日韩医患纠纷非诉讼化解机制及其对中国的启示

李志行(Lee, Ji-Haeng),毛??(Mao NeNe) 동북아시아문화학회 2020 동북아 문화연구 Vol.1 No.62

The social and cultural backgrounds of China, Japan and Korea are similarities. Therefore, there are many and references in social governance. The Japanese Medical Doctors Association has established a system of professional liability insurance, and the association would participate in the mediation if the medical disputes have generated. On the other hand South Korea has established a Medical Dispute Mediation and Arbitration Agency. What’s more, both countries have achieved good dispute resolution effects in the practice of ADR systems and formed a standardized for the medical dispute handling mechanism, so the doctor-patient conflict performance is not very intense. This paper analyzes the successful experience of Japan and South Korea in dealing with medical disputes. Especially the non-litigation method to resolve medical disputes and analyzes the main problems existing in the current medical dispute resolution mechanism and methods in China. This essay found that influenced by the traditional methods, the ADR mechanism in China, Japan and Korea has distinctive differences on its demand, way of formation and mechanism, etc, through the analysis of the formation and development of ADR mechanism in medical disputes. Specifically, ADR mechanism has been massively influenced by its traditional mediation system, which leads to a further transformation from traditional mediation to modern legislation. In Korea, ADR mechanism ‘s development indicates that the pressure of litigation is greatly promoting the special legislation, while in China, the process of adopting ADR mechanism shows that conflicts is pushing the system construction. Therefore, comparing these three countries’ ADR mechanism, China is supposed to improve its ADR mechanism from these four aspects: First, build up and improve the legislation about ADR mechanism and clear the specifications of ADR resolving procedures. Second, set up ADR special institutions to settle extralegal issues authoritatively, professionally and appropriately. Third, improve the supporting mechanism resolving medical disputes outside the litigation so as to establish a smooth channel for resolving medical disputes outside the litigation. Fourth, complete complementary amount regulations to institutionalize the settlement of medical disputes outside the lawsuit. Medical disputes in China, Japan and Korea shows different characteristics. Meanwhile, the promotion, leading agency, resolving procedures and resolving effect of their resolving mechanism outside the litigation also have distinctive differences. It’s necessary to summarize, develop and complete ADR mechanism by clarifying and analyzing why these differences exist based on the comparison and learning from the different features of medical disputes in China, Japan and Korea, which greatly inspires other countries on how to settle medical disputes and further promotes the relationships between doctors and patients.

사례연구 : 사례연구를 통한 소송이외의 의료분쟁 해결방안의 검토와 개선방안

강의성 ( Eui Sung Kang ),김장묵 ( Jang Mook Kim ),성동효 ( Dong Hyo Sung ),목남희 ( Nam Hee Mok ) 한국병원경영학회 2013 병원경영학회지 Vol.18 No.3

Medical litigation, as a method of resolving medical disputes, has been a huge burden on both the patient and medical institution as it is both costly and time-consuming. The Korea Medical Dispute Mediation and Arbitration Agency has created a dispute mediation process as a method of alternative dispute resolution(ADR). Being in its early stage of implementation, there are still areas requiring improvement as some functions overlap with the Korea Consumer Agency`s damage redress and mediation process. This study examines the problems of existing practices in medical litigation while reviewing the mediation process of the two agencies from legal/administrative aspects, and provides an in-depth analysis of the situation through case studies and interviews. While the Korea Medical Dispute Mediation and Arbitration Agency offers many advantages in resolving medical disputes, there must be a distinct division of roles and mutual cooperation with the Korea Consumer Agency. Considering the increasing amount of compensation in medical disputes, medical professionals are being requested to carry medical malpractice insurance. However, this has yet to become a general trend in the medical field despite the growing social demand. As such, the coverage of medical malpractice insurance should be expanded to prevent medical accidents from escalating into medical disputes, thus acting as a social safety net. This study seeks to examine the methods of medical dispute resolution and to allow institutional provisions to reduce the social costs arising from such disputes.

의료분쟁조정절차의 개시요건에 관한 연구

고형석(Ko Hyoung Suk) 원광대학교 법학연구소(의생명과학법센터) 2018 의생명과학과 법 Vol.19 No.-

의료분야에서 발생하는 분쟁을 효과적으로 해결하기 위해 의료분쟁조정법이 제정되었다. 그러나 다른 분쟁조정과 달리 의료분쟁조정은 일방의 신청만으로 개시되는 것이 아닌 피신청인의 동의가 있어야만 개시된다. 이러한 문제점을 해결하고자 2016년에 동법을 개정하여 중대의료분쟁에 한해 일방의 신청만으로 의료분쟁조정은 개시하도록 규정하였다. 그러나 그 이외의 의료분쟁에 대해서는 여전히 피신청인의 동의가 있어야 분쟁조정이 개시된다. 그 정당성에 대해 의료계에서는 원활한 진료보장, 조정신청의 남용 등을 이유로 제시하고 있다. 그러나 동법의 입법취지는 의료라는 전문분야에서 발생한 분쟁을 비전문가인 환자측에서 효과적으로 해결할 수 있도록 함이다. 그럼에도 불구하고 피신청인의 동의를 조정절차의 개시요건으로 정한 점은 의료분쟁의 효과적 해결을 방해하는 것을 합법화하는 것이기 때문에 동법의 입법목적과 일치하지 않는다. 또한 다른 분쟁조정제도에 있어서 피신청인의 동의를 조정절차의 개시요건으로 정하고 있지 않음에 비추어 보더라도 합리적 타당성은 존재하지 않다. 특히, 동일한 의료분쟁을 조정대상으로 하는 소비자분쟁조정의 경우에 일방의 신청만으로 조정절차가 개시된다는 점을 감안한다면 의료분쟁조정위원회의 조정개시요건은 더욱 타당성을 결여하며, 일반의료분쟁에 있어서 한국의료분쟁조정중재원은 조정의 역할을 담당하는 것이 아닌 감정기관으로 전락하게 된다. 이는 의료분쟁이라는 전문분야에서 발생한 분쟁을 전문기관에서 처리하도록 하기 위해 의료분쟁조정법이 제정되었다는 점과 상치한다. 따라서 의료분쟁조정법상 분쟁조정의 개시에 있어서 피신청인의 동의 요건은 삭제할 필요가 있다. 물론 의료계에서 주장하는 일부의 의견은 경청할 필요가 있다. 특히, 감정부의 구성에 있어서 의료인의 비중이 낮다는 점과 한국의료분쟁조정중재원의 조사 등에 대해 협조하지 않았다는 것을 이유로 과태료를 부과하는 점은 의료분쟁조정제도와 일치하지 않으며, 이러한 독소 조항으로 인해 의료인이 의료분쟁조정을 회피하는 주된 이유라는 점을 감안하여 조속한 개정이 필요하다. The Act on Remedies for Injuries from Medical Malpractice and Mediation of Medical Disputes has been enacted to effectively resolve disputes in the medical field. However, unlike other dispute settlements, medical dispute mediation procedure shall be initiated only with the consent of the Respondent, not by a single application. In order to solve these problems, this law was amended in 2016, and medical dispute mediation was set to be initiated only by one-sided application for major medical disputes. However, other medical disputes still require the consent of the Respondent to initiate dispute settlement. The purpose of the legislation is to ensure that disputes in the medical field can be effectively resolved by the untrained patient. Nonetheless, the fact that the Respondent’s consent was established as a requirement for the initiation of the mediation procedure is not consistent with the legislative purpose of the Act, since it would legitimize interfering with the effective settlement of medical disputes. In addition, there is no reasonable justification in light of the fact that the dispute mediation systems do not require the consent of the Respondent to be initiated by the Complainant. In particular, in the case of a consumer dispute mediation that is subject to the same medical dispute, mediation procedure will be initiated only with application of a party. Therefore, a consent requirement of the Respondent is required to be deleted in commencement conditions of medical dispute mediation procedures under the Act on Remedies for Injuries from Medical Malpractice and Mediation of Medical Disputes.

의료분쟁조정법의 특징과 그 개선방안

김영규(Kim, Young-Kyu) 숭실대학교 법학연구소 2013 法學論叢 Vol.29 No.-

의료행위로 의료분쟁이 발생한 경우 소송대체적 분쟁해결제도로서 조정제도의 도입이 요청됨에 따라 오랜 입법의 논의를 거쳐 2011년 4월 7일 의료분쟁조정법이 제정되었고, 이에 따라 2012년 4월 6일 위 법률의 시행령과 시행규칙이 각각 제정되었다. 이에 본 논문은 2012년 4월 8일부터 시행되는 의료분쟁조정법 및 위 법률에서 위임된 명령인 시행령(대통령령)과 시행규칙(보건복지부령)의 주요내용과 특징을 살펴보고, 법률과 명령이 가지고 있는 문제점과 그 개선방안을 검토함으로써 향후 바람직한 의료분쟁해결제도의 정착을 모색하고 있다. 의료분쟁조정법은 의료분쟁의 합리적 해결을 위해 특수법인인 한국의료조정중재원 안에 의료분쟁조정위원회와 감정단을 두고 있고, 조정 외에 중재, 소송에 의한 해결을 같이 도모하고 있다. 특히 이 법은 조정중재원의 의결, 조정절차의 비공개원칙, 감정단의 조사권, 분쟁의 조정과 소송과의 연계, 의료배상공제조합과 전문가책임보험, 불가항력 의료사고 보상, 손해배상금의 대불, 조정성립과 반의사불벌죄의 적용, 벌칙과 과태료 규정 등을 특징으로 한다. 여기에서 보다 바람직한 의료분쟁해결제도의 정착을 위하여는, 입증책임을 의료인에게 전환할 필요가 있다. 또 의료사고 보상을 위하여 ‘분만’ 이외의 의료행위에 따른 의료사고에 대해서도 보상범위를 확대하고 그 기준을 구체화할 필요가 있다. 이 밖에 보건의료인에게 의료배상공제조합에의 가입을 의무화하도록 하고, 조정절차의 비공개원칙을 공개원칙으로 전환할 필요 및 반의사불벌죄와 과태료규정을 삭제할 것이 요청된다. In the case of malpractice by medical care, it needs the adaption of ADR(Alternative Dispute Resolution) to solve the malpractice, therefore, Medical Disputes Mediation Act was established on April 7th 2011. This article mentioned about the main contents and characteristic of Medical Disputes Mediation Act, President of the command, Contents of Legislative notice of Command of the Ministry of Health and Welfare. And this article also analyzed the problems of the laws above and at the same time sought for the solution so that it is helpful to settle Medical Disputes Mediation Act as the solution of medical dispute. According to Medical Disputes Mediation Act there are medical disputes mediation committee and appraised institution in Korea Medical Disputes Mediation and Arbitration Agency which is special corporation. And it is operating for the reasonable resolution of medical dispute which are mediation, arbitration and resolution by litigation. But this law above contains lots of points to be problematic which are the closed principle of decision of Medical Disputes Mediation and Arbitration Agency and conciliation procedures, the connection between mediation and litigation, medical compensation mutual aid and Professional liability insurance, no-fault compensation of medical accident. As the result of analyzation in this article, it is suggested of conversion of the evidence responsibility by patients to health professions, the expansion of no-fault compensation, compulsory admission of medical compensation mutual aid of health professions, conversion the conciliation procedures to open, to remove of the prescriptions of fine for negligence.

의료분쟁조정위원회의 역할조정을 통한 국제진료 활성화 방안

김기홍 한국중재학회 2017 중재연구 Vol.27 No.4

국제진료 진행 시 국내환자와 외국인환자의 진료프로세스를 동일하게 적용해야 할 것이다. 모든 진료행위 과정의 전산의무기록 의무화 및 챠트를 통한 체크리스트를 작성해야 하고 문제발생에 따른 위기관리 대응 매뉴얼을 구축해야 한다. 이러한 과정의 개선은 단순히 위기 대응의 효과 뿐만아니라 진료행위의 효율성과 신속성, 정확성으로 연결되며, 의료진의 교체나 외국인환자의 재방문시에도 수준 높은 진료서비스를 연속해서 제공할 수 있다는 장점이 있다. 국제진료를 위해 외국인환자를 위한 전용 의료상담이 실시되어야 한다. 비영어권 국가의 경우 외국인환자는 진료행위의 모든 과정에서 심리적인 위축과 초초함이 극대화 되어 있기 때문에 부정확한 체크리스트로 인한 의료사고 발생을 초래할 수 있기 때문이다. 따라서 진료행위에 대한 모든 프로세스의 설명이 필요하며, 진료계약서, 의료분쟁에 따른 중재 및 해결절차, 해결방법 등에 관해 외국인환자를 위한 의료상담과 함께 사전에 진료계약이 체결될 수 있도록 해야 할 것이다. In this study, the Commission proposed the mitigation of remedies by improving the role of medical disputes and preventing medical disputes. Medical disputes include a comprehensive description of medical malpractice, medical negligence, medical malpractice, and medical malpractice. Medical negligence refers to the neglect of medical care due to careless medical care in the treatment of patients, leading to patient injury and death. An inappropriate response in the process of international treatment could result in international trials and a decline in international credibility. In cases where medical disputes arise, health care is strictly necessary to determine the truth or absence of medical malpractice, and these expertise and experience are usually provided by emotion. With the neutral and objective emotions provided fairly and impartially, medical care expertise and experience can be fair, and the medical disputes can be resolved peacefully if the parties are trustworthy. The Health Care Dispute Mediation Committee should focus on enhancing the professionalism, objectivity, and reliability of medical care.

의료사고와 의료분쟁에 대한 의료이용자들의 의식 조사

이현실 ( Hyun Sill Rhee ),이준협 ( Jun Hyup Lee ),임국환 ( Kook Hwan Rhim ),최만규 ( Man Kyu Choi ) 한국병원경영학회 2006 병원경영학회지 Vol.11 No.1

According to the available data, in these days, the number of medical accidents and disputes have significantly increased since 1990 in Korea. From this aspect, a variety of approaches and efforts to solve these problems is needed before it is too late. This study intended to identify the thoughts of patients who are directly connected with medical accidents and disputes and then to consider reasonable settlement methods of the increasing disputes. For achieving the purpose of this study, the self-administered questionnaire was conducted with 450 out-patients who visited three university hospitals, five small and medium-sized hospitals, and ten clinics in Seoul from June 13 to 17, 2005. Incomplete questionnaires were omitted and 410 respondents(91%) were included for the analysis of this study. Each section of the survey was composed of six categories such as the recognition of malpractice, a compensation system about no-fault medical accidents, the recognition of the judgement of medical accidents in court, reasonable settlement of medical accidents, reasons of lawsuit, and the need of the medical dispute settlement organization. The major results of this study were as follows. First, more than half of the respondents, 51.9 percent, worry about malpractice. And many respondents think malpractice causes their symptoms to persist or become worse, and also some respondents think that the doctor`s prescription changed too frequently. Second, as for a compensation system about no-fault medical accident, 55.7 percent of the respondents insist that a proper compensation for suffering patients or their families should be provided. And also as for the responsibility of compensation, respondents think joint compensation of both the medical institution and the government is needed foremost, followed by the medical insurance company and finally by the medical institution. The government as well as the related institutions should take responsibility for malpractice accidents for which the doctor is not responsible. Third, as for the acknowledgment of medical accident judgements by the court, 32.8 percent of respondents think that it is best to compromise with a medical institution, followed by lawsuit(26.2%), the assistance of civil organization(23.2%), and a powerful physical protest(7.6%). Fourth, as for the lawsuit of medical accidents, 62.9 percent of respondents think that patients and their families would be in a disadvantageous position in relation to medical institutions and doctors mentioning the lack of professional medical and lawful knowledge, experience and know-how as the reason. So many people have given up appeals owing to the difficulties involved in defending themselves through evidence. Fifth, about a half share of the respondents indicated that the medical institution`s neglect of the responsibility of medical accidents is one of the most important reasons of lawsuit. And next respondents mentioned the lack of the medical dispute settlement organization and a general distrust of medical institutions and doctors. Sixth, a majority of respondents consented to the introduction of the need of the medical dispute settlement organization, And about a half of the respondents mentioned a readiness to accept the mediation of the organization, but the rest did not express a clear opinion. It seems that conflict among the parties concerned have existed in relation to the medical dispute settlement organization and related legislation for many years. But as this study has shown, the needs of the medical dispute settlement organization is in desperate demand. Therefore, more negotiation efforts from all interest groups should be considered for the birth of the medical dispute settlement organization and related legislation.

의료기기분쟁과 분쟁조정제도 ― 독일의 법적 현황을 참고하여 ―

양천수 ( Chun-soo Yang ),우세나 ( Se-na Woo ) 안암법학회 2021 안암 법학 Vol.- No.62

최근 의료기기로 인한 인권침해 등과 같은 의료기기분쟁이 증가하면서 「의료기기법」개정이 검토된다. 오늘날 의료행위에서 의료기기가 차지하는 비중이 높아지면서 의료기기의 결함 문제 및 이로 인해 발생하는 분쟁을 해결하는 것이 중요한 이슈가 된다. 이에 의료기기의 결함으로 발생하는 피해로부터 환자나 이용자를 적절하게 보호할 수 있는 법제를 구축할 필요가 있다. 「의료기기법」개정안은 이러한 문제의식을 고려한 것으로 평가된다. 개정안은 크게 두 가지를 제시한다. 첫째는 제조자의 책임보험 가입을 의무화하는 것이다. 둘째는 분쟁조정제도를 설치하는 것이다. 그러면 이러한 개정안은 타당한가? 이를 검토하기 위해 이 글은 비교법 방법을 원용한다. 특히 이 글은 우리 법체계에 많은 영향을 미친 독일의 법제도, 그중에서도 의료기기의 분쟁조정을 어떻게 규율하는지를 검토한다. 이를 통해 이 글은 다음과 같은 시사점을 획득하였다. 첫째, 독일의료기기법은 의료기기분쟁을 정면에서 규율하는 법적ㆍ제도적 장치는 담고 있지 않다. 둘째, 독일은 우리처럼 의료분쟁을 전담하는 의료분쟁조정법을 갖고 있지 않다. 의료분쟁에 대한 ADR은 민간 주도로 구축되어 있다. 의료조정원이나 감정위원회가 그것이다. 셋째, 의료조정원이나 감정위원회에 대해서는 기본원칙으로 자발성과 비구속성이 적용된다. 넷째, 의료기기분쟁에 대한 ADR로는 독일 조정법에 따른 조정을 언급할 수 있다. 독일 조정법에 의한 조정 역시 철저하게 자율적으로 진행된다. 이 글은 이러한 시사점을 바탕으로 하여 우리의 「의료기기법」개정안을 다음과 같이 평가한다. 우선 책임보험 가입을 의무화하는 개정안은 긍정적으로 평가할 수 있다. 그러나 행정형 분쟁조정제도를 신설하는 것에는 의문을 제기한다. 행정형 분쟁조정제도는 조정의 본래적 취지와 맞지 않는 것으로 보이기 때문이다. 특히 조정을 통해 도출한 합의에 기판력에 준하는 강력한 법적 구속력을 부여하는 것은 문제로 보인다. 물론 그렇다고 해서 법적 구속력을 전적으로 부여하지 않는 것도 바람직하지는 않다. 조정으로 도출한 합의에는 조정제도의 효율성을 제고할 수 있도록 집행력 정도의 법적 구속력을 인정하는 게 적절해 보인다. 아울러 이 글은 법정책적으로는 다음과 같은 방안도 제안한다. 현재 운용 중인 의료분쟁조정제도가 관할하는 대상에 의료기기분쟁을 추가하는 방안이 그것이다. Recently, as medical device disputes such as human rights violations due to medical devices increase, the revision of the Korean 「Medical Devices Act」is being reviewed. As the proportion of medical devices in medical practice today increases, resolving the problem of defects in medical devices and its disputes becomes an important issue. Accordingly, it is necessary to establish a legal system that can adequately protect patients and users from damage caused by defects in medical devices. The amendment to the Korean 「Medical Devices Act」is evaluated to take into account this awareness. The amendment proposes two main things. The first is to oblige the manufacturers of medical devices to buy a liability insurance. The second is to establish a dispute mediation system for the medical device disputes. So, is this amendment valid? To review that question, this article uses the comparative law method. In particular, this article examines the legal system and situation of Germany, which has had a great influence on Korean legal systems, especially how it regulates dispute settlement of medical devices. Through those, this article has obtained the following implications. First, the German 「Medical Devices Act」does not contain legal and institutional mechanisms that govern medical device disputes. Second, German legal systems do not have a medical dispute mediation law dedicated to medical disputes like ours. The ADR on medical disputes is established by the private sector. The ‘Schlichtungsstelle’ or ‘Gutachterkommssion’ are those. Third, ‘Freiwilligkeit’ and ‘Unverbindlichkeit’ are applied as basic principles to the ‘Schlichtungsstelle’ and ‘Gutachterkommssion’. Fourth, the ADR for medical device disputes can refer to the mediation system according to the German mediation law. The mediation under the German mediation law is also ruled by the principle of autonomy. Based on these implications, this article evaluates the amendment of the Korean 「Medical Devices Ac t」as follows. First of all, the amendment which mandates buying a liability insurance can be evaluated positively. However, the establishment of an administrative dispute mediation system should meet questions. This is because the administrative dispute mediation system does not seem to fit the original purpose of the mediation system. In particular, it seems to be a problem to impart a strong legal binding power to agreements reached through a mediation. Of course, the article does not argue that the agreements should have no legal binding power. Instead, it seems appropriate for the author to recognize the legal binding power as executive power to improve the efficiency of the mediation system in agreements reached through a mediation. In addition, this article proposes the following measures for legal policy. This is a propose to add medical device disputes to the subject under the jurisdiction of the medical dispute mediation system currently in operation in Korea.

의료분쟁의 합리적 해결을 위한 연구

정영수 한국민사소송법학회 2010 民事訴訟 : 韓國民事訴訟法學會誌 Vol.14 No.2

The medical dispute has been social issue in our country. The medical dispute could be solved by the judgement of a court as other kinds of disputes. But a solution by the judgement of a court might cause the cost disadvantage to the patient. Besides, it has a bad effect on confidence between the patient and physician. So it needs the alternative dispute resolution(ADR) for a rational solution of the medical dispute. We have introduced various out of court dispute settlement mechanisms during the last 15 years, and to no vail, and recently proposed Medical Disputes Adjustment Act. This paper focuses on an effective approach to dealing with the medical dispute, and describes out of court medical malpractice litigation systems in Japan, Germany and US, for example, binding arbitration, screening panel and mediation in US. And it is important that why patients tend to sue medical providers and how lack of communicated information between physicians and patients. Allowing physicians to explain what happened and apologize or express regret and creating opportunity for the rebuilding of patient-physician relationships may lead to prevention of the medical litigation. The medical dispute has been social issue in our country. The medical dispute could be solved by the judgement of a court as other kinds of disputes. But a solution by the judgement of a court might cause the cost disadvantage to the patient. Besides, it has a bad effect on confidence between the patient and physician. So it needs the alternative dispute resolution(ADR) for a rational solution of the medical dispute. We have introduced various out of court dispute settlement mechanisms during the last 15 years, and to no vail, and recently proposed Medical Disputes Adjustment Act. This paper focuses on an effective approach to dealing with the medical dispute, and describes out of court medical malpractice litigation systems in Japan, Germany and US, for example, binding arbitration, screening panel and mediation in US. And it is important that why patients tend to sue medical providers and how lack of communicated information between physicians and patients. Allowing physicians to explain what happened and apologize or express regret and creating opportunity for the rebuilding of patient-physician relationships may lead to prevention of the medical litigation.

A Study on the Changing Trend of Chinese Public Conflicts and the Conflict Resolution Strategies: Focused on Medical Disputes

Lee, Ji-haeng(이지행) 한국동북아학회 2020 한국동북아논총 Vol.25 No.1

중국은 개혁개방 이후 경제정책 및 경제시스템의 변화로 국내 정치와 사회체제의 큰 변화를 경험하게 된다. 따라서 중국은 과거 사회주의식 전체공동체 사회에서 점차 차별화된 분화형 사회로 전환하고 있으며 국가는 더 이상 독점적 자원을 통제하지 않고 사회 및 경제의 자율성을 중시하며, 이러한 사회환경의 변화는 공공분야에서 다양한 이익갈등과 모순을 야기하고 있다. 아울러 중국식 사회주의 건설은 공공분야에서 발생하는 갈등의 형태 및 특징 더 나아가 갈등관리 방식에 있어서 서로 다른 모습을 보여주고 있다. 본 연구는 중국의 공공부분 갈등 중 의료분야에서 발생하는 갈등의 변화와 갈등관리 정책을 시기별로 나누어 차별적으로 분석하였다. 중국정부는 의료갈등의 해결을 위해 다양한 제도 및 정책을 시행하였으며, 특히 의료갈등의 조정 및 해결을 규범화하고 강화하기 위해 중국 국무원이 지난 2018년 제정한 <의료분쟁 예방 및 처리조례>는 현재 중국의 대표적인 의료갈등 조정관리제도로 손꼽히고 있다. 새로 제정된 조례에서는 인민조정제도가 신설, 추가되어 중국 의료분쟁 해결의 새로운 전환점이 되길 기대하고 있다. 그러나 중국 의료분쟁 조정제도는 아직 해결해야 할 여러 가지 문제들과 직면해 있다. 따라서 본 연구는 중국 공공갈등의 변화 및 특징을 기초로 중국 의료분쟁의 현황과 추세를 분석하며 동시에 중국 의료분쟁 조정제도의 한계와 전략을 분석하고자 한다. Since the reform and opening up, Chinese economic system’s transformation has changed Chinese political and social systems. China is gradually transforming from “overall community” to a “differentiated community”. China no longer carries out the overall control based on monopoly resources, and social and economic autonomy has been strengthening continuously. Meanwhile, conflicts also arise because of social differentiation. As the construction of socialism with Chinese characteristics is entering into a new era, the situation, characteristics and governance of public conflicts are undergoing important changes. Under these circumstances, this essay analyzes China’s medical disputes and their mediation methods, strategies and tactics based on the collective name of laws, regulations, normative documents, policies, judicial interpretations, etc. of medical disputes in China in recent years. It is found that in the research, the mediation of medical disputes in China in recent years has been divided into four stages, and each stage has different laws and regulations to resolve issues related to medical disputes. Particularly, in order to further regulate how to handle medical disputes, the State Council of China issued the Regulations on the Prevention and Handling of Medical Disputes in 2018 to increase people’s mediation as the main processing channel, fully demonstrating the importance of people’s meditation. However, there are still a large number of problems unsettled in the medical dispute mediation mechanism in China. In terms of the changes and the characteristics of public conflicts in China, this essay analyzes the current status and trend of medical disputes in China, and the strategies and challenges of the new medical dispute resolution mechanism.

국제보건의료분쟁의 해결

손경한(Sohn Kyung Han) 충북대학교 법학연구소 2016 과학기술과 법 Vol.7 No.1

Since last century, international trade of pharmaceuticals and medical instruments have increased and healthcare insurance business expanded over the national border. Recently, international medical tourism and cross-border operation of medical institutions have become active. Accordingly, disputes in international healthcare area have also increased. This article focuses on international disputes between patients and medical service or products providers. The significant characteristics of the healthcare industry are the formation of healthcare community for its constituents. This is because healthcare is closely related to, and a part of social security system of a community. Such healthcare community can be formed nationally or regionally. The regional healthcare community may cover a part of a country or several countries. The healthcare community defines and regulates the relationship among the constituents, i.e., patients, medical service providers, drugs and medical products suppliers and health insurers. Even a private medical treatment contract between a patient and a medical institution is strongly influenced, if not governed, by the regime of the healthcare community. We can find many international conventions and treaties which mention or rule international healthcare matters. For example, the Charter of the United Nations, the Universal Declaration of Human Rights, the International Covenant on Civil and Political Rights, International Covenant on Economic, Social and Cultural Rights, EU Charter of Fundamental Rights 2000, Convention on the Elimination of all Forms of Discrimination Against Women, 1979, ILO Occupational Safety and Health Convention 1981, International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families 1990, Convention on the Rights of Child 1989, Convention on the Rights of Persons with Disabilities 2006, The international trade laws also deal with health protection such as the WTO Treaty itself and the Agreement on the Application of Sanitary and Phytosanitary Measures(SPS Agreement). As directed by Article 57 of the Charter of the United Nations, the International Health Organization Constitution was established in 1946 to form the WHO, which is in charge of the international public healthcare matters. The WHO has promulgated the International Health Regulations of which the most current version was amended in 2005. In addition to these international hard laws, there are numerous international soft laws in medical treatment. Some of the well known international rules are Nuremberg Code 1947, WMA International Code of Medical Ethics 1949(currently 2006), Declaration of Helsinki-Ethical Principles for Medical Research Involving Human Subjects 1964 (currently 1974), Declaration of Alma-Ata at International Conference on Primary Health Care 1978, and WMA Declaration of Lisbon on the Rights of the Patient 1981 (currently 2015). Some of those rules became customary international laws. If not, they may be treated as a part of the “generally recognized international rules” as provided in Article 6 of the Korean Constitution or as those of the “general principles of law recognized by civilized nations”under the international law. Due to characteristics of healthcare service, the traditional rules of private international law do not apply to healthcare disputes. Rather, the law of the relevant healthcare community apples in most cases. The only exception is the case where the patient voluntarily left his home to get the healthcare service in a foreign country. In such case the law of patient’s healthcare community is excluded and the law of the healthcare institution will apply unless the parties agreed otherwise as to the governing law of the healthcare service.