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The Grammar of Medical Practice and the Middle Voice: Toward Middle-Voice Justice and a More Inclusive Medical Culture

  • Korean Journal of Medical Ethics
  • Abbr : 의료윤리
  • 2025, 28(4), pp.241~256
  • Publisher : The Korean Society For Medical Ethics
  • Research Area : Medicine and Pharmacy > General Medicine
  • Received : November 23, 2025
  • Accepted : December 29, 2025
  • Published : December 31, 2025

강철 1 Sang Tae Choi 2

1연세대학교 보건대학원
2중앙대학교 의과대학 내과학교실

Accredited

ABSTRACT

Medical practice is a multi-layered phenomenon characterized by systemic complexity, epistemicuncertainty, and outcome‑oriented nature. However, legal discourse in medical litigation oftenreduces this complexity by employing active/passive grammatical constructions, framing clinician–patient interactions in terms of a simplistic offender/victim binary. In response, this article introducesthe concept of the middle-voice, defined by two grammatical features: (1) the internal involvementof human and non-human elements in the occurrence of action, and (2) the dynamic emergenceof action through contextual interactions. It proposes a middle-voice structure that incorporatesantecedent-condition clauses, inanimate subject constructions, and the Korean “-ge doeda” form(equivalent to the English verb “become”). This framework supports the development of middlevoicejustice, which moves beyond adversarial models and promotes a more inclusive culture ofmedical accountability and safety. By offering a theoretical basis for institutional applications, such asin the design of apology laws, this approach enables more accurate descriptions of medical accidents,more balanced attributions of responsibility, and reconsideration of the institutional foundationsnecessary for a just medical culture.

Citation status

* References for papers published after 2024 are currently being built.

This paper was written with support from the National Research Foundation of Korea.