진료과오 사건에서 간접사실을 통한 인과관계 추정 -대법원 2023. 8. 31. 선고 2022다219427 판결-

In medical malpractice cases, the burden of proving both negligence and causation falls on the patient. Due to the asymmetry of information resulting from the expertise, discretion, and confidentiality inherent in medical practice, the patient is placed in a relatively disadvantaged position in proving negligence. Moreover, it is often difficult to establish a causal link between negligence and the resulting damage, as medicine is a field still in progress. This article examines the Supreme Court decision rendered on 2022Da219427, which, in line with previous case law, confirms the legal principle that causation may be inferred where the patient proves the existence of indirect facts. However, the decision goes further by holding that if the patient proves both (i) the existence of an act that can be assessed as a medical error, namely a breach of the duty of care required of an ordinarily competent medical professional, and (ii) the probability that this error caused the harm, then causation may be presumed. Thus, the decision is significant in that it clarifies the requirements for presuming causation through indirect facts and articulates the structure of such inference. Moreover, the decision differentiates the degree of proof required in civil cases from that required in criminal cases, where proof beyond a reasonable doubt is necessary. It establishes that in civil proceedings, a standard of probability suffices for the presumption of causation, thereby acknowledging that civil and criminal liability may lead to divergent outcomes in identical factual scenarios.