의료과오의 민사책임과 관련하여 크게 불법행위책임과 계약책임으로 나누어 논의가 행해졌다. 과거에는 의사와 환자의 관계를 계약관계가 아닌 인적 신뢰관계로 보았고, 따라서 다수설과 판례는 의사의 과실이 있는 경우에 불법행위책임으로 해결하였다. 그러나 의료인이 의료서비스를 제공하는 경우에 계약관계가 존재하는 것이 일반적일 뿐만 아니라, 환자 측에서 권리의식이 고양되면서 의사와 환자의 관계를 의료공급자와 의료소비자의 관계로 인식하게 되었다. 의료서비스계약은 의사측과 환자측 사이에 유상․쌍무계약이다. 의료계약의 법적 성질에 관하여 위임계약설, 도급계약설, 고용계약설, 무명계약설 등이 존재한다. 의사측이 선량한 관리자의 주의의무를 베풀어야 한다는 것을 들어 위임계약설 내지 준위임계약설이 우리나라의 다수설이나 오히려 독립된 고용계약설로 보아야 한다. 의료계약은 유상계약이니만큼 무상계약인 위임계약에도 선량한 관리자의 주의의무가 요구되는 만큼 유상계약인 의료계약에는 당연히 요구되기 때문이다. 의료계약은 의료공급자와 의료소비자 사이의 소비자계약으로 볼 수도 있다. 계약법적 접근은 계약의 ‘당사자의 자치성’에서 그 장점을 찾을 수 있다. 여기에서 의사의 설명의무가 나오고 환자 측에서는 의료정보에 대한 접근의 권리가 나온다. 의료계약의 주된 급부는 진료채무와 보수지급채무이다. 더 나아가 의사는 환자에게 진단과 치료, 환자의 상태 등에 대한 정보를 명확하게 제공해야 할 의무를 부담한다. 의료인은 진료기록의무와 환자의 비밀유지의무를 아울러 부담한다. 환자는 의사에게 협조의무를 부담한다. 의료과오와 관련된 가장 중요한 쟁점중의 하나가 증명책임의 문제이다. 다수설과 판례는 진료채무의 수단채무성을 들어 채권자인 환자측에 의사의 과실에 대한 증명책임이 있다고 한다. 그러나 우리 민법 제390조는 모두 채무에 적용되는 것이고 입법자는 채무자의 과실을 권리장애사실로서 채무자에게 증명책임을 부과하고 있다. 따라서 계약법적 접근에 의할 때 의사의 과실은 의사측에 증명책임이 있다고 본다. 네덜란드에서는 1995년에 민법에 의료서비스계약을 편입하여 입법하였다. 여기에서 의사의 권리와 의무, 환자의 권리와 의무 등을 분명하게 규정하고 있다. 우리나라에서도 이와 같이 의료계약법을 규정하는 것이 가능하지만, 의사와 환자의 구체적인 권리에 대한 깊이 있는 논의와 판례의 축적이 이루어진 이후에 이루어져야 할 것으로 보인다.

The Contractual Construction of the Malpractice Song, Oh-Sik* There are many issues related to the civil liability of the malpractice. In the past, relation between physician and patient was considered not as the contractual relation but as the personal fiduciary one. Accordingly, the prevail opinion and the precedent in Korea have taken the tort liability theory in the case of the doctor's negligence However, it is common that contractual relation exists when physician provides medical service. Moreover, patients have recognized the relation 'doctor-patient' as the relation 'health care provider-heath care consumer', insist that they have a fair and proper right because of malpractice. The medical service contract is a compensation and bilateral contract between hospital/doctor and patient/agency. There are four kind of theory considering legal character of the medical service contract: employment contract, mandate contract, work contract, non typical contract. Having taken notice of 'a reasonable care', the prevail opinion have taken the theory of mandate contract. But I consider the medical service contract as the independent employment contract based on a compensation. he medical service contract can be considered as a consumer contract between health care provider and health care consumer, too. The contract option has the major advantage that a contract is based on party autonomy. This is a natural habitat for such patients' rights as the right to information, to consent and to access to medical records. The main performances in medical contract are the health care service and the fee. Besides, physicians are now obliged to inform the patient cleary about the proposed examination and treatment about developments concerning examination, treatment and the condition of the patient's health. Physicians has a duty to keep the record, to keep patients' privacy. Patients has a duty to cooperate with a doctor. One of the most important issues is the burden of proof of negligence. The scholars and Korean Supreme Court referring to 'the obligation moyens' of medical obligation adopt the obligation moyens theory and admit the plaintiff to take the burden of proof. The doctor have to prove the fact of negligence according to KBGB §390. Because the legislator regulated the negligence as a requirement of right hinderance. In 1995, Netherland enacted the medical service contract into the Civil Code. Likewise, the legislation of the Act of the medical service contract can be considered. However, though we enact the Act of the medical service contract, the enactment have to be exercised after the deep and broad discussion about specific contents of the medical service contract and patient’s right and duty and the accumulation of the precedent.

The Contractual Construction of the Malpractice Song, Oh-Sik* There are many issues related to the civil liability of the malpractice. In the past, relation between physician and patient was considered not as the contractual relation but as the personal fiduciary one. Accordingly, the prevail opinion and the precedent in Korea have taken the tort liability theory in the case of the doctor's negligence However, it is common that contractual relation exists when physician provides medical service. Moreover, patients have recognized the relation 'doctor-patient' as the relation 'health care provider-heath care consumer', insist that they have a fair and proper right because of malpractice. The medical service contract is a compensation and bilateral contract between hospital/doctor and patient/agency. There are four kind of theory considering legal character of the medical service contract: employment contract, mandate contract, work contract, non typical contract. Having taken notice of 'a reasonable care', the prevail opinion have taken the theory of mandate contract. But I consider the medical service contract as the independent employment contract based on a compensation. he medical service contract can be considered as a consumer contract between health care provider and health care consumer, too. The contract option has the major advantage that a contract is based on party autonomy. This is a natural habitat for such patients' rights as the right to information, to consent and to access to medical records. The main performances in medical contract are the health care service and the fee. Besides, physicians are now obliged to inform the patient cleary about the proposed examination and treatment about developments concerning examination, treatment and the condition of the patient's health. Physicians has a duty to keep the record, to keep patients' privacy. Patients has a duty to cooperate with a doctor. One of the most important issues is the burden of proof of negligence. The scholars and Korean Supreme Court referring to 'the obligation moyens' of medical obligation adopt the obligation moyens theory and admit the plaintiff to take the burden of proof. The doctor have to prove the fact of negligence according to KBGB §390. Because the legislator regulated the negligence as a requirement of right hinderance. In 1995, Netherland enacted the medical service contract into the Civil Code. Likewise, the legislation of the Act of the medical service contract can be considered. However, though we enact the Act of the medical service contract, the enactment have to be exercised after the deep and broad discussion about specific contents of the medical service contract and patient’s right and duty and the accumulation of the precedent.

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Malpracticem Medical Service Contract, Obligation moyence, Independent employment contract, Consumer contract. Informed consent, Burden of proof