Aftereffects of the ‘aunt who gave injections’, “To what extent is home visit treatment legal?”

As famous celebrities became embroiled in suspicions of ‘injection aunts’, the practice of medical visits outside hospitals was put on the chopping block.
We looked into the legal standards, exceptions, and levels of punishment for visiting medical treatment, which is widely practiced even among the general public.

Following comedian Park Na-rae, the so-called ‘rosacea aunt’ controversy is spreading widely in the entertainment industry, including famous idol group members and YouTubers. When suspicions arose, they admitted to illegally visiting medical services and declared a cessation of broadcasting activities. Aunt Juju refers to a type of ‘unlicensed illegal medical practitioner.’ It is a metaphorical term for a woman who visits homes without a medical license and illegally administers nutritional supplements or injections.

It is difficult to dismiss illegal medical visits as an aberration of some celebrities. In online communities such as mom cafes and SNS, you can easily find posts such as “Looking for a nurse to give injections at home” or “I have an IV in my family at home because I have a nurse.” In one online cafe, there was even a line of comments such as “I left your number in a message” on a post asking “I’m not feeling well right now. Can I get an IV in 2 hours?” This suggests that visiting medical services are being carried out without protection even among the general public.

Jang Hyeon-jae, director of Fatima Clinic, a specialist in home visits for 29 years, cited ‘lack of awareness’ as the main reason for illegal visit treatment. There are many people who view IV treatment outside the hospital as a simple nutritional supplement and do not recognize it as a medical practice. Director Jang Hyeon-jae said, “When we provide on-site treatment, due to the nature of the space, we are not fully equipped with medical equipment like hospitals, so we are more careful about diagnosis.”

Non-medical people without medical qualifications visit ‘Aunt Rosacea’

According to Article 33 of the Medical Service Act, IV procedures performed outside hospitals are clearly illegal under the Medical Service Act. This means that the procedure should only be performed at medical institutions where medical services can be performed. However, as an exception, in cases where emergency patients are treated in accordance with the Emergency Medical Services Act or at the request of the patient or patient's guardian, treatment may be performed at a location other than a medical institution. In addition, visitation treatment is permitted when the head of the national or local government deems it necessary for the public interest or when there are unavoidable reasons for providing treatment at the patient's location.

So what are the criteria for judging the first exception, ‘emergency patient’? Attorney Jang Se-chang of Daeryun Law Firm said, “It depends on the judgment of the medical staff,” and added, “Under the exception rule that ‘treatment is possible upon request from the patient or guardian,’ it is possible to receive on-site treatment even if it is not an emergency.” He said, “However, if you use visit treatment even if you are able to move or it is not an emergency, you cannot apply for health insurance medical fees,” and “The patient must pay the full cost of visit treatment.”

The court and the Ministry of Health and Welfare are interpreting the exceptional circumstances mentioned above relatively strictly. For example, in 2011, in a case where a medical corporation required its doctors to regularly visit multiple social welfare facilities for treatment, the Supreme Court ruled that ‘treatment at the request of a patient or patient’s guardian’ means only cases provided in response to an individual and specific request from a specific patient. This means that the act of deliberately repeating medical visits without the patient's request may also constitute a violation of medical law.

Visiting treatment is only possible with a domestic medical license. In other words, it means that medical practices such as nurses coming to people’s homes to prescribe prescriptions and administer injections are ‘illegal.’ Some say that “retired nurses and currently active nurses can apply,” but this is also not true. This is because Article 27 of the Medical Service Act states, “Medical personnel cannot perform medical practices other than those licensed.” Nurses serve as assistants in medical treatment performed under the guidance of doctors. This means that nurses can administer drugs according to the doctor's prescriptions and instructions, but they cannot decide the type or dosage of the drug on their own. However, there is an exception in cases where patients who have been discharged after surgery or have difficulty moving receive ‘home nursing services.’ A family nurse practitioner who has passed the national qualification examination can administer medication according to a doctor's prescription at a location other than a medical institution. Therefore, the medical community believes that “those who are called ‘aunts of injections’ are likely to be non-medical people who are not qualified to visit medical services.”
 

The risks and punishment levels of illegal medical visits must be emphasized.

In online communities, there are also stories of experiences in which a family member or acquaintance who is a doctor provided medical treatment on a visit. Jinhee Kim, a medical lawyer, said, “Cases like this can be viewed as the standard for general visit treatment.” He said, “However, in accordance with relevant laws, you must keep a medical record containing symptoms, diagnosis, treatment process, and details to avoid problems later.”

If a person who is not qualified to be a medical professional provides on-site treatment, he or she may be subject to imprisonment of up to 5 years or a fine of up to 50 million won. Attorney Jang Se-chang warned, “If such an act is repeatedly carried out for money or made into a business, the ‘Special Measures Act on the Control of Health Crimes’ rather than the Medical Service Act applies, and the person can be imprisoned for life or more than two years.” According to a 1997 case law, “if a medical visit is carried out with the intention to repeat illegal medical practice, it is considered ‘medical practice as a profession,’ even if the act is limited to a one-time act.”

The same goes for drugs. According to the Pharmaceutical Affairs Act, non-pharmacy owners (pharmacists or oriental pharmacists) cannot sell medicines, and medicines cannot be sold in places other than stores. In particular, prescription drugs can only be sold with a doctor's prescription. Violation of this may result in imprisonment of up to 5 years or a fine of up to 50 million won according to the Pharmaceutical Affairs Act. It is also illegal for pharmacists to provide on-site medical treatment, diagnose a patient's illness, and provide prescription medication. In fact, in 2017, the Supreme Court judged and punished a case in which a person holding only a pharmacist's license engaged in medical treatment that falls within the scope of a doctor's license was an unlicensed medical practice.

What kind of punishment will a patient receive after receiving medical treatment? If the patient did not know that the medical practice was illegal, in principle, he or she is not subject to criminal punishment. However, if you are more than a simple victim and are an ‘instructor’ who caused someone to practice medicine without a license, you cannot be free from legal responsibility. Article 27, Paragraph 5 of the Medical Service Act stipulates that “no one shall allow a non-medical person to perform medical services.” Even if the subject of treatment is ‘oneself,’ it is against the law.

There is also a need to reconsider awareness of illegal home visits and drug prescriptions. In particular, there is a tendency to think that nutritional supplements, such as intravenous fluids, can be easily administered anywhere without a doctor's diagnosis. In principle, fluids are prescribed when there is a medical need, such as dehydration, electrolyte abnormalities, or infection. Lee Yoo-jeong, a professor of family medicine at Korea University Guro Hospital, warned, “If you repeatedly receive intravenous fluids without a doctor’s prescription, infection at the injection site or inflammation of blood vessels may occur. Excessive moisture builds up in the body, which poses a risk to the heart and lungs, and in severe cases, there is a possibility that it may lead to systemic infection.”

#Home medical care #Illegal procedure #Illegal prescription #Injection aunt #Women’s Donga

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