Carelessness, causation and proof in medical negligence offences

1. 01Question

   In judging a doctor's negligence in a medical accident, what must be examined, what must be proved for causation between that negligence and the result, and to what degree must both be proved before negligence is found under Article 268 of the Criminal Code?

2. 02Holding

   Negligence must be found by asking whether the doctor foresaw and avoided the result, measured against the care of an ordinary average person in the same work, taking into account the level of medicine, the medical environment and conditions, and the special features of the procedure at the time. Causation requires proof that the result would not have occurred without the breach of duty. Both the negligence pleaded in the indictment and the fact that it caused the injury or death must therefore be proved beyond reasonable doubt by strict evidence, and where the prosecution fails to prove the specific conduct amounting to that negligence, the result alone cannot raise a presumption of it.

   Summary of the holding, verbatim

   의료사고에서 의사의 과실을 인정하기 위해서는, 의사가 결과 발생을 예견할 수 있었음에도 이를 예견하지 못하였거나 결과 발생을 회피할 수 있었음에도 이를 회피하지 못하였는지 여부를 검토하여야 하고, 과실 유무를 판단할 때에는 같은 업무·직무에 종사하는 일반적 평균인의 주의 정도를 표준으로 하여 사고 당시의 일반적 의학의 수준과 의료 환경 및 조건, 의료행위의 특수성 등을 고려하여야 한다.

   Unofficial English translation

   In order to find a physician's negligence in a medical accident, it must be examined whether the physician failed to foresee the occurrence of the result although the physician could have foreseen it, or failed to avoid the occurrence of the result although the physician could have avoided it, and when determining whether negligence exists, the degree of care of an ordinary average person engaged in the same work or duties shall be taken as the standard, and the level of general medicine at the time of the accident, the medical environment and conditions, the particularity of the medical practice, and the like must be taken into consideration.

3. 03Disposition

   Reversed and remanded Stated in the decision

   원심판결을 파기하고, 사건을 의정부지방법원에 환송한다.

   Unofficial English translation

   The judgment of the court below is reversed, and the case is remanded to the Uijeongbu District Court.

4. 04Form of the test

   Elements stated Stated in the decision

   의료사고에서 의사의 과실을 인정하기 위해서는, 의사가 결과 발생을 예견할 수 있었음에도 이를 예견하지 못하였거나 결과 발생을 회피할 수 있었음에도 이를 회피하지 못하였는지 여부를 검토하여야 하고

   Unofficial English translation

   In order to find a physician's negligence in a medical accident, it must be examined whether the physician failed to foresee the occurrence of the result although the physician could have foreseen it, or failed to avoid the occurrence of the result although the physician could have avoided it, and

5. 05Factors

   • 의사가 결과 발생을 예견할 수 있었음에도 이를 예견하지 못하였거나 결과 발생을 회피할 수 있었음에도 이를 회피하지 못하였는지 여부를 검토하여야 하고
   • 같은 업무·직무에 종사하는 일반적 평균인의 주의 정도를 표준으로 하여
   • 사고 당시의 일반적 의학의 수준과 의료 환경 및 조건, 의료행위의 특수성 등을 고려하여야 한다
   • 주의의무 위반이 없었더라면 그러한 결과가 발생하지 않았을 것임이 증명되어야 한다
   • 의료행위 과정에서 공소사실에 기재된 업무상과실의 존재는 물론 그러한 업무상과실로 인하여 환자에게 상해·사망 등 결과가 발생한 점에 대하여도 엄격한 증거에 따라 합리적 의심의 여지가 없을 정도로 증명이 이루어져야 한다

   Unofficial English translation

   • it must be examined whether the physician failed to foresee the occurrence of the result although the physician could have foreseen it, or failed to avoid the occurrence of the result although the physician could have avoided it, and

   • the degree of care of an ordinary average person engaged in the same work or duties shall be taken as the standard, and

   • the level of general medicine at the time of the accident, the medical environment and conditions, the particularity of the medical practice, and the like must be taken into consideration

   • it must be proved that, but for the breach of the duty of care, such result would not have occurred

   • not only the existence of the professional negligence stated in the facts charged in the course of the medical practice, but also the fact that injury, death, or the like was caused to the patient by such professional negligence must be proved by strict evidence to the extent that there is no reasonable doubt

6. 06Relation to precedent

   Follows earlier decisions Stated in the decision

   대법원 1996. 11. 8. 선고 95도2710 판결, 대법원 2003. 1. 10. 선고 2001도3292 판결, 대법원 2011. 4. 28. 선고 2010도14102 판결

   Unofficial English translation

   Supreme Court Decision 95Do2710 decided November 8, 1996, Supreme Court Decision 2001Do3292 decided January 10, 2003, Supreme Court Decision 2010Do14102 decided April 28, 2011

   Decisions referred to

   대법원 1996. 11. 8. 선고 95도2710 판결(공1996하, 3632), 대법원 2003. 1. 10. 선고 2001도3292 판결(공2003상, 656), 대법원 2011. 4. 28. 선고 2010도14102 판결, 대법원 2015. 3. 26. 선고 2012도3450 판결, 대법원 2016. 8. 29. 선고 2014도6540 판결

7. 07Burden of proof

   The prosecution Stated in the decision

   검사가 공소사실에 기재한 바와 같은 업무상과실로 평가할 수 있는 행위의 존재 또는 그 업무상과실의 내용을 구체적으로 증명하지 못하였다면

   Unofficial English translation

   if the prosecutor fails to specifically prove the existence of an act that may be evaluated as the professional negligence as stated in the facts charged, or the content of such professional negligence

8. 08Open question and revisit condition

   What level of ordinary medical practice sets the average standard of care for a shoulder injection, and how is that standard established when the parties dispute it?

   The retrial judgment from the Uijeongbu District Court, once it decides whether the pleaded unhygienic conduct occurred, will show how this proof requirement works in practice. A change to Article 268 of the Criminal Code, or a later Supreme Court decision revising the negligence standard for medical accidents, would call for this entry to be read again.

Read 2026-10-25 · Cross-read 2026-10-25. All quotes matched against the official text. The Chinese-character placeholders the court used for anonymised parties are given in their Korean readings, and parenthetical Chinese-character glosses are omitted.

Every entry is published only after all quotes have been matched character by character against the official text, and audited by an independent second reading from a different model family across all eight axes. Both agreed axes and text-grounded interpretive divergences are recorded openly. The ledger is a research record, not an assessment of the court or advice on any matter.