[Contribution] Surrogate prescription, balance between patient convenience and safety

It is not unfamiliar to see cases where a guardian caring for a dementia patient visits the hospital on behalf of the patient but turns away after being told that the patient must come in person. For elderly patients with limited mobility or patients who need long-term medication due to chronic diseases, proxy prescriptions, or more precisely, 'proxy receipt of prescriptions', are not simply convenience, but a key element of treatment continuity.

The current medical law stipulates that only patients who have been directly examined by a doctor, dentist, or oriental medicine doctor can receive a prescription. However, as an exception, it stipulates that prescriptions can be received on behalf of patients only in very limited situations, such as when the patient is unconscious or has significant difficulty moving and the same prescription is given for a long period of time for the same injury or disease. However, even in this case, only the patient's immediate ascendants, descendants, spouse, spouse's immediate ascendants, siblings, etc. can serve as representative recipients. The Pharmaceutical Affairs Act also, in principle, presupposes direct receipt by the patient. However, in a reality where aging is rapidly progressing, these regulations place a significant burden on patients and their families. This is a bigger problem for elderly patients in rural areas who have difficulty traveling long distances, and for their guardians who must combine care and work.

The reason why the demand for ‘proxy receipt of prescriptions’ is increasing is clear. As of 2024, the population aged 65 or older exceeds 20% of the total, entering a super-aging society, and the prevalence of dementia, cancer, and chronic diseases continues to rise. Coupled with the problem of medically underserved areas, the current system, which requires patients to visit hospitals in person for simple checkups or medication prescriptions, shows a gap with the flow of patient-centered medical care.

However, indiscriminate permission is never the solution. First of all, the doctor's face-to-face treatment of the patient must be provided. If patients do not receive treatment directly, it is difficult for doctors to confirm accurate clinical symptoms and changes, and the possibility of drug side effects or misuse increases. Additionally, if the medicine is incorrectly delivered to a third party or received without the patient's consent, it may lead to privacy protection issues as well as legal disputes. In particular, these days, social problems such as drug distribution and drug abuse are frequently occurring due to the prescription and proxy reception of psychotropic drugs, which are narcotic drugs. The key is to find a balance between convenience and safety.

Therefore, there is a need for institutional supplementation. For example, there is a method of institutionalizing a method for family members to legally receive money on their behalf by introducing a strict guardian registration system based on patient consent. If we carefully review the side effects that these measures may cause and prepare a comprehensive institutional solution at the hospital treatment, prescription, and pharmacy stages, we will be able to find an answer to the problem of balance between currency exchange and personal information protection.

The issue of proxy prescriptions, or proxy collection of prescriptions, is an area where patient convenience and safety, medical professionals' responsibilities, and patients' rights are complexly intertwined. However, what is clear is that this is a problem directly related to the quality of life of patients and the care system of society as a whole. Establishing an institutional solution that ensures patient safety while alleviating the burden on families is an important task that our medical community must solve as we move towards a super-aging society.

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[Contribution] Surrogate prescription, balance between patient convenience and safety (link)