An illustration of a modern operation room | Image: Korea Pro
In a move to counter medical malpractice and restore shaken public trust, South Korea has mandated the installation of surveillance cameras in operating rooms across the nation. This groundbreaking decision, primarily driven by disturbing incidents including unauthorized surrogate surgeries and sexual crimes, marks South Korea as the first country globally to enforce such a measure.
The mandate, part of the revised Medical Service Act, represents a significant shift in the dynamics of medical accountability, intending to safeguard unconscious or anesthetized patients at their most vulnerable. Yet it also ushers in complex debates concerning medical ethics, patient privacy and trust in healthcare settings.
SURROGATE SURGERY
Central to the legislative action was the tragic case of Kwon Dae-hee. In 2016, Kwon, a young man seeking facial contouring surgery — a high-risk procedure involving bone alteration — fell victim to reckless medical practices at a plastic surgery clinic in Seoul.
CCTV footage from the operating room revealed that the lead surgeon was operating on multiple patients simultaneously and left Kwon mid-procedure, delegating the task of controlling excessive bleeding to a nursing assistant without proper medical licensure.
Kwon’s death catalyzed public outrage, spotlighting the need for accountability and transparency in operating rooms. Clinics, often perceived as prioritizing profit over patient care, have been found to engage in practices that significantly elevate the risk of medical accidents, such as treating numerous patients in a production-line manner, leaving patients like Kwon to suffer the consequences.
The fallout from this case and the persistent advocacy from the victim’s family and public supporters were instrumental in the legislative push for surveillance in operating rooms.
The evidence provided by the CCTV footage in Kwon’s case was indisputable, leading not only to court-ordered compensation for the victim’s family but also to a three-year jail sentence for the surgeon involved.
NEW LEGISLATION
The revised Medical Service Act, enacted on Sept. 25, stipulates that medical clinics nationwide must equip their surgical facilities with closed-circuit cameras, a proactive step designed to act as a deterrent against malpractice or crime.
However, the law is nuanced in its application. Recordings are not automatic; they occur at the explicit request of patients or their legal representatives, marking an attempt to balance privacy concerns with the push for transparency. Medical staff, however, retain the right to refuse recording, given “valid reasons” — a vague term yet to be rigorously defined.
Despite the legal obligations, there have been instances of malicious compliance, exposing loopholes that jeopardize the law’s efficacy. A poignant illustration is the case of a woman in her seventies who died during an operation. Despite the presence of installed cameras, the surgery went unrecorded due to the family’s failure to explicitly file a request for a recording before the procedure.
Instead of verbally instructing the patient and her family of their new rights under the revised law, the clinic posted an obscure notice on a wall where patients do not typically look.
This incident, among others, raises concerns about the ease with which medical facilities might circumvent regulations.
Further, the legislation states that the mandate allows for discretion in high-risk, urgent surgical cases demanding immediate and undistracted medical intervention or scenarios where recording might compromise the treatment.
The onus of request lies with the patient, a point of contention if patients are unaware of their rights or the new measure.
Further, the legislation does not automatically grant viewing rights to the recorded parties. To access the footage, patients or their families must secure the consent of all medical staff present during the surgery — a stipulation that could prove challenging, especially if the footage contains evidence unfavorable to the medical personnel involved.
An illustration of doctors and nurses | Image: Korea Pro
PUBLIC AND PROFESSIONAL RECEPTION
The new surveillance mandate has cleaved public opinion in South Korea, especially between the general populace and medical professionals.
For many, the government’s decision is a long-overdue victory for patient rights. Advocacy groups and ordinary citizens express hope that this level of transparency will be a bulwark against the malpractices that have long undermined trust in medical institutions.
However, the reception within the medical community is far less enthusiastic. The Korean Medical Association (KMA), a significant representative body for the profession, reveals deep-seated opposition. A survey it conducted showed 93.2% of medical professionals contesting the revised act.
Their grievances mainly center around concerns that constant surveillance compromises doctors’ autonomy, creating a “Big Brother” atmosphere that could be more inhibitive than protective.
Physicians worry they’ll be compelled to practice overly cautious medicine, ordering unnecessary tests or avoiding high-risk procedures, not for the patients’ benefit but as a safeguard against potential litigation — a practice that could dilute the quality of care and spike healthcare costs.
Additionally, the medical community cited the psychological toll of continuous monitoring as a stressor that could impede surgeons’ performance, jeopardizing the very patient safety the law aims to fortify.
In defiance of the revised law, the KMA filed a constitutional appeal in September, branding the mandate an overreach that undermines medical professionals’ rights.
SEXUAL ASSAULT CASES
However, a series of disturbing incidents have jolted South Korea, revealing a trend of sexual assaults committed by medical staff on unconscious patients, further eroding public trust in medical institutions.
A case that starkly illustrates this issue involved a medical intern at a maternity clinic. According to local news sources, the intern egregiously violated professional and ethical boundaries, touching an anesthetized female patient inappropriately multiple times and making sexual comments during a surgical procedure, which further increased calls for the installation of cameras.
The intern’s medical license was suspended, but he didn’t face permanent professional ostracism. His license was reinstated after a three-month suspension, allowing him to continue his medical training at another hospital in Seoul.
Current legal frameworks in South Korea offer a surprising degree of protection to medical professionals, even those who commit heinous acts. The grounds for permanent revocation of a medical license are exceedingly narrow, limited to circumstances like mental incapacitation, drug addiction, decision-making impairment, or administrative violations such as falsifying medical records or license lending.
However, professionals found guilty of severe crimes, including homicide or sexual assault of a patient, face no mandatory loss of license, an omission that has sparked public ire and disbelief.
Data disclosed by Democratic Party lawmaker Nam In-soon, originating from the National Police Agency, is particularly alarming: out of 717 doctors arrested for sex crimes in the past five years, only five faced license suspensions, with none permanently ousted from the profession.
GOING FORWARD
Implementing South Korea’s surveillance law in operating rooms is poised to significantly alter the dynamics between patients and medical professionals, potentially heralding a new era of transparency and accountability in healthcare. However, the law’s long-term outcomes remain uncertain.
Despite its good intentions, the law underscores the ongoing discord between the medical community and public trust. Past transgressions, from surrogate surgeries to sexual assaults, have tainted the perception of a profession traditionally regarded with the utmost respect.
Whether this law will serve as a catalyst for restored confidence or morph into a flashpoint for further conflicts is contingent on its execution. It necessitates delicate balancing — safeguarding patient rights while maintaining the dignity and morale of medical professionals.
The ultimate success of this legislation remains to be seen.
In a move to counter medical malpractice and restore shaken public trust, South Korea has mandated the installation of surveillance cameras in operating rooms across the nation. This groundbreaking decision, primarily driven by disturbing incidents including unauthorized surrogate surgeries and sexual crimes, marks South Korea as the first country globally to enforce such a measure.
The mandate, part of the revised Medical Service Act, represents a significant shift in the dynamics of medical accountability, intending to safeguard unconscious or anesthetized patients at their most vulnerable. Yet it also ushers in complex debates concerning medical ethics, patient privacy and trust in healthcare settings.
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Junghyun is a media-friendly junior journalist with a BA in Liberal Arts and Science from the Netherlands. Raised in South Korea, Malaysia and the Netherlands, she is currently based in Seoul, undergoing her journalism internship program at The Korea Herald, South Korea’s largest English newspaper company. Her main interest is in covering South Korean culture and social affairs.