Patients, doctors at loggerheads as operating room CCTV footage made mandatory

Hospital staff inspect a close-circuit camera in an operating room at a hospital in Suwon, Gyeonggi Province, in this Aug. 23, 2021 photo. Newsis

By Lee Hae-rin

Both patients’ groups and the medical sector are reacting against a revised Medical Services Act that requires medical institutions to install close-circuit cameras (CCTV) in operating rooms to prevent possible abuses against patients under anesthesia.

The patients’ groups and bereaved families members of medical accident victims argue that the revision, which will take effect on Monday, needs further complementary measures to require hospitals to archive video footage for longer periods of time and have fewer exceptional clauses to avoid surveillance.

On the other hand, hospitals and medical groups claim video-monitoring will undermine trust in doctors, violate patient privacy and doctor’s freedom of occupation.

The revision was approved by the National Assembly in 2021 amid overwhelming public support following a series of medical accidents involving surgeries by unqualified staff or medical staff’s sexual harassment of patients under anesthesia.

The revision requires medical institutes to install CCTVs in operating rooms and record surgical procedures upon the requests of patients who will go under general anesthesia or their families. Those who violate the requirement are subject to fines of up to 5 million won ($3,700).

However, the revised law still has many loopholes in the view of patients and their families, according to Lee Na-geum, who has led an advocacy group for medical justice and patients’ rights since her son Kwon Dae-hee died after undergoing plastic surgery in 2016.

“The clauses on (hospitals’) reasons to refuse recording, video storage period and the procedure to make the footage accessible are insufficient and vague to meet patients’ needs,” Lee said, stressing that doctors could find ways to avoid recording under the revision.

According to the Ministry of Health and Welfare’s guideline to the revision released on Friday, medical institutions can refuse CCTV recording in case of emergency and natural disasters, or if video-monitoring is deemed to disrupt surgeries, medical residents’ training or doctors’ active measures to save a patient’s life.

Lee said under such regulations, which she and her organization believe are ambiguous and subjective, hospitals can circumvent the requirement.

“For example, at university hospitals, almost all surgeries require anesthesia and medical residents to be accompanied by professors for training,” Lee explained, underscoring hospitals can choose not to record any surgery for the reason mentioned.

Also, the revision requires hospitals to store video for at least 30 days, which Lee views should be extended to at least 90 days, considering the time needed to initiate legal proceedings when disputes arise.

Lee’s son, then a university junior, died of haemorrhage in 2016 after being in a coma for 49 days as a result of jawline surgery in Seoul.

The hospital denied any negligence leading to his death, but Lee obtained CCTV footage of the surgery and after viewing it over 1,000 times concluded that it was performed in part by an unqualified assistant instead of the hospital's chief plastic surgeon, resulting in the patient Kwon losing over 3.5 liters of blood.

Three years after Kwon’s death, the surgeon was found guilty of involuntary manslaughter and received a three-year prison term.

Meanwhile, the Korean Medical Association (KMA) and the Korean Hospital Association (KHA) filed a constitutional appeal against the clause on Sept. 5.

“CCTV recording could reveal doctors’ surgical techniques and know-how, and mislead viewers into seeing a doctors’ inevitable physical contact with a patient as sexual assault,” KMA President Lee Pil-soo said in a statement at the time.

He also said the revision could discourage doctors from taking active steps during surgery, which would “deprive people of the chance to have their health restored and save lives through the best treatments.”

Video surveillance could also “lead to violation of privacy and personal rights of patients,” because private information and images of their body could be leaked through potential cybersecurity breaches, according to the KHA President Yoon Dong-sup.

The KMA plans to hold a press conference to condemn the law’s enforcement at its headquarters in Seoul, Monday.