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This thesis introduces the trends of korean courts' ruling on damages in medical malpractice cases for past 10 years. First of all, Korean courts' ruling have had a tendency to pay only non-economic damages for not taking the informed consent. If a doctor cannot get the informed consent from a patient, he compensate only non-economic damages for the infringement of self-determination rights of patient. It's enough for the plaintiff to prove the infringement of self-determination rights, if the plaintiff just want to get non-economic damages. The Korean Supreme court have ruled that if plaintiffs want to get economic damages for the infringement of self-determination rights or informed consent, plaintiffs must prove that the infringement of self-determination rights is the proximate cause of the economic damages of patient. There is another tendency for the Korean Supreme court to limit the damages in medical malpractice cases on the ground of patient's diseases' dangerousness or patient's idiosyncrasy. In the past courts often limit the damages only to 70~80% of total damages, but now a days courts mostly limit the damages to 20~30%. This thesis also introduce the Korean courts' trends about Valuing damages in personal injury actions awarded for gratuitously rendered nursing and medical care.

Korea has gained the much more performances in the fields of pubic health laws and related policies on the basis of the substantial economic achievements. In 1977, the social medical insurance was established for companies with more than 500 employees, and in 1989, Korea successfully achieved the national medical insurance system covering the total population within only 12 years beginning with multiple insurers. There remained some problems, however, to be improved such as both the low level of contribution rates and benefit packages due to the inefficiency in utilizing limited medical resources. In 2000, all insurers were unified into a single insurer(National Health Insurance Corporation), and special independent Health Insurance Review & Assessment Service(HIRA) was also established. From the origin of medical insurance system in 1977, the Korean reimbursement system has been fee-for-service system, and after the establishment of HIRA, it has been providing objective and expert medical cost review services and health quality assessment services.

In this paper, the Judgment 2007DA76290 of the Korean Supreme Court was analysed in two points of the legal theory and litigation. The judgment arouses some issues of medical malpractice liability. They includes the concept of the complications and permanent lesion and the difference between them, some problems in a judge's applying the requirements for the physician's tort liability to the medical malpractice situations, the theory of obligation de moyens related with the burden of proof of the negligent conduct for a physician's liability for misperformance of contract, the influence of a patient's physical conditions on the physician's liability, the breach of duty to disclose in selecting the safer one of the treatment methods bringing about the complications or leaving the permanent lesion and so on. In the situations of the case referred to above, the plaintiff should have tried to establish that a reasonable physician in the specific situation of the case would have substituted the safer method of treatment for the method in the case. If the plaintiff had succeeded in establishing it, he or she could have recovered even the physical harm resulting from the permanent lesion brought about by the complications of the specific treatment in the case. The plaintiff failed to do so and recovered only the emotional distress which the patient suffered owing to the physician's breach of the duty to disclose. Therefore the legal malpractice of the counsel might be found in this case.

The Article 17 (1) of the Medical Service Act states that no one but medical doctor, dentist or herb doctor shall prepare medical certificate, post-mortem examination, certificate or prescription. Though medical certificate, post-mortem examination or certificate is a private document issued by doctor personally, it is accepted as reliable as public document. Therefore, for medical certificate, post-mortem examination or certificate, unlike other private document to guarantee authenticipy of the content, the Article 233 of the Criminal Act states the Crime of Issuance of Falsified Medical Certificates. In other words, the Criminal Act Article 233 states that If a medical or herb doctor, dentist or midwife prepares false medical certificate, post-mortem examination or certificate life or death, one shall be punished by imprisonment or imprisonment without prison labor for not more than three years, suspension of qualifications for not more than seven years, or a fine not exceeding thirtht million won. The subject of the Crime of Issuance of Falsified Medical Certificates is only a medical or herb doctor, dentist or midwife and the eligibility requirements are specified in the Medical Service Act. Medical certificate is the medical document to be issued by medical doctor to certify the health status and show the Jugdement about the result of the diagnosis, Post-mortem examination is the document to be listed by medical doctor to confirm medically about human body or dead body, and Certificate life or death is a kind of medical certificate to verify the fact of birth or death, the cause of death, such as Birth Certificate, Certificate of Stillbirth or Certificate of Dead Fetus. To constitute the crime of Issuance of Falsified Medical Certificates, it is necessary for the contents of the certificate to be substantially contrary to the truth, as well as it is needed the subjective perception that the contents of the certificate are false. The Supreme Court Decision 2004DO3360 Delivered on March 23, 2006 declared that although the Defendant did not MRI scan, etc. for precise observation about the disability status of Mr Park, it was difficult to believe that the contents of the Disability Certificate of this case were contrary to the objective truth or the defendant had perception that the contents of the certificate were false. I don't agree with the Supreme Court Decision, because the Supreme Court confirmed the decision by the court below despite the Supreme Court should have made the court below retry the reason why the Defendant did not MRI scan, etc. for precise observation about the disability status of Mr Park.

Im koreanischen Gesundheitsversicherungssystem spielt die soziale Solidarität Hauptrolle bei unterschiedlichen gesundheitspolitischen Entscheidungen. Daher wird manchmal vernachlässigt, dass auch die Qualitätsverbesserung der Medizin und der Umfang der von der Krankenversicherung unterstützten medizinischen Leistungen wichtige Elemente der Krankenversciehrung sind. Um die letztere zwei Ideologien zu verwirklichen, soll insbesondere das Prinzip der Konkurrenz funktionieren können. Aber im koreanischen System hat die Konkurrenz fast gar kein Platz für sich. Auch das deutsche GKV(Gesetzliche Krankenversicherung)-system versucht die Sozialversicherung zu sein. Aber den deutschen Krankenversicherungssystem sieht es-speziell mit dem Vergleich vom Koreanischen- zumindest viele unterschiedliche Funktionssysteme immanent zu sein. Zum einen tendiert die Einführung des Gesundheitsfonds und vom Einheitlichen Beitragssatz die Sozialsolidarität zu verstärken. Zum anderen tragen aber die Systeme von Zusatzbeitrag, Prämien und Wahltarife dazu bei, bessere Qualität der medizischen Leistungen zu garantieren und die Präferenz von Patienten ernst zu nehmen. Es ist zwar nicht einfach vorauszusagen, zu welchen Ergebnissen diese Elementen führen. Aber die Funktion der unterscheidlichen Elementen, die die Konkurrenz motivieren können, zeigen schon viele Andeutungen für die Veränderung des korenischen Systems.

Im Allgemeinen auch psychische Patienten können sich darüber selbst entscheiden, ärztliche Behandlung zu nehmen und ins Krankenhaus aufgenommen zu werden. Im Südkorea bei der zwangsweisen Unterbringung wird kein KBGB des privatlichen Rechts, sondern Gesetz über psychisch Gesundheitspflege des öffentlichen Rechts vorzüglich verwandt. Aber das noch kann ein selbst Bestimmungsrecht von der psychischen Patient verletzen. Im Deutschland regelt BGB § 1906 Zwangsunterbringung der psychische Patienten, die Gefähr des Selbstmord oder der Eigengefährdung haben. Außerdem hat jedes Land eigen Gesetz über psychischen Kranken, das öffentliche Vorschrift für Zwangsunterbringung regelt. Im Fall der Zwangsunterbringung im Deutschland BGB § 1906 wird primärer als öffentlich Rechts verwandt, um die Selbstbestimmungsrecht der Patienten zu unterstützen. Auch im Korea KBGB(koreanisches Bürgerliches Gesetzbuch) Veränderungen für die Einführung des Betreuungsrechts, die sich mit der Zwangsunterbringung befassen, sollten diskutiert werden, damit die Selbstbestimmung schätzen.

It is the so-called Shinchon Severance Hospital Case brought to an end by the decision of the Supreme Court that opened the real discourse of withholding or withdrawing of LST(Life-Sustaining Treatment) in the legal profession as well as medical profession in Korea. Everyone has sympathy with the validity and necessity of legal regulation on withdrawing-including withholding-of LST save the requirements & procedure of withdrawing of LST. In this situation, the legislative bill of amendment to the Korean Civil Law introducing of adult guardianship was pre-announced by the Ministry of Justice on September 18th 2009. The adult guardianship is a guardianship system that supports an mentally handicapped adult to deal with his affairs by support of a guardian. The object of adult guardianship includes affairs of body or well-being as well as property of adult wards. In particular, affairs of medical matters are of importance in the duty and authority of adult guardians. So, the introduction of adult guardianship is of much importance de lege lata as well as de lege ferena in the discussion of withdrawing of LST as a medical treatment. Since the legislation on withdrawing of LST intents to protect the right of death with dignity on the basis of patients' autonomy, the ratio legis of withdrawing of LST is variant from that of adult guardianship. In this context, it seems reasonable to legislate the withdrawing of LST separately from the adult guardianship. In the meantime, the adult guardianship of the legislative bill of amendment to the Korean Civil Law is related to the withdrawing of LST, since the main purpose of adult guardianship is to protect patients' quality of lives and to regulate guardianship contracts based on patients' autonomy. In that context, it seems reasonable to incorporate the legislation of withdrawing of LST into the adult guardianship system. In the latter case, it is not easy to adopt the withdrawing of LST into the legislative bill of the Korean Civil Law for the bill is pre-announced already as previously stated. However, the legislation of withdrawing of LST is not inferior to the legislation of adult guardianship as a matter of urgency. Moreover, it is likely that the legislative bill of Amendment to the Korean Civil Law generates discrepancies in interpretation of the requirements & procedure of withdrawing of LST as the amended German Civil Law did. In short, it is desirable for the legislator to revise the legislative bill despite delay.

Die ärztliche Behandlung des Patienten durch den Arzt geschieht im Rahmen eines Rechtsverhältnisses. Das Arzt-Patienten-Rechtsverhältnis stellt regelmässig der Arztvertrag oder Behandlungsvertrag dar. Arzt und Patient schliessen einen Arztvertrag ab. Grundsätzlich verbindet der Arztvertrag die Partner persönlich. Aber minderjährige Patienten sind geschäftsunfähig oder in der Geschäftsfähigkeit beschränkt. Minderjährige Patienten vermögen also allein grundsätzlich keine wirksamen Willenserklärungen abzugeben und somit keine wirksamen Arztverträge zu schliessen. Arztverträge von minderjährigen Patienten sind nur bei Einwilligung der gesetzlichen Vertreter wirksam. Vom Abschluss des Arztvertrags ist deutlich die Einwilligung zur Behandlung zu unterscheiden. Die Einwilligung ist kein Rechtsgeschäft. Die Einwilligung durch die Eltern erfolgt nur solange der minderjährige Patient nicht reif genug ist, die Entscheidung selbst zu treffen. Jugendlicher Patient ist z.B. in der Lage, die Einwilligung selbst zu geben, sofern er Wesen, Bedeutung und Tragweite der Behandlung zu verstehen vermag. Der Vorschriften des KBGB zur Geschäftsführung ohne Auftrag gelten, wenn der Arzt einen Bewusstlosen versorgt. Nach §734 KBGB erfolgt die Geschäftsführung ohne Auftrag dann zu Recht, wenn sie dem Interesse und dem wirklichen oder mutmasslichen Willen des Patienten entspricht. Der Patient kann aus einem Ausland stammen. Für ausländische Patienten gilt generell das koreanische Recht. Grundsätzlich sollte man einen des Koreanischen nicht mächtigen Ausländer nach Möglichkeit in seiner Sprache aufklären und dann den Arztvertrag abschliessen. Aufgrund der Privatautonomie kann jeder Patient frei entscheiden, ob, mit wem und worüber er einen Arztvertrag abschliesst. Deswegen ist auch der Wille des Anhängers vom Sekten und abweichenden Lebensauffassung grundsätzlich zu berücksichtigen. Zum Beispiel handelt der Zeuge Jehovas auf eigene Gefahr, wenn er eine notwendige Behandlung ablehnt. Aber die Freiheit, eine gebotene Behandlung abzulehnen, kann in Konflikt mit dem Schutz des minderjährigen Patienten gelangen. Sobald die sektiererische oder abweichende Haltung droht, einen minderjährigen Patienten zu gefährden, hat das elterliche Sorgerecht einzuschränken.

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.

According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that ‘the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.’ In addition, the Supreme Court admits that ‘only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.’ Furthermore, the Supreme Court finds that ‘if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.’ The Supreme Court also finds that ‘if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.’ This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

This paper is to discuss essential business of hospital business. While the labor world and ILO made continuous recommendation for improvements towards the compulsory arbitration system along with the controversy over unconstitutionality of the system, the Constitutional Court ruled that the system is constitutional on December 23, 1996(90hunba19) and on May 15, 2003 (2001hunga31). Despite this decision from the Constitutional Court, there has been much controversy over whether the compulsory arbitration system infringes the rights of collective action against the principle of trade union & labor relations adjustment which allows Commissioner of the Labor Relations Commission to decide on submission of arbitration by virtue of his/her authority in case where industrial disputes take place in the essential public-service businesses. The revision on the above provision was closely examined from the year 2003 and an agreement was made on the abolition of the compulsory arbitration system and the introduction of essential business with a grand compromise among labor unions, employers and the government on September 11, 2006 followed by revision(Essential business system enacted on January 1, 2008) of the Trade Union & Labor Relations Adjustment Act on December 30 in the same year. Accordingly, in order to perform the essential business, parties to labor relations must have an agreement or obtain a decision by the Labor Relations Commission before taking industrial actions. This paper firstly examined the concept of essential public-service businesses and essential business, legal meaning of essential business, procedures for making agreement and decision and legal effects. Secondly it intensively explored a theory against the principle of the legality which was raised from some part of society. In other words, it is claimed that a theory against the principle of the legality is not consistent with the rule of legislation and some abstract wording is against void for vagueness doctrine because part of crime constitution requirements is delegated to the Presidential Decree or to consultation among parties to labor relations. But analysis on the rule of legislation and void for vagueness doctrine reflected in the decision by the Constitutional Court led that argument for a theory against the principle of the legality is not reasonable. Close examination was done on a formal act of essential business agreement and necessity of prior agreement before submission of decision to the Labor Relations Commission which might have difficulties in performing work. In addition, an example agreement on hospital essential business is attached to help you understand this paper better.

ennzeichnend für die ärztlichen Tätigkeiten, wenn Konflikte in medikamentösen Behandlungen auftreten, passiert es oft, dass es wegen unnötigen Missverständnissen oder Mangel an Verständnis zwischen Arzt und Patient als extremes Phänomen zum impulsiven Strafprozess oder physischer Gewalt von Seite des Patienten kommt. In diesem Falle verteidigt sich der Arzt mit Schutzbehandlung und Behandlungsablehnung um die Folgen der ärztlichen Behandlung zu entweichen. Es ist dadurch auf beiden Seiten, Arzt und Patient, eine schwierige Sache. Denn der Versuch solche Fälle in Konflikten durch Zivilklage zu klären, ist die Beweisführung des Patienten und die dadurch in Länge gezogene Anklage meist durch die ärztliche Fachlichkeit und Behutsamkeit nicht wirklich möglich. Infolgedessen ist es nötig alternative Streitbeilegungsmethoden wie Schlichtung, Regelung oder Vermittelung einzuführen, anstatt von Gerichtsverfahren. Konflikte in einer ärztlichen Behandlung sind für den Patienten und auch für den Arzt eine Plage, denn physischer und geistiger Schaden wird dadurch verursacht. So ist eine schnelle Einführung vertrauenswürdiger Methoden in diesem Bereich notwendiger als in anderen. In diesem Aufsatz wird eine mögliche Einführung von einer passenden alternativen Beilegung von Rechtsstreitigkeiten in Südkorea und ein Plan zur Aktivierung von dieser vorgeführt. Derzeitig wird in Deutschland als Alternative für Anklagen in den jeweiligen Bundesländern die von den Ärztevereinen erstellten und beaufsichtigten Schlichtungsstellen und Gutachterkommission in Rat genommen. Schließlich sollten wir aufgrund der vorliegenden Fakten und die Vor-und Nachteile dieser Schlichtungsmethoden auffassen und als Vorbild unserer anwenden und versuchen diese in Aktion zu bringen.

This study aims to review legal problems of similar medical practice and suggest methods of improvement. Similar medical practice refers to all medical practices conducted in the state that human qualification is not fulfilled. It may cause serious damages on health and lives of national people. Currently, similar medical practices are recognized as unlicensed medical practices and prohibited based on the Medical law and additionally punished by then special law in Korea. However, the current Medical Law does not provide clear and accurate concept of medical practices so that it is difficult to regulate similar medical practices. The issue of complementary and alternative therapy related to similar medical practices is also in special state different from other countries. In addition, since similar medical practices lack of evidences in terms of safety, the dangerousness of accidents is high and it may affect badly on health of national people and health care policies. Methods of improvement in order to resolve problems regarding similar medical practices are: first, concept and scope of medical practice should be clear, accurate and concrete. Second, complementary and alternative therapies related to similar medical practices need to be strictly examined and the supervisory right should be given to doctors should be given even though a part of it is allowed. Third, research institutes specialized in the field should be established for scientific examination of complementary and alternative therapy and objective research results should be open to the public. Finally, since damage cases caused by similar medical practices by non-medical personnel, national management and supervision for similar medical practices should be reinforced.

(Background) Recent biotechnological breakthroughs are shedding new lights on various ethical and legal issues about human biological material. Since Rudolph Virchow, a German pathologist, had founded the medical discipline of cellular pathology, issues centering around human biological materials began to draw attention. The issues involving human biological materials were revisited with more attention along with series concerns when the human genome map was finally completed. Recently, with researches on human genes and bioengineering reaping enormous commercial values in the form of material patent, such changes require a society to reassess the present and future status of human tissue within the legal system. This in turn gave rise to a heated debate over how to protect the rights of material donors: property rule vs. no property rule. (Debate and Cases) Property rule recognizes the donors' property rights on human biological materials. Thus, donors can claim real action if there were any bleach of informed consent or a donation contract. Donors can also claim damages to the responsible party when there is an infringement of property rights. Some even uphold the concept of material patents overtaking. From the viewpoint of no property rule, human biological materials are objects separated from donors. Thus, a recipient or a third party will be held liable if there were any infringement of donor's human rights. Human biological materials should not be commercially traded and a patent based on a human biological materials research does not belong to the donor of the tissues used during the course of research. In the US, two courts, Moore v. Regents of the University of California, and Greenberg v. Miami Children’s Hospital Research Institute, Inc., have already decided that research participants retain no ownership of the biological specimens they contribute to medical research. Significantly, both Moore and Greenberg cases found that the researcher had parted with all ownership rights in the tissue samples when they donated them to the institutions, even though there was no provision in the informed consent forms stating either that the participants donated their tissue or waived their rights to ownership of the tissue. These rulings were led to huge controversy over property rights on human tissues. This research supports no property rule on the ground that it can protect the human dignity and prevent humans from objectification and commercialization. Human biological materials are already parted from human bodies and should be treated differently from the engineering and researches of those materials. Donors do not retain any ownership. (Suggestions) No property rule requires a legal breakthrough in the US in terms of donors' rights protection due to the absence of punitive damages provisions. The Donor rights issue on human biological material can be addressed through prospective legislation or tax policies, price control over patent products, and wider coverage of medical insurance. (Conclusions) Amid growing awareness over commercial values of human biological materials, no property rule should be adopted in order to protect human dignity but not without revamping legal provisions. The donors' rights issue in material patents requires prospective legislation based on current uncertainties. Also should be sought are solutions in the social context and all these discussions should be based on sound medical ethics of both medical staffs and researchers.