving the following types of surgery: facial rejuvenation (38 cases), facial contouring surgery (27 cases), mammoplasty (16 cases), blepharoplasty (29 cases), rhinoplasty (21 cases), body-contouring surgery (15 cases), and breast reconstruction (2 cases). Common reasons for postoperative dissatisfaction were deformities (22%), scars (17%), asymmetry (14%), and infections (6%). Most of the malpractice lawsuits occurred in Seoul (population 10 million people; 54% of total plastic surgeons) and in primary-level local clinics (113 cases, 82.5%). In cases in which only invalid informed consent was recognized, the average amount of consolation money was KRW 9,107,143 (USD 8438). In cases in which both violation of non-malfeasance and invalid informed consent were recognized, the average amount of consolation money was KRW 12,741,857 (USD 11,806), corresponding to 38.6% of the amount of the judgment. Conclusions Surgeons should pay special attention to obtaining informed consent, because it is a double-edged sword; it has clinical purposes for doctors and patients but may also be a litigation strategy for lawyers.

• Journal of Arbitration Studies
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• v.30 no.1
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• pp.185-198
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• 2020

In the event of a medical conflict in South Korea, civil lawsuits can be very complicated, time-consuming, and costly. Under the Medical Conflict Conciliation Act, the mediation system has expanded its function to coordinate disputes between individuals and medical institutions in a more efficient manner prior to litigation. Currently, conflict mediation organizations and legal systems are established in each sector, and the Healthcare Dispute Settlement Commission will also play an important role in the public sector. In this study, the characteristics of the evaluation system of the Korea Institute of Medical Conflict Arbitration are examined; and, by looking at the case of medical examinations, it is proposed to show the mediation system and the manner and role of the examinations. Medical expertise is a very important area of the qualitative standards and expertise of participants because the participants must play a role in medical consultation and appraisal in connection with medical experts.

• Health Policy and Management
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• v.2 no.1
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• pp.80-114
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• 1992

Current compensation schemes for medical malpractice based on negligence is absolutely malfunctioning in Korea. Focussing on the reform of present tort systems for resolving medical malpractice disputes, this paper discusses the alternative models of the Social Relief Schemes for Medical Malpractice (SRSMM). Alternative models of SRSMM should fundamentally be based on either negligence or nofalult compensation principle. On the foundation of the previous relief principle, the SRSMM should be equupped with three major components-the preventio/reduction of the sharp increasing medical malpractice, the effective and efficient resolving process for malpractice disputes and the proper social financing scheme for compensation. The paper deals with pros and cons of the possible alternative models for reform centering on the three major components of the scheme. As conclusions, administrative arbitration machinaries and a compulsory fund for compensating the injured under the negligence principle are proposed to resolve the current problems Korea has faced.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.5
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• pp.318-323
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• 2017

Objectives: Mandibular angle reduction or reduction genioplasty is a routine well-known facial contouring surgery that reduces the width of the lower face resulting in an oval shaped face. During the intraoral resection of the mandibular angle or chin using an oscillating saw, unexpected peripheral nerve damage including inferior alveolar nerve (IAN) damage could occur. This study analyzed cases of damaged IANs during facial contouring surgery, and asked what the basic standard of care in these medical litigation-involved cases should be. Materials and Methods: We retrospectively reviewed a total of 28 patients with IAN damage after mandibular contouring from August 2008 to July 2015. Most of the patients did not have an antipathy to medical staff because they wanted their faces to be ovoid shaped. We summarized three representative cases according to each patient's perceptions and different operation procedures under the approvement by the Institutional Review Board of Seoul National University. Results: Most of the patients did not want to receive any further operations not due to fear of an operation but because of the changes in their facial appearance. Thus, their fear may be due to a desire for a better perfect outcome, and to avoid unsolicited patient complaints related litigation. Conclusion: This article analyzed representative IAN cutting cases that occurred during mandibular contouring esthetic surgery and evaluated a questionnaire on the standard of care for the desired patient outcomes and the specialized surgeon's position with respect to legal liability.

• The Korean Society of Law and Medicine
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• v.15 no.1
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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.

• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.11-41
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• 2013

Article 347 of criminal law provides the act of deceiving another, thereby taking property or obtaining pecuniary advantage from another. On the other hand, the concepts of fraud and abuse are confused upon interpretation since the definition in National Healthcare Insurance Law is unclear, and it affects closely to the administrative measures such as surcharge levy by the period of inspection, therefore, the disputes continue in the forms of formal objection, administrative ruling and administrative litigation. This study aims to look over the legal problems on application of criminal fraud toward the abuse of 'Paid Medical Expenses(Article 57, Sections 1 and 4 of the National Health Insurance Act)'. The main issues are concept of abuse(Article 57, Sections 1 and 4 of the National Health Insurance Act), the problems of Directions of Health-Welfare Ministry on aspect of 'Nullum crimen sine lege' Principles, the proper sentenc-ing guidelines of fraud.

• The Korean Journal of Emergency Medical Services
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• v.26 no.1
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• pp.119-127
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• 2022

Purpose: This study aimed to examine the necessity of administrative compensation insurance and claims cases during the emergency medical service process among administrative compensation insurance cases and suggests problems and improvement measures. Methods: We compared the details of administrative compensation insurance claims of 15 cities and provinces, excluding Seoul and Kwangju, from 2017 to 2020 by requesting details disclosure of the comprehensive deduction for administrative compensation in 17 cities and provinces across the country. Results: A total of 69 cases were compensated through the administrative comprehensive compensation deductions. There were 53 cases of damage that occurred at the field stage, 14 cases at the transfer and hospital stage, and two other cases. Conclusion: The 119 paramedics, which are the perpetrators, should be active in field activities and free from the psychological pressure caused by increased workload and litigation. Active compensation administration is required for damage cases occurring in the firefighting activities context.

• Journal of Arbitration Studies
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• v.26 no.4
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• pp.129-149
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• 2016

Medical dispute means the dispute between the hospital and the patient due to a medical accident. In general, medical accidents must be in accordance with the terms that are used in the medical dispute adjustment method stated in Article 2 (definition). In relation to this, there is a need to discuss an efficient operation scheme for Alternative Dispute Resolution (ADR) in medical disputes. In addition, it is necessary to look at issues of civil liability and criminal liability. In particular, in the consumer dispute arbitration committee, there is a case to make a "decision not to adjust" in aggressive intervention in the process of conflict resolution. The medical staff, on the basis of its "decision," can use this as a proven material for civil and criminal cases. This is rather upon the determination of the consumer council as a typical side effect to defend the user's perspective. This is the "decision" as was expressed from an order, "not adjusted." It is also determined to be easy and clearly timely. In the medical litigation, it is requesting the burden of proof of a patient's cause-and-effect relationship with the doctors committing negligence and medical malpractice. This seems to require the promotion of legislation in the direction to reduce future cases. It is determined that the burden of proof of medical accidents must be improved. The institution receiving the medical accident should prevent a closure report. Further, it is necessary to limit the transition to a franchise point. In this paper, we understand the problems of the current medical dispute resolution system, trying to establish a medical dispute resolution system desirable through an efficient alternative. In addition, it wants help in the protection and realization in medical consumers' and patients' rights. The relevant authorities will take advantage of these measures. After all, this could contribute to the system for a smooth resolution of a medical dispute.

• The Korean Society of Law and Medicine
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• v.13 no.2
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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.