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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.

의료과오소송에 있어 과실이란 일반적으로 ‘일정한 결과가 발생한다는 것을 알고 있어야 함에도 부주의, 즉 주의를 게을리 하였기 때문에 이를 알지 못하고 어떤 행위를 하는 심리상태’를 의미한다. 따라서 과실의 본질은 주의의무 위반이 되고, 주의의무의 위반이 곧 과실이라는 명제가 성립한다. 그러나 이러한 과실의 개념은 주의의무의 위반이라는 추상적, 규범적 판단에 기초를 두고 있으므로 확고한 것이 아니고, 시대에 따라, 장소에 따라, 또는 소송의 형태에 따라, 담당법관에 따라 과실의 존부나 범위가 달라질 수 있다. 이 논문에서는 ‘의료과오소송에서 무엇을 의료과실, 즉 의사의 주의의무 위반이라고 할 것인가’라는 규범적 가치판단의 문제에 대하여 먼저 의료과오소송의 성격이 전문가 책임소송의 한 형태라는 점에서 의사는 비록 의료행위의 특성상 비계약적 요소가 포함되어 있기는 하나 의료계약에 기초하여 주된 의료급부의무 이외에도 신의칙상 부수의무로서 환자에 대한 보호의무를 부담한다고 보아 의료과실이란 의사의 환자에 대한 보호의무 위반이라고 규정하였다. 그리고 이에 기초하여 최근의 의료과실에 대한 입증책임 완화시도와 관련하여 법원의 입장에서 실제 사례를 둘러싸고 원고 측이 어떠한 구체적 사실을 주장, 입증한 경우에 의료과실의 존재를 인정할 것인지 여부에 대한 구체적인 판단기준 및 그에 대한 문제점을 살펴보았다.

In a medical malpractice suit, negligence generally means ‘the mental state of acting in a certain behavior due to lack of attention, even though he or she should be aware that such result would happen’. Thus, the essence of negligence is a nonperformance of an obligation to be attentive, and a nonperformance of an obligation of attention is negligence. However, since the idea of negligence is based on abstract and normative judgment, it is not a solid concept, which can be changed in existence or range from time, place, form of suit, and the judge in charge. In this thesis, to the problem that ‘what is a medical negligence, in other words a nonperformance of an obligation of attention for a doctor in a medical malpractice suit’, since the suit is a form of suits to be based on expert responsibilities, doctors, though having factors that are non-contractual as a trait for medical treatment, should have the responsibility of protection for the patients as a subordinate duty due to a principle of faith and sincerity besides the main duty for medical contract-performance. Further on the concept, whether the court should approve of medical malpractice in real cases when the plaintiff asserts, and proves a specific fact from the recent moderation of the burden of proof about medical malpractices has been discussed.

Nowadays it is important for us to resolute medical disputes. Because a high incidence of medical accidents may be brought about according to many chances of treatment in the operation of health insurance and increasing concern of patient health. Patients and medical doctors have plenty of difficulty in uncomfortable treatment circumstances of a high incidence of medical accidents. It is especially desirable that our society should prevent medical accidents and resolute speedy, fairly and rationally the happened medical disputes. Many legislations were suggested to resolute medical dispute. But legal issue points stress only speedy medical dispute resolution procedure and don't compromise fair and professional procedure. Accordingly these legal arguing points had not been accepted by the National Assembly and people. If the speedy resolution of medical dispute was demanded to solve unsafe treatment circumstances, it is necessitated that the legislation containing legal issue points to procedure is enacted. Of course the interest of patients and doctors to legal issue points must be balanced. Because an arguing points to the reversal of proof burden is consisted of the entity judgement in connection with setting the basis of resolution of medical dispute, the legislation to these is checked carefully.

Recently the Supreme Court held that “in cases in which a patient suffering from a mental disorder attempts to commit suicide, fails, and then succeeds in a subsequent attempt, the following circumstances must be present in order to acknowledge reasonable causation between the negligence of the hospital with regards to taking care of the patient and the death of the patient; there must have existed negligence on the part of the hospital with regards to their failure to stop the 1stsuicide attempt, injurious aftereffects must have been caused to the patient by the1stsuicide attempt, and said aftereffects must have been the main cause for the 2nd successful suicide attemtp” This, in effect, lessens the requirements of past holdings of the Supreme Court which held that “to acknowledge reasonable causation between the negligence of the hospital and the patient that commits suicide, the patient must have experienced such severe physical and mental suffering from the previous attempt so that they could not help but choose to commit suicide”. The fact that the Supreme Court did not clearly state such changes in their view on this matter should be corrected. Also, the fact that the court only held the hospital liable for damages of less than 50 million won, only calculating damages up to the point when the deceased passed, is inadequate compared to other cases and should be corrected.

Current crown law punishes crime related to unborn child with abortion crime. So we might think that any infringement on unborn child is pretty well protected. But, in terms of illegal abortion, a charge of injuring person and homicide, there are lots blind spots in punishing criminals. Especially, there are numerous unclear cases in illegal abortion. If a doctor killed an unborn child by accident in medical operations, we can't punish him because it was an accident. There still exist controversial cases such as, if an unborn child was somehow damaged and was dead after birth, or was born with disabilities, how are we supposed to punish that? Recently, in a case where a doctor left alone a mother who had a baby and the baby died, our Supreme Court of Korea (Supreme Court of Korea 2007.6.29 2005do 3832) had given a verdict of "not guilty". It looked like they were very fair with current crime law. But, we want this case to be investigated if there weren't any logical contradictions as well as concurrent translation within Constitution Law.

Im sog. Kemptener-Fall aus dem Jahre 1994 in Deutschland hat der 1. Strafsenat des BGH die Bedeutung des Patientenwillens erstmals für einen solchen Fall hervorgehoben, in dem die Krankheit noch keinen irreversibel tödlichen Verlauf genommen hat. Der 1. Senat des BGH entwickelt aus den Prämissen, die er in drei Leitsätzen festhält, schlüssig und im geläufigen Modus der Dogmatik eine Begründung, die gleichwohl den weitaus überwiegenden Teil der eigentlichen Probleme des Falles nicht einmal sichtbar genacht, geschweige denn einer Lösung nähbar brächte. Die Leitsätze formulieren rechtliche Prinzipien, beziehen aber unvermeidlich zugleich und selbstverständlich Stellung zu einigen der schwierrigsten und ungelösten ethischen Fragen der modernen Medizin. Im sog. Kemptener-Fall brachte die Lösung des Senat für Mediziner, Ethiker und Juristen keine befriegende Lösun, sondern allein zahlose Zweifel und Unklarheiten. Denn dabei geht es nicht um moralisch unerwünschten Ergebnis der Rechtsanwendung im Einzelfall. Vielmehr hat die moderne Medizin für den ärztlichen Eintscheidungsbereich zwischen Leben und Tod einen Typus professionellen Alltagshandelns gebracht. Deshalb ist es eine Illusion, wollte man von der strafrechtlichen Dogmatik befriegende Resoltate erwarten. Trotzdem kann man nicht die dogmatische Untersuchung aufhören, weil eine Gesetzgebungslehre oder eine Strafrechtspolitik von den dogmatischen Probleme ausgehen muss. In diesem Hintegrund im Beitrag wurde dieser Fall durch kritische Auseinandersetzung strafrechtsdogmatisch zu begründen versucht, Dabei wird die Interessenabwägung zwischen Lebens- und Sterbensinteressen als der Rechtfertigungsbegründung beim tödlichen Behandlungsabbruch vertreten.

의료사고에 있어서 의사의 과실을 인정하기 위해서는 의사가 결과발생을 예견할 수 있었음에도 불구하고 그 결과발생을 예견하지 못하였고 그 결과발생을 회피할 수 있었음에도 불구하고 그 결과발생을 회피하지 못한 과실이 검토되어야 하고, 그 과실의 유무를 판단함에는 같은 업무와 직무에 종사하는 일반적 보통인의 주의정도를 표준으로 하여야 하며, 이에는 사고당시의 일반적인 의학의 수준과 의료환경 및 조건, 의료행위의 특수성 등이 고려되어야 함. 이러한 원칙은 당직근무중 발생한 의료사고에서도 예외없이 적용됨. 다만, 당직 근무라는 특수성으로 인하여 어떤 의사이든지 간에 평상시와 같은 의료수준에 적합한 모든 진단, 치료방법을 동원하고 시설을 이용하여 진료실행시에 기술적 주의를 다하는 등의 행동을 하기가 곤란하고 사회관념상으로 기대하기 어려움. 이러한 관점에서 당직의료인 관련 대법원판결을 살펴보면, 당직근무중 발생한 의료사고에 대하여 그렇지 아니한 의료사고에 비하여 사고당시의 일반적인 의학의 수준과 의료환경 및 조건, 의료행위의 특수성 등을 더 고려하여 업무상과실유무를 판단하고 있는 것으로 보여지고, 당직의료인에서도 특히 응급 당직의료인은 병동 당직의료인 보다 의료행위의 특수성을 더 인정하고 있는 것으로 판단된다.

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.

As a withdrawing care's study, the purpose of this study is searching about withdrawing care's acceptance and circumstances through Bora-mae hospital case(chapter 1). Withdrawing life-sustaining treatment has various forms. Though the meaning of euthanasia, death with dignity, natural death, physician assisted suicide are duplicated, the meaning of those are different slightly. Firstly, this study looks about the difference of the those meaning and acceptance range(condition) by withdrawing care's forms(chapter 2). Bora-mae hospital case sentenced guilty about physician who discharged incompetent patient who was after surgery by patient's wife determination. This Bora-mae case that sentenced guilty about discharge against medical advise(DAMA) that is regarded to custom has brought intensive confliction of legal, social, medical aspect, Bora-mae hospital case has many legal problems. First, as to criminal law rule 250(murder), the problem is whether discharge and withdrawing life-sustaining treatment is commission or omission. this study concluded omission(district court: omission, appeal, supreme court: commission). Because legal denounce point of discharge and medical treatment withdrawing is omission that physician who is obligatory on patient to cure. If physician's act is regarded omission, it is necessary to determine whether he has guardian status and obligation. Without guardian status and obligation, omission crime can't exist. This study decided that physician had guardian status and obligation and foundation of guardian status was pre-action or acceptance of emergency patient. Physician's medical treatment duty finished when patient(or patient's guardian) demands discharge. But when patient death is foreseen and other possible treatment does not exist, his duty of life prolonging treatment does not finish. This originate from physician's social responsibility and public status that limits patient's private liberty. This study regarded physician's action as accomplice about whether physician's discharging action is accomplice or the principal offender(district court: the principal offender, appeal, supreme court: accomplice). Though the principal offender needs criminal determination and action, there is no this common determination and functional action control of physician in Bora-mae case(chapter 3). Bora-mae hospital case partly originated from deficiency of legal, institutive system including medical security system shortage, the instruction is 1. medical security system strengthening, 2. hospital ethical committee's activity strengthening, 3. institutionalization of withdrawing life-sustaining treatment, 4. acceptance of pre-decision making system, 5. sufficient persuasion of physician for patient and faithful writing of medical paper, 6. respect for patients' self-determination and rights, 7. consciousness's changing for withdrawing life-sustaining treatment and persistent education about medical ethics(chapter 4). Considering Bora-mae case, medical sector is not the dead ground of a criminal punishment. Intervention of criminal law in medical sector give rise to ill effect, that is, excess medical examination and treatment, safeguard treatment, delay of discharge from a hospital. Because sufficient guarantee of life becomes mere empty slogan under situation that impose a burden of heavy cost to family or hospital, public and systematic solution should be given(chapter 5).

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.

The right to live is the most valuable benefit and protection of the law. And Medical science is the study considering value of life as the top priority. As modern medical science has progressed and expanding lifespan skills have developed, the number of symptom, called a human vegetable, has been also increased. As a result, people concerns whether euthanasia should be permitted. ① Active euthanasia is prohibited and a doctor who conduct it is punished. ② Indirect euthanasia can be permitted unless it is against a patient's intention. ③ Permission of passive euthanasia depends on intention of a patient. In other words, when a patient accepts, a doctor respects the right of self determination of patient and irreversible situation such as brain death happens, treatment stop is permitted. Even a patient who is in the last stage of cancer has a right to die in the dignity and elegance. Solutions for ceasing medical treatment are as follows; First, establishment of 'Bioethics Committee'. Second, setting procedures to empower a court a right to decide whether medical treatment is ceased. Third, setting procedure a government to assist treatment fees. In this paper, direction for social agreement of legal policy regarding the ceasing treatment is provided.

Aesthetic plastic surgery rarely has the lifesaving, the medical necessity, and the emergency, because it was executed in order to acquire personal satisfaction in the external features. In addition, aesthetic plastic surgery has the strong commerciality in that it is based on the attraction of a client through medical advertisement and the range of uninsurance. These characteristics cause whether aesthetic plastic surgery is included in medical procedure and the legal contract between physician and client is controversial issue. Also, attention and explanation in aesthetic plastic surgery are more emphasized than those in general medical procedure. According, this document presents the various characteristics of aesthetic plastic surgery, which differs from that of general medical procedure.