의사의 과실에 의한 임신⋅출산⋅출생에 따른 손해배상책임 - 우리나라 판례에 대한 종합적 평석을 겸하여 -

이은영 한국민사법학회 2009 民事法學 Vol.46 No.-

Among birth-related torts, in the case of that an unwanted child is being pregnant or is born caused by medical malpractice, parents or children bring lawsuits against medical doctors or health care providers for damages. These actions are called as claims for damages resulting from unwanted children in general. These actions for damages resulting from unwanted children can be divided into wrongful pregnancy, wrongful birth and wrongful life. Since the actions for damages resulting from an unwanted child has been discussed in practice at first the end of the 1970's in Korea, the courts were sentenced about ten cases for damages resulting from wrongful conception, wrongful birth and wrongful life until in the concrete. As the results of these cases, most of judgments not allow the medical malpractice or they only allow the pretium doloris(Schmerzengeld) damages resulting from breach of informed consent and financial loss including the medical expenses and other necessary expenditures during the pregnancy which is permitted by 「The Mother and Child Health Law」. On the other hand, it seems negative for financial loss including the child-rearing, education costs and loss of expected income. Above all, the damages for child-rearing costs is on the contrary to the legal sentiments of the public or the public policy and customs of the community. In addition, it seems to be recognized as undervaluing human dignity because the actions regard children as objects of assessable property or damages. It is, however, an erroneous conclusion which is derived from the ignorance of distinction between the new source of damage and the damage itself which can be taken place with the development of medicine and medical technology. The damage resulting from an unwanted child is not different from other medical malpractice-oriented damage. Likewise, the legal principle of damages for an unwanted child is not greatly different from other general principles of damages as well. The amount of damages calculated by each claims is finally accounted on the basis of the application of fault offset rule, benefits rule, and of liability limitation rule which has been approved by courts in Korea. If the amount of damages including child-rearing costs is exceeds the doctor's fault, it can be reduced by the principle of damages adjustment in the light of fair and just sharing of losses. This solution corresponds with the idea of corrective justice on which law of damages is based.

Is placental KISS-1 expression associated with first trimester abortion spontaneous?

( Eser Colak ),( Emel Ebru Ozcimen ),( Ozgur Hilal Erinanç ),( Yusuf Aytac Tohma ),( Mehmet Ufuk Ceran ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.4

Objective Several studies have examined biological markers during the first trimester to predict the maintenance of a healthy pregnancy. One such marker is kisspeptin, which is encoded by the KISS-1 gene. We aimed to determine whether firsttrimester pregnancy losses were associated with levels of placental KISS-1 expression. Methods This prospective case control study was conducted at a tertiary center. The study group included 27 and 24 patients who underwent dilation and curettage at <10 weeks of gestation, due to first trimester spontaneous pregnancy loss and for elective termination (control), respectively. Placental and decidual tissues from all patients were sectioned and immunohistochemically analyzed for kisspeptin. Results Age, gravida status, parity number, gestational week, and number of previous abortions did not significantly differ between the groups. KISS-1 expression levels were significantly lower in the group with spontaneous abortion compared with the group with elective termination. The median staining intensity of KISS-1 expression in the elective and spontaneous termination groups were 3 (strong) and 2 (moderate), respectively (P=0.004). KISS-1 expression levels were significantly lower among patients with previous abortions in the elective termination group (P=0.002). Conclusion KISS-1 expression levels were found to be significantly reduced in patients with spontaneous pregnancy loss; KISS-1 plays an important role in the implantation and continuation of pregnancy.

원치 않은 아이 소송의 개념정의와 유형화에 대한 새로운 시도

이은영(Eun Young Lee) 중앙법학회 2009 中央法學 Vol.11 No.2

The possibility of birth-related torts by medical doctors or health care providers has been increased with the medical malpractices of contraception, sterilization, TOP(termination of pregnancy) and ART(Assisted Reproductive Technologies). Among birth-related torts, in the case of that an unwanted child is being pregnant or is born caused by medical malpractice, parents or children bring lawsuits against medical doctors or health care providers for damages. These actions are called as claims for damages resulting from unwanted children in general. These actions for damages resulting from unwanted children can be divided into wrongful pregnancy, wrongful birth and wrongful life. Traditionally the wrongful pregnancy action means an action brought against a doctor or hospital that pregnant women was delivered of health child caused by medical malpractice in order for a patent, while the wrongful birth action is and action for damages resulting from the birth of an abnormality child caused by medical malpractice. The wrongful life action, on the other hand, is brought by the very child against a doctor who caused unwanted birth to claim for damages resulting from by his or her own birth. But, the traditional definition of these actions went wrong. This article, therefore, attempts a new definition and classification. According to the new definition the wrongful pregnancy action can be brought against a doctor or hospital to caused medical malpractice in order for a parent to seek the damages for the pregnancy itself, while the wrongful birth action is an action for damages resulting from the birth of an unwanted child caused by medical malpractice, regardless of child`s abnormality. The wrongful life action, on the other hand, is brought by the very child against a doctor who caused unwanted birth to claim for damages resulting from by his or her own birth. In addition, actions for damages resulting from an unwanted child can be divided into actions resulting from wanted/unwanted pregnancy, TOP, birth in accordance with the wish of parents, and actions by healthy/unhealthy child and/or parents in accordance with the condition of their health.

경구피임약 포장결함에 의한 제약회사의 손해배상책임

봉영준 ( Young Jun Bong ) 한양대학교 법학연구소 2015 법학논총 Vol.32 No.2

최근 경구피임약의 배열순서가 잘못된 경우와 정해진 활성제의 숫자가 잘못 들어가는 경우가 발생하여 이를 복용한 여성들이 원치 않은 임신을 하게 된 사례가 발생하였다. 이와 같이원치 않은 임신에 관하여 과거 국내·국외에서 논의되어 왔던 의사-환자 사이의 원치 않은 아이 논쟁이 검토되어 질 수 있는데, 경구피임약 포장에 있어서 잘못이 있다면 제조물의 표시상의 결함에 해당하여 제약회사의 제조물책임이 문제된다. 특히 제조물책임법 제3조 제1항의 제조물의 결함으로 신체손해에 해당하는 것과 관련하여 원치 않은 임신으로 정상아나 장애아를 임신·출산하는 것 그 자체가 여성의 신체 상해가 될 수 있는가가 문제된다. 비교법적으로 이를 신체상해에 해당한다고 보는 입장과 신체상해에 해당하지 않는 입장이 나뉘고 있는데, 원치 않은 임신은 여성의 생리적 기능을 훼손할 뿐만 아니라, 임신 자체가 아름답고 여성으로서 겪어야 할 자연적인 것이라고 할 수 없으므로 신체상해성을 인정하여야 할 것이다. 또한 제약회사의 경구피임약 포장결함에 의하여 정상아 또는 장애아를 출산한 경우 그 결함과 아이의 부양비의 손해 발생과의 인과관계가 문제되는데, 경구피임약의 제조회사도 제품 결함에 의한 소비자의 임신을 야기하여 통상 부양비의 손해가 발생하였다면 그것이 원고에게 직접적이고 근원적으로 야기된 손해라고 볼 수 있다. 그리고 제약회사의 경구피임약 결함으로 소비자의 장애아 임신·출산이 있는 경우는 언제라도 제품 결함이 있는 경우 제약회사는 장애아 의 임신을 야기할 수 있다는 것을 충분히 예견할 수 있었을 것이고, 소비자가 경구피임약을 복용한 것은 소비자가 장애아의 양육을 위하여 필요한 추가비용만을 회피하려고 하는 것이 아니며, 장애아가 있는 자녀 자체를 출산하지 않으려고 복용한 것이므로 추가양육비에 대하여도 제약회사는 책임을 부담하여야 할 것이다. 결국 경구피임약 포장결함에 의한 제약회사의 부양비 손해배상책임은 의사의 의료행위상 과오에 의한 원치 않은 임신·출산과 차이가 없다고 볼 것이다. Even in the case of unwanted pregnancy to defects of oral contraceptives, as well as litigation by medical malpractice, Court should admit the compensation of the child rearing expenses. Pregnancy itself is not a natural step although a woman want it or not. Because p unwanted pregnancy gives changes and pain to the body of woman and causes interference to the body integrity. Therefore it is possible to claim for the mental and property damages and relatives, for example her husband, can claim mental damages on the basis of Arthicle 752 of the Civil Code. In addition plaintiff can claim accident compensation to the insurance company. Pharmaceutical company should pay for the child rearing expenses in case wrongful conception and wrongful birth caused by defects of birth control pill. As for the cause and effect relationship between fault and damages, pharmaceutical company’s liability in packaging defects of birth control pill is same like the liability of doctor that fails to operate properly sterlization, diagnosis of pregnancy, diagnose hereditary problems, and abortion. In case chlild rearing expenses for wrongful conception and wrongful birth is admitted, I think the compensation should be based on the table of the child rearing expenses calculation by Seoul Family Court.

원치 않은 아이의 출생과 의료과오책임

권오봉,윤석찬 부산대학교 법학연구소 2010 법학연구 Vol.51 No.1

It seems to be clear that medical malpractice is admitted in the case of births associated with negligent contraceptive surgery or having a congenitally abnormal child because it was not predictable as a result of a doctor’s negligence in spite of undergoing triple test or amniocentesis. The purpose of this note is to examine the legal responsibility principle in the wrongful birth and to suggest the solution of that case urging the court change the doctrine of precedent. The birth of a child cannot be regarded as a damage although it is "wrongful life". Even so, if parents have a contraceptive operation because of the economic problem, the damage for the birth of a child or maintenance and education costs should be compensated insofar as they are based on the medical negligence. Considering the Supreme court precedents referring to the reasonable reason, it is natural that the damage awarded should be those for rearing the child as well as pain and suffering. Because that is in accord with the responsibility principle of contract law and the principle of fairness. Nevertheless, The Supreme Court admitted childbirth costs and pain and suffering of an unwanted pregnancy but rejected the damage for the child's support citing the Constitution and article 931 of the civil law as a legal basis. In addition, the court did not concede even pain and suffering on the grounds that Down syndrome abortion is illegal in the case where parents asked complete medical examination in order not to have a defective child like a baby with Down syndrome and this test was conducted but such a child was born due to inadequate provision of information by a doctor's negligence. In other words, the court implied there was no infringement of rights because mother did not have an option although Down syndrome had been identified before childbirth, on account of the reason abortion would not be legally permitted. However, this attitude of the court reflects a strong involvement with formal logic and is regarded as an antinomy. Because, considering the purpose of the amniocentesis and the recent trends in abortions, pregnancy termination would be hardly rejected. Mother, by contrast, has a right to know whether the fetus is normal or abnormal through the medical examination which is legally permitted. Therefore, the mental damage caused by the matter she cannot prepare properly should be recognized. Meanwhile, Federal Court of Justice of Germany fully admits maintenance and education costs for the child irrespective of whether the child is normal or abnormal, wrongful conception or wrongful birth as long as the doctor's negligence is admitted.

원치 않은 아이의 출생과 의료과오책임

권오봉(Kwon Oh-Bong),윤석찬(Yoon Seok-Chan) 부산대학교 법학연구소 2010 법학연구 Vol.50 No.1

낙태의 폐단으로 인한 인간의 존엄성 상실이라는 사회적 자정의 분위기 속에서 낙태거부를 선언한 산부인과 의사들의 동참과 호응은 예상보다도 활발하다 평할 수 있다. 이러한 예단하에서 낙태는 이제부터는 어려워 질 것이며, 이로 인하여 사전에 피임 내지 불임시술이 압도적으로 증가하리라 전망할 수 있다. 그런데 이러한 낙태예 방적 조치에 있어 입증되어 질 수 있는 의사의 과실로 피임 내지 불임이 되지 않거나 혹은 장애아를 피하기 위하여 산전검사를 하였으나 명백한 의사의 과실로 그러한 장애가 예견되지 못해서 장애아를 출산한 경우에 있어서는 의사의 과실이 개입된 이상 의료과오가 성립한다고 보아야 하고, 이러한 유형의 의료과오는 점차 많이 발생할 것으로 예상된다. 본고는 소위 원치 않은 아이가 출산한 경우에 대하여 그 법적분쟁의 해결에 단초를 제공하고 우리 판례의 입장의 변화를 촉구하는 의미에서 그러한 책임법리를 고찰해 보았다. 비교법적 관점에서도 확인된 바와 같이 우리나라를 비롯해 외국에서는 인간의 존엄성의 언명 하에 "원치 않는 아이”라 하더라도 결코 "손해”라고는 볼 수는 없다는 것이다. 그러나 경제적 사유 등으로 피임시술 내지 불임시술을 하였고 여기에 의사의 과실이 개입되어 원치 않는 아이를 출산하여 부양의무를 부담해야 한다면 양육비 내지 교육비도 일반적인 의료과오상의 손해배상범위 안에서 파악되어야 하며 독일 판례이론인 보호목적설과 이를 인용하는 상당인과관계에 관한 기존의 우리나라 대법원 판례의 입장대로라면 상당성 있는 손해로서 위자료와 함께 배상되어져야 할 것이다. 그럼에도 불구하고 원치 않은 임신의 사안에서 우리나라 대법원 판례는 분만비용과 위자료만을 인정하고, 양육비 및 교육비 상당의 손해배상청구를 우리 헌법정신과 민법 제913조의 규정에 비추어 제3자에게 전가할 수 없다는 논거에서 부정하고 있다는 점에서 피해자 보호에 부족한 점이 지적된다. 게다가 우리나라의 실정상 과대한 사교육비의 부담이 자녀출산기피의 제일 원인인 현실적 상황에서 의사의 과실로 비롯된 잘못된 피임시술로 원치 않은 아이를 출산하면 그에 상응한 손해배상책임을 의사에게 인정하여 양육비를 부담하게 하는 것이 출산을 피하려는 계약목적이 고려된 올바른 계약책임법리의 해석이 되고 아울러 공평의 원칙에도 부합한다고 보여진다. 동일한 사안에서 독일 연방대법원(BGH)은 원치 않은 아이의 양육비와 교육비를 전적으로 손해로서 인정한 바는 우리에게 시사하는 바가 크다고 본다. 이미 의학기술의 발달로 이제는 인구의 조절이 가능하게 되었고 가족계획이라는 것도 오래전부터 일반화되고 현실화되었다. 특히 임신한 산모가 경제적 사유가 아닌 장애아를 낳을지도 모를 우려가 있어 의사와 상담을 하였고, 의사는 과실로 이러한 장애아 검사를 게을리 한 경우에 그 장애아의 원인이 합법적 낙태가 되지 않는 다운증후군이라는 사유로 설령 의사에게 과실이 없어 다운증후군이 출산 전에 밝혀지더라도 불법적 낙태가 허용되지 않기에 위자료청구조차도 인정되지 아니한다는 우리 판례의 논리는 지나치게 형식논리에 치우친 것으로 보인다. 동 판례의 논리대로라면 굳이 산모가 진료계약을 체결하면서 비용을 투자하여 태아가 다운증후군인지 여부를 검사할 필요가 없었다는 점이 간과되게 된다. It seems to be clear that medical malpractice is admitted in the case of births associated with negligent contraceptive surgery or having a congenitally abnormal child because it was not predictable as a result of a doctor’s negligence in spite of undergoing triple test or amniocentesis. The purpose of this note is to examine the legal responsibility principle in the wrongful birth and to suggest the solution of that case urging the court change the doctrine of precedent. The birth of a child cannot be regarded as a damage although it is "wrongful life". Even so, if parents have a contraceptive operation because of the economic problem, the damage for the birth of a child or maintenance and education costs should be compensated insofar as they are based on the medical negligence. Considering the Supreme court precedents referring to the reasonable reason, it is natural that the damage awarded should be those for rearing the child as well as pain and suffering. Because that is in accord with the responsibility principle of contract law and the principle of fairness. Nevertheless, The Supreme Court admitted childbirth costs and pain and suffering of an unwanted pregnancy but rejected the damage for the child's support citing the Constitution and article 931 of the civil law as a legal basis. In addition, the court did not concede even pain and suffering on the grounds that Down syndrome abortion is illegal in the case where parents asked complete medical examination in order not to have a defective child like a baby with Down syndrome and this test was conducted but such a child was born due to inadequate provision of information by a doctor's negligence. In other words, the court implied there was no infringement of rights because mother did not have an option although Down syndrome had been identified before childbirth, on account of the reason abortion would not be legally permitted. However, this attitude of the court reflects a strong involvement with formal logic and is regarded as an antinomy. Because, considering the purpose of the amniocentesis and the recent trends in abortions, pregnancy termination would be hardly rejected. Mother, by contrast, has a right to know whether the fetus is normal or abnormal through the medical examination which is legally permitted. Therefore, the mental damage caused by the matter she cannot prepare properly should be recognized. Meanwhile, Federal Court of Justice of Germany fully admits maintenance and education costs for the child irrespective of whether the child is normal or abnormal, wrongful conception or wrongful birth as long as the doctor's negligence is admitted.

형법상 자기낙태죄에 대한 헌법재판소 결정(2017헌바127)에 관한 헌법적 검토

박경철 ( Park Gyung-chul ) 한양대학교 법학연구소 2020 법학논총 Vol.37 No.4

이 논문은 헌법재판소가 형법 제269조 제1항의 자기낙태죄에 대해서 2019년 4월 11일 선고한 2017헌바127결정을 헌법적 관점에서 분석하였다. 헌법재판소는, 자기낙태죄가 과잉금지원칙 위반에 위반하여 여성의 임신유지여부에 관한 자기결정권을 침해하였는지 여부를 심사함에 있어서, 특히 침해의 최소성원칙과 법익의 균형성원칙을 준수하고 있는지 여부를 심사함에 있어서 여성에게 원하지 않은 임신을 하지 아니할 자유 내지 권리가 여성의 자기결정권의 보호범위에 포함되는지 여부와 인정된다면 어떠한 보장수단이 제도화되어 있는지를 고려하고 있지 아니하다는 점에서 논증과정이 치밀하지 못했다고 판단된다. 그리고 이 사건 결정에서 헌법불합치의견과 합헌의견은, 태아를 출생한 인간과 같은 동일한 생명권의 주체임을 전제로 하고 있는데, 생명의 발전과정을 일정한 단계로 구분하여 상이한 법적 효과를 부여할 수 있다는 헌법불합치의견의 주장은 인간의 살아있는 상태 그대로를 보호하는 생명권의 본질과 조화될 수 없으며, 모자보건법에 규정된 광범위한 낙태정당화사유를 수용하는 합헌의견의 주장은 태아를 출생한 인간과 같은 동일한 생명권의 주체임을 법현실에서 논리 일관되게 주장하지 못하는 문제점이 있다. 이런 점에서 태아의 생명을 인간의 존엄성에서 비롯되는 국가의 생명보호의무에 의하여 보호되어야 하는 생명으로 이해하는 단순위헌의견의 법리구성이 타당하다고 판단된다. 또한 위헌의견이나 헌법불합치의견은 여성의 자기결정권으로서 임신중단을 선택할 자유를 폭넓게 보장하면서도 여성의 임신중단에 관한 자기결정권의 행사과정에서, 즉 태아의 생명이 배제되는 과정에서 국가가 태아생명보호의무를 이행하기 위하여야 할 내용들에 대해서 경시하고 있다는 문제점 있다고 판단된다. This paper deals with the 2017 Hun-Ba 127 Decision, which was sentenced by the Korean Constitutional Court on April 11, 2019 for self-induced abortion under Article 269 (1) of the Criminal Code, from a constitutional point of view. I believe, in reviewing violations of principle of proportionality for self-induced abortion, consideration should be given to whether women's right not to have unwanted pregnancy and whether institutional protecting measures for it there are. In this decision, this part was not taken into account. The constitutional nonconformity opinion and the constitutionality opinion not only recognize the fetus as an independent living being different from the mother, but also recognize that the fetus, which is a human being in creation, is the same human right holder as the born human. However, I believe, although the fetus is an independent organism that is distinct from the mother, the fetus can not be the human right holder, but the fetus is as a life that must be protected by the state, as the unconstitutionality opinion argues. I think, even if a woman have a right to terminate a pregnancy due to social or economic reasons for a certain period of total pregnancy time, to terminate a pregnancy is a violation of the life of the fetus, which should be protected by the state. In order to protect the life of the fetus, the state should establish a compulsory counseling system as a procedure to confirm the true intention of a pregnant woman and to let her take a prudent decision, before executing an abortion.

윤리적 관점에서 본 응급피임약

최진일(Choi, Jin Il) 가톨릭생명윤리연구소 2015 인격주의 생명윤리 Vol.5 No.2

고농도의 프로게스테론을 함유하고 있는 응급피임약은 성교이후 수정이 이루어졌다고 여길 경우 복용한다. 배아의 착상을 방해하여 불원(不願) 임신을 막기 위해서다. 이것이 응급피임약의 근본적인 목적이다. 따라서 응급피임약은 배아의 생명을 위한 약이 아니라 배아의 생명에 반하는 목적으로 생산된 약이다. 2012년 이 약의 접근성을 높이고자 일반약 전환이 제기되었다. 3년 기간의 유보 기간을 가지면서 대부분의 옹호자들은 그 정당성의 근거를 여성의 자기결정권과 건강권에서 찾는 듯하다. 한편, 응급피임약의 접근성을 높이고자 하는 보다 근본적인 이유는 향락주의적 성문화로 인해 발생하고 있는 미혼모, 낙태 문제 해결을 위한 것으로 보인다. 이것은 응급피임약 논의가 개인적인 문제와 사회적인 문제가 맞물려 있다는 것을 함축한다. 하지만 그 논의가 자기결정권의 측면을 크게 부각시킴에 따라, 우리 사회의 향락주의적 성문화 자체에 대한 비판적 고찰은 간과하는 경향이 있다. 즉 비용-이익 계산의 관점에서, 응급피임약의 접근성 향상을 표면적으로 드러나는 문제에 대한 유일한 해결책으로 삼으려는 경향이 있다. 한편 자기결정은 이성적 판단에 근거한 것으로, 그 이성적 판단의 기준이 무엇인지에 대한 윤리적 성찰은 자기결정에서 핵심으로 다루어야 할 문제이다. 응급피임약 논의에서 자기결정권을 접근성을 높이기 위한 중심 근거로 삼고 있지만 그 이성적 판단 기준에 대한 윤리적 성찰은 사실 편향되어 있다. 응급피임약은 배아의 생명을 위협하는 것으로서, 응급피임약 자체가 비윤리적이다. 덧붙여, 왜곡된 이성적 판단을 근거로 하는 응급피임약의 선택은 이미 선(善)을 거슬리고 있는 것이다. 따라서 응급피임약 자체도 허 용될 수 없지만, 그 접근성을 높이게 될 경우 개인의 행복추구와 사회의 공동선 구축을 위해서도 역기능의 역할을 수행하게 될 것이다. Emergency contraception pills(EC) that contain high progesterone is taken after intercourse given in a case fertilization would be achieved to prevent unwanted pregnancies disturbing implantation of the human embryo. It is the fundamental goal of EC. For this reason, the EC is produced not for the life of the embryo but against the life. In 2012, there was an attempt to make EC easily accessible to get it without prescription. During 3 years to monitor its use, most advocates of EC seem to find the foundation of justification on the right to women's self-determination and health. On the other hand, the deeper reason for increasing the easy accessibility is probably to resolve problems of unmarried (youth) mother, abortion generated by hedonistic sexual culture. It implies that the debate on EC is interwoven individual with social problems. However, as the debates focus largely on the aspect of self-determination, the critical consideration about the hedonistic sexual culture per se seems to be overlooked. In other words, many tend to consider the easy accessibility of EC as only the solution for the problem which is superficially exposed from the perspective of cost-benefit calculation. Meanwhile, self-determination is based on rational judgments, and thus the ethical reflection on what are the criteria of the judgements must be the heart of self-determination. Although self-determination is the core foundation to justify the increasing accessibility of EC, the ethical reflection on the criteria is actually biased. EC is threatening the life of the human embryos, hence EC itself is unethical. In addition, the choice of EC in which the distorted rational foundation is embedded is already against the good. Therefore, not only cannot EC itself be permissible, but it will also be against promoting happiness for individuals and cultivating common good for our society when the increasing easy accessibility of EC is allowed.