The appeal is dismissed.

The grounds of appeal are examined (to the extent of supplement in case of supplemental appellate briefs not timely filed).

1. We examine the patient's right of self-determination and doctor's duty of care to refuse blood transfusion in the course of operation.

A. The medical treatment contract is concluded between the doctor and the patient in a case where the patient requests the doctor to provide medical treatment under the medical treatment contract and the doctor starts the medical treatment in response to the request.

In accordance with a medical treatment contract, a doctor shall bear the obligation to diagnose and treat a patient by using all medical knowledge and medical technology for the treatment of a disease, etc., and the patient shall bear the obligation to pay remuneration.

Due to the progress of a disease and the change in the patient’s condition, the content and scope of the medical treatment at the time of the contract are general and abstract, but since the contents of the medical treatment provided according to the confirmation of a disease, the patient’s condition and natural change, and the biological reaction by the medical treatment (hereinafter “patient’s health condition, etc.”) are embodied, the doctor has considerable discretion to choose the methods of medical treatment as appropriate based on the patient’s health condition, etc. at the time of the medical treatment and the patient’s own knowledge and experience.

(2) In light of the medical level at the time of the occurrence of a disease, a doctor shall explain the symptoms of the disease, the details and necessity of the treatment method, the potential risks of the occurrence of a disease, etc., and have the patient choose whether to undergo the treatment by sufficiently comparing the necessity or risk of the disease and deciding whether to undergo the treatment. However, in the event of performing the treatment, such as the surgery of the patient, a doctor shall obtain consent to the treatment.