South Korea has become the first country in the world to mandate close-circuit cameras (CCTV) in operating rooms (ORs).
However, the move has sparked controversy among patient groups and surgeons alike.
The newly revised Medical Services Act came into effect last month, mandating the installation of CCTV in ORs across all medical institutions.
HD-quality cameras must be positioned so that both the patient and the whole surgical team are visible on screen.
The aim is to prevent possible abuses against patients under anaesthesia.
Those who violate the new requirement are subject to fines of up to 5 million won, or $3,700.
But the plans have sparked a contentious battle over patient privacy, trust in doctors and medical practitioners’ freedom to operate without constant surveillance.
The revised law, approved by the National Assembly in 2021 with strong public support, follows a series of medical accidents involving surgery conducted by unqualified personnel and instances of sexual harassment of patients under anaesthesia by medical staff.
While the move addresses some valid concerns, patients and their families argue that the revised legislation contains numerous loopholes and fails to go far enough.
Lee Na-geum, a leading advocate for medical justice and patients’ rights, believes the clauses related to reasons for refusal, video storage duration and access procedures are inadequate and vague, potentially allowing doctors to evade recording.
Hospitals can reject CCTV recording during emergencies, natural disasters, or situations where video surveillance might disrupt surgery, medical training or life-saving measures.
Additionally, the revised rules require hospitals to retain video footage for a minimum of 30 days, a period that Lee and her organisation insist should be extended to at least 90 days, considering the time needed for legal proceedings in case of disputes.
But critics want the onus on hospitals to archive video footage for longer. They also want fewer clauses regarding exceptions to surveillance, arguing that these conditions are ambiguous and subject to manipulation.
Lee’s advocacy stems from the tragic death of her son, Kwon Dae-hee, who passed away in 2016 after undergoing jawline surgery in Seoul.
CCTV footage revealed that an unqualified assistant had participated in the surgery, leading to Kwon losing over 3.5 litres of blood. Three years later, the surgeon was found guilty of involuntary manslaughter and received a three-year prison sentence.
Meanwhile, hospitals and medical groups claim that video monitoring undermines trust in doctors and violates patient privacy and doctors’ freedom of occupation.
The Korean Medical Association (KMA) and the Korean Hospital Association (KHA) have challenged the revised law’s constitutionality.
KMA President Lee Pil-soo argued that CCTV recordings might expose sensitive surgical techniques, potentially misinterpreted as inappropriate physical contact with patients.
Furthermore, KMA expressed concerns that the revision might discourage doctors from taking proactive steps during surgery, potentially depriving patients of the best available treatments.
KHA President Yoon Dong-sup warned that video surveillance could lead to privacy and personal rights breaches, as patients’ private information and body images might be exposed through cybersecurity vulnerabilities.
At the time of publishing, the KMA was scheduled to hold a press conference condemning the law’s enforcement.
