Ghost Surgery Prompts Increased Surveillance in South Korea

Ghost surgery is not a new phenomenon. But an increase in cases in South Korea has led the country to pass legislation mandating cameras in operating theatres. Ghost surgery has been on the rise in South Korea since popularity of medical tourism started gaining popularity.

What is ghost surgery?

Ghost surgery is a form of medical malpractice, whereby a surgery is performed by a different individual than the surgeon the patient consents to. In many cases, surgeons will switch places, but just as many instances of ghost surgery are performed by medical or nursing assistants, or even student residents. The majority of cases occur when patients are unconscious.

Some consider ghost surgery to be an ethical grey area, especially if the operation is completed successfully, without injury to the patient. Most victims of ghost surgery only find out that it’s happened if something goes wrong and their treatment is botched. Still, the majority of medical professionals agree it compromises medical ethics.

As in other consent ‘grey-areas’, a patient’s consent to a surgery is conditional, based among other things on the doctor they believe will perform the procedure. If the terms of their consent are altered, consent cannot be given.

The phenomenon has been around for decades, all over the world. Writing in 1980, New York lawyer Margaret Holmes concluded that 50-85% of the operations performed in teaching hospitals by 1978 were done by residents, often without an attending surgeon present.

The South Korean case

South Korea has been especially plagued by ghost surgeries, eroding public trust in hospitals. Legal experts believe the country’s history with ghost surgeries began in the 2010s, at plastic surgery clinics. Around that time, the Korean government began actively promoting medical tourism to the country – where people would travel to South Korea to get cosmetic surgery.

Ghost surgery fears in South Korea are so widespread that fears of the phenomenon were part of the plot in popular Korean Netflix show, Squid Game

The heightened demand may have pushed doctors to secretly hand off procedures to their assistants and nurses. These ghost surgeries sometimes ended in tragedy, such as in the case of university student Kwon Dae-hee, who passed away in 2016 after complications from a jawline ghost surgery.

Certain contextual factors may have contributed to this deadly trend in South Korea. There’s an undersupply of doctors in the country – only 2.5 people out of every 1000 in the country are doctors; lower than the OECD average of 3.3. And over 90% of all hospitals in South Korea are private, increasing the risk of profitability outweighing ethical standards.

In response, the government has introduced legislation to require all surgeries performed on unconscious patients to be filmed on surveillance cameras. If a patient or a relative requests that a surgery be filmed, the hospital must comply, though doctors can refuse for limited reasons. This footage will be valid for use in medical and criminal investigations. The legislation will go into effect in September next year.

Around 100 ghost surgery cases were prosecuted in South Korea in the period 2013-2018. But the Korean Society of Plastic Surgeons estimates the true number of victims to sit at 100,000 for the same period. “People are dying in operating rooms,” says patient advocate An Gi-jong, “we can’t rely on doctors to solve problems on their own anymore.”

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