The increase of medical malpractice disputes is believed to be caused mainly by the lack of confidence in doctor-patient relationship. As with the development of medical technology, the increasing awareness of human rights, and the enlargement of National Health Insurance, the medical malpractice litigations are rapidly increasing in these decades. The sky-rocketing medical malpractice lawsuit is a remarkable problem in advanced countries of the world. The present state of those affairs is not insignificant in Korea any more. All of us know that the trend is obviously aggravating.
This study aims to find out more effective ways of guaranteeing both health right of patients and medical profession right of doctors. Accordingly this study stands in a neutral position considering the views of the both sides objectively. This study deals with as many judicial precedents as possible in order to get a more substantial result.
To say more specifically, the purpose of this dissertation is as the following.
First, I try to analyse the reason why medical incidents frequently happen, and the mechanism by which a medical incident becomes a medical malpractice dispute.
Second, I try to specifically define some terms related to medical malpractice including as medical practice, medical accident or medical incident, medical malpractice, and medical malpractice dispute.
Third, I try to find out more effective ways of alleviating patients' liability of proving medical malpractice for the purpose of protecting medical practice consumers.
Fourth, I try to analyse the present relief system of medical malpractice including medical malpractice insurance system in some foreign developed countries.
Fifth, I try to develop the relief system of medical malpractice suitable for the circumstances in Korea on the basis of the analysis of law making procedures regarding the relief system of medical malpractice.
For these purposes, this dissertation consists of 6 chapters.
Chapter 1 is devoted to the introduction, purpose and scope of the study. In this chapter, the importance of prompt and reasonable settlement of medical malpractice disputes is indicated.
Chapter 2 deals with general theories related to the medical liability of medical malpractice. The conception of medical malpractice and the present state of medical-disputes are explored, and the increasing reason of medical malpractice disputes is pointed out. And the obligation of physicians' special attention and study of various recent judicial cases are investigated.
Chapter 3 deals with aspects of legal contracts between a doctor and a patient, the general theory of liability caused by medical malpractice, and the duty of explaining problems derivable from informed consent.
Chapter 4 deals with the relief system of medical malpractice. The relief system of medical malpractice can be divided into two types. The one is reparation based on the liability of medical malpractice which could be mistakes, errors or negligence. In order to prepare a rational basis, we studied Patient Compensation Funds, Limits on Recovery, Attorney Fee Regulation, Mutual-insurance companies, Joint Underwriting Association, Joint and Several Liability Rule, Periodic Payment of Damages, Pretrial Screening Panels and so on. All of them in the USA are efficient for reducing the cost of medical liability. The other is no-fault compensation system such as that in Sweden.
The present relief system of medical malpractice in Korea is discussed. Those schemes can be classified into three types. But all of those were not efficient for settling the medical malpractice disputes and for reducing the cost of medical liability in our country.
In Chapter 5, the discussion of legislation about medical malpractice and relief system is considered and the legislation is suggested. It is suggested that we need to introduce the compulsory medical malpractice insurance. And we should make the physicians to contract with the insurer of medical malpractice in a party. The insurer can be an insurance company or physicians' mutual benefit association.
The discussion is made to find out how to develop the medical malpractice insurance in Korea. And we should reform our medical malpractice or tort system by making the pre-judgement system constituted of medical-examiners or coroners. Additionally, I dare to say, no-fault compensation system isn't suitable for us. But, we must induce somewhat supplementary no-fault compensation system for the sake of patients' human rights. That system indemnifies the compensation in case of no-fault incident of medical practices.
Finally, in Chapter 6, the summary and conclusion of this study is provided.
Everyone knows there is no almighty panacea in the world. Jurisdictions couldn't take parts of both sides absolutely. I dare to say that no perfect regime about this sophisticated social problem exists. But we should establish a fair and persuasive norm of conduct and judicial judgement to protect maximum interests of patients on one hand, and to guarantee physicians' right or duty to carry on their works.
The one is the introduction of a medical professional liability insurance system. This insurance system should be compulsory. The other is the establishment of a pre-judgement system about medical malpractice. The core of this system is the compulsory conciliation committee that is constituted representative of medical-examiners. All the medical malpractices have to pass through this committee. With this system we will be able to get prompt and reasonable solutions. Alternatives to the present trial should reduce litigation costs and bring quicker settlements than traditional court proceedings.

本文的研究是为了保障国民的健康权和医疗人员的医业权而进行的.为了达到上述目的，本文努力站在既不倾向于患者也不倾向于医者的客观立场来进行研究. 本文为了正确把握医疗现实状况，避免空泛研究，尽可能多地采取了一些实例.
下面具体说明一下本文的研究目的:
第一、分析医疗事故骤增的原因，及对于医疗事故的构成医疗纷争化的原因.
第二、明确定立医疗界一些混用的如‘医疗行为’、‘医疗事故’、‘医疗过失’、‘医疗纷争’等 同‘医疗事故被害’有关的概念.
第三、医生有损害赔偿责任. 本文一方面研讨损害赔偿责任的两个根据(契约责任和不法责任的差异)，及医生的注意义务和说明义务等跟医疗事故有关的民事法的法规; 一方面为了救济医疗消费者，通过立证责任的缓和及转换，摸索立证责任的减轻方案.
第四、以先进国家的医疗事故赔偿责任保险制度为例，分析医疗事故被害救济制度的现状，找出其中的经验.
第五、以讨论和分析医疗事故被害救济的立法论议过程为基础，开发符合国情的韩国型医疗事故被害救济制度.
本文研究方法如下:
由本文研究结果得出的医疗事故被害救济制度，是以民事责任法的一般原则为基础，结合社会保险原理和现有医疗保险制度摸索出来的具体的实践模型.
本文首先分析研讨了大韩医师协会、消费者保护院、医疗消费者被害协会、大韩损害保险协会、损害保险会社的有关医疗纷争的统计资料，各大法院案例，保健福利部和国会的立法提案等说明资料. 也参考了有关医疗事故方面的国内学者著书及论文.并比较分析了以先进国家医疗事故赔偿责任保险制度为例的医疗事故被害救济制度，和我国的现行制度，最后导出合理解决医疗纷争的立法方案.
本文具体研究范围如下:
为达到本文研究目的，具体研究范围是这样的:
第一章、绪论中指出因医疗纷争频繁发生，定立医疗事故被害救济制度具有紧迫性和必要性.并概括本文研究的目的和范围，介绍本文的研究方法.
第二章、明确定立医疗界一些混用的如‘医疗行为’、‘医疗事故’、‘医疗过失’、‘医疗纷争’等有关医疗用语的概念; 分析医疗事故的发生原因，医疗事故纷争的构成，医疗纷争骤增的原因; 考察医疗事故被害的类型.
第三章、考察医疗事故的有关被害救济法规; 讨论医生和患者之间的法律关系，医疗契约的法律性质; 考察因医疗过失、说明义务违反应负的民事责任; 考察民事责任中的损害赔偿请求权的根据; 考察决定诉讼成败的立法责任问题及损害赔偿责任的范围等; 考察针对因医疗器械等设备的缺陷引起的被害救济的制造物责任法和针对预防接种等医疗事故的国家责任法.
第四章、考察以美国为首的主要外国的医疗事故被害救济制度，同时也考察我国的医疗事故被害救济制度-大韩医师协会、医疗共济制度、医师赔偿责任保险制度，以及裁判外纷争调停制度-消费者纷争调停制度、民事调停制度.
第五章、分析讨论有关解决医疗纷争的各种立法论，找出其中问题.为使医师赔偿责任保险活性化，强制实行团体赔偿责任保险.设置公正的医疗事故判定机构，限制医疗事故被害者的直接请求权，医疗保险者的求偿权，提出无过失责任制度的补充等有关改善方案.
第六章、归纳研究结果，得出研究结论.
本研究结论归纳如下:
医疗事故有因医疗人员过失引起的事故，有因违反说明义务或因医疗器械引起的事故，还有违反医疗规定的事故.由于上述医疗事故的存在，用于被害救济制度的有民法中的损害赔偿责任法，制造物责任法，国家赔偿责任法.
医疗事故发生的背景，除了医疗行为造成的对人体的侵害这一本质原因以外，还有医疗供给者、医疗需要方的原因，救护方的原因，结合诊疗状况的原因，社会制度的原因，这些原因都是相互关联的.
一般来说，医生和患者的关系是通过他们签定的契约而决定的. 医生由于过失，违反契约上的说明义务，也就是诊疗义务和附随医务时，就要通过竞合承担契约上的债务不履行责任或不法行为责任.
最近，医生的说明义务被编入医疗过失领域，对医生来说，转换了立证责任，即医生违反契约上的说明义务时，根据损害赔偿请求不管是属于‘债务不履行’还是‘不法行为’，医生都要对自己做说明的事实进行立证.所以医生违反说明义务时，患者提出诉讼将很容易胜诉.
医生过失诉讼中，所有的情报倾向于医方，医疗施术内容具有高度的专业性，这对患者来说. 立证医生的过失绝对不是一件容易的事. 医疗过失诉讼中，立证责任是左右诉讼胜败关键的一步，不管诉因归于‘不法行为’还是‘债务不履行’，结果都是患者一方承担诊疗过失的立证责任. 所以，为了保护患方，应该制定立证减轻乃至缓和的制度.
另一方面，医生违反说明义务即在侵害自己决定权的同时，也形成了违法的身体侵害.所以为避免对患者造成损害，应事前做具体充分的说明.医生对自身的说明行为不能证实时，要承担因违反说明义务造成的损害赔偿责任.
由于对医生立证责任的转换，最近医疗过失和违反说明义务实行竞合时，越来越多的患者以医生违反说明义务为理由要求损害赔偿，这样的现象可以说是一种时代的潮流或趋向.
发生医疗事故后，为保证作为被害者的患者迅速、顺利地得到损害赔偿，除了前面提到的法规外，也应该设立后援制度，与其平行.
应设置公正的医疗事故判定机构，实行强制医师赔偿责任保险制度，根据立法方案，医疗事故发生时，按照现代医学界限区分是否属于不可抗力事故.当医疗事故被判定为不可抗力事故时，应设立‘被害救济基金’，导入‘无过失补偿制度’，实施对‘不可抗力’和‘无过失’的补偿，或判定前的优先补偿，从而做到更彻底地保护国民健康权.
作为补充的‘无过失补偿制度’，能够保持医生和患者之间的信赖关系，预防‘防御医疗’，使患者能够得到迅速补偿，当然也克服了立证责任上的不公平问题.

醫療事故는 현대의학의 한계 속에서 不可抗力的으로 발생하기도 하지만 대다수가 醫療人의 過誤에 기인하고 있음은 周知의 사실이다. 최근에는 우리나라에서도 健康權에 대한 市民意識이 提高된 가운데 醫療事故로 인한 醫療紛爭의 發生率이 크게 증가하고 있다.
醫療事故는 대부분이 의료인의 診療過失·說明義務違反 등의 診療上의 過誤로 인하여 발생하고 있다. 그러나 때로는 醫療器機의 缺陷 등의 物的 要因이나 또는 公法上의 醫療에 의해서도 발생할 수 있다.
醫師의 醫療過誤에 의하여 환자에게 손해가 발생한 경우에는 피해자인 환자는 醫療過誤訴訟을 제기하여 損害賠償을 받을 수 있다. 그러나 醫療事故의 被害者 救濟에 관한 特別法이 없기 때문에 환자는 醫療過誤訴訟에서 民法上의 債務不履行責任과 不法行爲責任 중 어느 하나에 의하여 損害賠償請求를 할 수 밖에 없다.
환자가 의사의 診療過失을 이유로 訴訟을 제기하는 경우에는 訴因을 不法行爲責任으로 하든, 債務不履行責任으로 하든 결국은 환자측이 醫師의 過失 등의 立證責任을 지게 된다. 醫療過誤訴訟에서 立證責任은 訴訟의 勝敗를 좌우하는 매우 중요한 것이다. 그런데 診療過失訴訟에서는 모든 情報가 의사측에 偏在하여 있고 醫療施術의 내용이 고도의 專門的인 것이므로 환자측에서 醫師의 過失을 立證하기란 결코 쉽지 않은 일이다. 따라서 醫療過誤에 의하여 피해를 입은 환자를 보호하기 위하여서는 광범위한 立證輕減 내지 緩和를 위한 制度가 마련되어야 한다.
한편 의사의 說明義務違反은 自己決定權의 侵害인 동시에 결과적으로 위법한 身體侵害가 된다. 따라서 患者의 損害로 실현된 그 위험에 대하여 의사가 사전에 환자에게 충분하고도 구체적인 說明을 하여야 한다. 의사가 자신의 說明移行을 立證하지 못하면 說明義務違反으로 인한 損害賠償責任을 지게 된다. 이러한 의사에 대한 立證責任의 轉換으로 인하여 최근에는 의사의 診療過失과 說明義務違反이 경합될 때 환자가 대한 醫師의 說明義務違反을 이유로 損害賠償을 청구하는 사례가 늘고 있다. 이러한 현상은 시대의 조류이자 세계적인 추세이기도 하다.
우리나라에서 醫療事故의 被害者들을 보호하기 위하여서 독립된 醫療事故 被害救濟法 또는 醫療紛爭調停法이 절실한 실정이나 관련 利益集團들간의 利害對立으로 수년째 표류하고 있다. 일반국민의 健康權과 醫師의 醫業權이 함께 보장될 수 있도록 공정한 醫療事故 判定機構의 設置 및 醫師賠償責任保險制度의 活性化가 이루어질 수 있도록 法과 制度를 조속히 완비하여야 한다. 그리고 醫療消費者의 被害救濟라는 측면에서 醫師賠償責任保險과 아울러 無過失補償制度의 補充的 導入도 이루어져야 할 것이다. 이 補充的인 無過失補償制度는 의사와 환자 사이의 信賴關係를 유지하고 防禦診療를 예방할 수 있으므로 환자의 신속한 損害塡補는 물론 立證責任上의 不公平한 問題點을 극복할 수 있다. 위 세 가지 制度의 導入은 醫療事故가 발생했을 때 피해자측에 적정한 賠償 또는 補償을 해주기 위하여서 반드시 필요하다고 본다. 결론적으로 醫療紛爭 調停法 또는 醫療事故 被害者救濟法이 마련될 수 없으면, 交通事故被害者를 보호하기 위하여 自動車 損害賠償 保障法을 마련하여 모든 自動車 保有者들이 責任保險을 强制加入토록 한 것처럼 醫療事故 損害賠償 保障法을 만들어서 醫師賠償責任保險制度의 活性化를 이루어 一般國民의 健康權이 保障될 수 있도록 해야 할 것이다.