[비즈한국] Last month, a nurse at Daegu Catholic University Medical Center sparked public outrage after posting photos on social media of a newborn sitting on her lap, accompanied by captions such as "Experiencing intermittent explosive disorder," "Feeling like dropping the baby," and "I was annoyed as soon as they arrived, so I restrained them." The victim's family stated that they have captured evidence suggesting at least three nurses, including the one who posted the photos, abused five or more additional newborns, and have submitted this material to investigative authorities.
According to major child abuse statistics released by the Ministry of Health and Welfare, there have been 261 cases of child abuse occurring in "hospitals" over the last five years, averaging 52.2 cases per year. By year, the numbers are 63 cases (0.2%) in 2019, 55 cases (0.2%) in 2020, 57 cases (0.2%) in 2021, 46 cases (0.2%) in 2022, and 40 cases (0.2%) in 2023. This incident has reignited calls for mandatory CCTV installation in neonatal units and strengthened child abuse prevention training for nurses. We examined how current laws regulate this issue, and analyzed trends such as the number of neonatal intensive care unit (NICU) beds per nurse, based on the results of the 1st to 3rd "NICU Adequacy Evaluations" conducted by the Health Insurance Review and Assessment Service (HIRA).
With the allegations of abuse by a nurse at Daegu Catholic University Medical Center, the installation of CCTVs in neonatal units has once again become a point of contention. Similar discussions took place in 2019, when a nurse at an obstetric clinic in Dongnae-gu, Busan, dropped a five-day-old newborn, leaving the baby in a vegetative state. During the investigation, it was discovered that the nurse had abused 14 newborns on more than 20 occasions. At the time, a petition to the Blue House demanding mandatory CCTV in neonatal units and operating rooms garnered over 200,000 signatures, but the subsequent amendment to the Medical Service Act excluded "neonatal units."
Because newborns cannot prove abuse themselves, investigations without CCTV rely solely on the perpetrator's confession. The Medical Service Act amended in September 2021 limited mandatory CCTV installation to "operating rooms." The amendment mandates that medical institutions where surgeries are performed on patients under general anesthesia or sedation (where the patient is unconscious) must install CCTVs and record the surgery if requested by the patient or their guardian. This applies when the patient is in a state where they cannot perceive, remember, or express their will. Critics point out that since newborns are just as unable to express their will as patients undergoing surgery, CCTV recording is necessary. Related bills, such as amendments to the Mother and Child Health Act targeting neonatal units, were proposed in the National Assembly but were ultimately discarded.
It has also been found that "child abuse prevention training" for nurses is insufficient. Under the Child Welfare Act, medical personnel such as nurses are mandated reporters of child abuse and must receive one hour of training annually. The curriculum covers laws regarding child abuse prevention and reporting obligations, how to report when child abuse is discovered, and procedures for protecting child victims. The focus is on the duties of a reporter rather than the prevention of abuse. Furthermore, medical personnel are required to complete at least eight hours of continuing education annually under the Medical Service Act, but "child abuse prevention" is not a mandatory subject. On the online continuing education website for nurses, searches for keywords like "newborn" and "abuse" yielded only loosely related subjects such as "High-risk Newborn Nursing" and "Nursing Ethics and Practice." The latter, which seemed most relevant, dealt with ethical issues focused on terminal, acute, and intensive care patients. Among over a dozen subjects, no specific child abuse prevention training was found.
There are also opinions that the "number of beds per nurse" in the NICU should be reduced. The quality of care in an intensive care unit increases when the number of patients per nurse is lower. According to the Medical Service Act, the number of patients per nurse in the NICU must not exceed 1.5. Data from the 1st to 3rd "NICU Adequacy Evaluations" conducted by HIRA shows that while the number of beds per nurse has decreased, the variation between medical institutions has not narrowed. The average number of beds per nurse was 0.83 in the first evaluation (2018), 0.73 in the second (2020), and 0.75 in the third (2022). However, the gap between the minimum and maximum values remains persistent, recorded at 1.09 in the first, 0.99 in the second, and 1.04 in the third.
Meanwhile, the Ministry of Health and Welfare's child abuse statistics do not properly categorize cases where "medical personnel" are the perpetrators. It is only inferred that medical personnel are the perpetrators when the place of occurrence is a "hospital." While medical personnel are included in the reporter categories, the classification of the "relationship between the perpetrator and the victimized child" only lists parents, relatives, substitute caregivers, kindergarten staff, elementary/middle/high school staff, academy employees, childcare staff, child welfare facility workers, other facility workers, youth-related facility workers, foster parents, nannies, others (neighbors, strangers), and so on.