KMA holds public health hostage in protest of new licensing bill

Posted on : 2021-02-23 17:46 KST Modified on : 2021-02-23 17:46 KST
The Koraen Medical Association’s threat to stop cooperating with Seoul draws the ire of the S. Korean public
Minister of Health and Welfare Kwon Deok-cheol (left) returns to his seat after a photo op at a second meeting of the joint physician-government COVID-19 vaccination committee, which was held at the Korea Health Promotion Institute on Feb. 21. Choi Dae-zip, president of the Korean Medical Association, is seen on the right. (Yonhap News)
Minister of Health and Welfare Kwon Deok-cheol (left) returns to his seat after a photo op at a second meeting of the joint physician-government COVID-19 vaccination committee, which was held at the Korea Health Promotion Institute on Feb. 21. Choi Dae-zip, president of the Korean Medical Association, is seen on the right. (Yonhap News)

An amendment to South Korea’s Medical Service Act that would allow for revoking the licenses of physicians convicted of crimes involving prison sentences or harsher penalties is to go before the National Assembly Legislation & Judiciary Committee on Feb. 25 after passing a Health and Welfare Committee review on Feb. 19.

The Korean Medical Association (KMA) has threatened to stop cooperating with the administration of COVID-19 vaccines if the Legislation and Judiciary Committee approves the amendment. But its actions are drawing the ire of experts and the general public, who view the punishments for physicians convicted of crimes as being laxer in South Korea than in other countries.

The matter is also seen as something that the KMA is ill-equipped to regulate on its own, while many are insisting that physicians should bear the same social responsibilities as other professional classes such as attorneys.

The proposed Medical Service Act amendment would allow for revoking the license of any physician sentenced to prison or a harsher penalty for five years after completion of their sentence.

But an exception has also been included for cases where deaths result from errors in the course of healthcare activities — a gesture intended to prevent a situation where physicians refuse to perform surgery.

In 1973, the Medical Service Act listed “sentencing to prison time or harsher penalties, regardless of the category of crime” as grounds for revoking a physician’s license.

As the South Korean government pursued a separation of the prescription and dispensation of pharmaceuticals in 2000, it reached a behind-the-scenes agreement with physicians. The Medical Service Act was amended to limit the scope of crimes subject to license revocation to “falsely prepar[ing] and issu[ing] a medical certificate” and crimes related to medical services.

But the revised scope has been the subject of ongoing criticisms, with many insisting the scope and level of punishment for physicians are too limited.

In November 2020, Hong Hyeong-seon, a senior expert for the National Assembly Health and Welfare Committee, drafted a review report noting that Japan revokes the licenses of any physician “sentenced to fines or harsher penalties,” without restrictions according to crime.

In Germany, licenses and permits are revoked when physicians are convicted of crimes directly or indirectly related to their professional duties, including malpractice-related injury, fraud, sexual offenses, document falsification and tax evasion. In the UK, physician registration is revoked or suspended in cases of crimes related to professional duties, such as inappropriate relations with patients, and in cases of individual crimes related to driving, assault, sexual misconduct and other inappropriate actions.

The Medical Service Act amendment also reflects concerns that physicians convicted of sexual crimes are being treated too leniently, with numerous cases emerging where the only punishment has been a one-month suspension of qualifications.

According to Ministry of Health and Welfare (MOHW) figures, a total of five physicians and practitioners of Korean medicine have been convicted of sexual crimes since 2015; in all cases, the only measure taken was a one-month suspension of qualifications. A representative example was the case of a physician surnamed Yang, who was sentenced to two years and six months in prison for assaulting three female patients while they were anesthetized to undergo a colonoscopy.

Even with the amendment, physicians’ licenses would be suspended for five years rather than permanently revoked. After that period, physicians would be eligible to apply for reissuance. In the five years since 2015, license reissuances have been granted to 120 out of 124 applications, or 96.8 percent.

The government also dismissed the KMA’s contention that a physician’s qualifications could be revoked for a prison sentence or harsher penalty resulting from an unintentional traffic accident that causes someone’s death.

In a Feb. 22 briefing, MOHW health service policy coordinator Lee Chang-joon said, “In most cases, fatal traffic accidents are punished by fines, while prison sentences and harsher penalties are reserved solely for intentional and malicious incidents such as driving without a license or assaulting another driver.”

The KMA has further claimed that it is unfair to apply similar standards for punishing physicians and attorneys, arguing that the scope of their duties is different. To make its case, the association cited a 2019 Constitutional Court decision in a petition submitted by an attorney, in which the court concluded that “while the scope of the duties of physicians and others is limited to their field of expertise, an attorney’s extends to all legal practices.”

But this interpretation has also been rebutted. Noh Hee-beom, an attorney and former Constitutional Court researcher, said the KMA was “interpreting [the ruling] in a self-serving way.”

“The Constitutional Court decision at the time did not claim that physicians do not bear any social responsibility or serve the public interest, nor could the decision be used as a basis for arguing that physicians should be given preferential treatment,” Noh said.

Chung Hyeong-joon, a physician who chairs the policy committee for the Korean Federation of Medical Activist Groups for Health Rights, said, “As we saw with the strike last year, the KMA is unable to control the physician community. We can’t expect to see effective self-regulation in cases of physicians convicted of serious crimes.”

Kim Yoon, a professor of healthcare management at the Seoul National University medical school, said, “If there are aspects that aren’t reasonable, then [the KMA] should present alternatives as it makes its demands.”

“The KMA’s attitude of saying things like ‘we won’t cooperate with vaccine administration’ or ‘we’re going to go on strike’ is highly inappropriate at a time when all of society views vaccination as a life-or-death matter,” Kim said.

By Kim Ji-hoon, staff reporter

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