Doctors cannot be held criminally liable for a medical accident, even one that caused serious harm to a patient, unless the causal link between their negligence and the harm is proven beyond a reasonable doubt, South Korea's Supreme Court has ruled.
The court's second division, with Justice Kwon Young-joon as the presiding judge, overturned a lower court ruling that had handed suspended prison terms to two doctors identified only as A and B on charges of causing bodily injury through professional negligence, legal sources said on the 8th. The case was sent back to the Uijeongbu District Court.
A and B worked as a dermatologist and a pediatrician, respectively, at a university hospital in Goyang, Gyeonggi Province. The case arose from their treatment of a patient who visited the hospital in 2013 with a skin rash on the back.
A prescribed dapsone, a drug whose side effects include toxic hepatitis. Patients on the drug require regular blood tests and liver function tests before and after administration, and must be informed of the risk of side effects. A ordered none of those tests and gave no such explanation.
The patient later developed a high fever and other symptoms after taking dapsone and was admitted to the hospital's emergency room. B, who took over the patient's care, had received a consultation reply from the dermatology department indicating that steroid treatment appeared necessary. B, however, did not administer steroids continuously, instead giving them for short periods and then stopping, repeatedly. The patient fell into a coma from fulminant hepatic failure in late August and underwent a liver transplant.
At issue was whether B's failure to administer steroids continuously amounted to professional negligence, and whether a causal link could be established between A's professional negligence and the patient's injury.
The trial court sentenced A to eight months in prison, suspended for two years, and acquitted B. The appeals court, however, imposed the same eight-month suspended term on B as well. The appellate bench said that "at least after receiving the first consultation reply, there was strong reason to suspect dapsone hypersensitivity syndrome, yet steroid administration was delayed, interrupted and carried out only intermittently."
The Supreme Court took a different view. It found that the lower court had misunderstood the legal principles governing a doctor's duty of care, professional negligence, and proof of a causal link to the resulting injury.
The court concluded that professional negligence was difficult to establish in B's case. It stressed that in criminal cases arising from medical accidents, a doctor's professional negligence must be proven beyond a reasonable doubt.
"In providing treatment, a doctor has considerable discretion to choose the method judged appropriate in light of the patient's condition, the medical standards of the time, and the doctor's own knowledge and experience," the court said. "As long as that choice does not fall outside a reasonable range, it cannot be said, based on the outcome, that only one option was justified and that taking a different measure constituted negligence." The court noted that throughout the patient's hospital stay it remained unclear whether the condition was dapsone hypersensitivity syndrome or a bacterial or viral infection, making it difficult to conclude that B's judgment fell outside the range of reasonable discretion.
The court also overturned the ruling against A, signaling an acquittal. "Even if A is found to have committed professional negligence by failing to conduct the tests and provide the explanation, the evidence submitted by the prosecution does not suffice to prove beyond a reasonable doubt that the patient would not have suffered the injury absent that negligence," the court held.
