선의(船醫) 승무의 중요성은 적절한 의료환경 조성과 선원의 보건권 확보에 있다. 그러나 모든 선박에 선의 승무를 요구하는 것은 현실적으로 어려우며, 국제협약 및 국내법에서는 일부 선박에 대해서만 요건을 정하고 있다. 이에 본 연구는 우선 󰡔선원법󰡕 제정과 함께 시작하여 국제협약(STCW, MLC) 도입으로 인하여 개정되어 현재에 이르게 된 선의(船醫) 승무 요건을 살펴보고, 해석상 쟁점 사항을 발견하며, 이에 대한 입법적 개선안을 제안하였다. 먼저, 2006 MLC 협약과 󰡔선원법󰡕에 의거하여 현재 승무 요건은 3일 이상 국제항해에 종사 하는 최대 승선 인원 100인 이상인 선박으로 규정되어 있다. 이 과정에서 승무 요건에 대한 다양한 해석이 발생하고 있으며, 명확한 해석이 필요하다. 본 연 구는 “Carrying”의 의미를 통한 최대 승선 인원에 대한 범위를 여객으로 한정 하며, 3일 이상 국제항해의 적용과 선의의 정의에 대한 해석상의 쟁점을 제기 하고, 입법론적 해결 방안을 제안하였다. 행정형벌이 예상된 만큼 형사법의 원 칙으로서 죄형법정주의에 따라 법률의 구성요건 명확해야 하는 명확성 원칙의 저촉을 방지함을 목적으로 본 연구를 통해 선의 승무에 대한 명확한 지침과 법 적 안정성을 확보하고, 법률 준수 및 적법한 법 집행을 기대할 수 있을 것으로 보인다.

By Medical Service Law(below, abbr as ‘Law’), the medical institutions should be established and run by ‘the doctors or the qualified persons’(below, abbr as ‘doctors’), who are permitted by the related laws. And there is a case such as non-doctors establish the institutions, hire doctors and run the institutions, or non-doctors and doctors co-establish the institutions and run the institutions. This kind of act is treated as violations under Law. When, in their running the institutions, doctors treat the patients, which means doctors give the patients the medical care in place of National Health Insurance Service(below, abbr as NHIS), doctors ask the costs of the medical care to NHIS. If the costs of the medical treatment(the medical care) do not exist or are exaggerated, the act of asking the costs will constitute Fraud. But if doctors in such institutions described above treat the patients fairly, and then ask NHIS the costs with no falsity or exaggeration, does that act constitute Fraud? This kind of act has not been treated as Fraud until 2013. But from the second half of 2013, this kind of act has been prosecuted as Fraud. Is that prosecution right? Is it guilty as Fraud? Medical treatment has a broad effecion on the health and welfare of people, so business mind should be excluded from medical treatment. And Law has regulations on the qualification of establishing the institutions to prevent the substantial distortion of medical treatment. But if doctors’ treatment is true, which means there is no falsity or exaggeration in medical treatment, then there can not exist the substantial distortion. And the article 57 ① of Law regulates ‘trick or the other undue method’, but I think this kind of act does not conform to the article 57 ① of Law. And even if this kind of act conforms to the article 57 ① of Law, it does not mean that it is Fraud. Because Fraud has the strong character of mala in se, transcendentally the act of Fraud should be evaluated anti-social and immoral. But this kind of act can not be assessed anti-social and immoral transcendentally. And the criminal control on this kind of act can not be the fundamental measure to prevent the financial aggravation of NHIS. And because this kind of act is treated as violations under Law, if the punishment of Fraud is added, it could violate the principle of proportion or principle of subsidiarity.