hankyoreh

Seoul National University Hospital Vice President Kim Yeon-soo bows after a press conference announcing the change of the category of death on farmer Baek Nam-ki’s death certificate from “illness” to “external causes”

The death certificate for farmer Baek Nam-ki has been revised to change the category of death from “illness” to “external causes.”

Seoul National University Hospital announced the change at an emergency press conference at its children’s hospital in Seoul’s Yeongeon neighborhood on the afternoon of June 15. The hospital explained that the revision of Baek’s death certificate was discussed at a June 7 meeting of its medical ethics committee, adding that the neurosurgery specialist who drafted the certificate ultimately revised it on June 14 to list the category of death as “external causes.” The cause of death was also revised from “acute subdural hemorrhage,” a type of cerebral hemorrhage, to “traumatic subdural hemorrhage,” which emphasizes that it was the result of trauma.

The revision of Baek’s cause of death comes nine months after the original death certificate triggered heavy debate when it was issued in Sep. 2016. While it is unusual enough for a hospital to revise a person’s cause of death, the fact that it did so nine months after the fact is drawing particular attention.

The revision came after the specialist who drafted the original death certificate for Baek received a recommendation to make the change from the hospital’s own medical ethics committee. But the revision nine months after the fact indicates the possibility that the hospital’s decision to revise the certificate was a response to the arrival of a new administration in the Blue House.

Responding to the questions, the hospital explained that internal discussions were able to begin after Baek’s family filed suit against it in January to demand compensation, and that time was needed to follow the necessary procedures, including meetings of the ethics committee.

“There was no procedure before by which the hospital would have been able to intervene in the presiding doctor’s drafting of a death certificate, but the family’s lawsuit against the hospital provided momentum,” explained hospital vice president Kim Yeon-soo.

The hospital’s final decision to recommend revision came during a June 7 medical ethics committee meeting after it requested an explanation from the presiding neurosurgery department and was told it would be “advisable to follow Korean Medical Association (KMA) guidelines” on the death certificate.

“A specialist is someone of trained status, but he or she has the knowledge and experience to make a determination of the category of death, and because legal responsibility lies with the person drafting it, we recommended that the specialist who wrote the death certificate be the one who revised it,” Kim explained.

Earlier this month, the hospital established a physicians’ professional ethics committee to discuss instances where individual physicians’ determinations differ from those of a professional group. The committee is scheduled to go to work once the detailed guidelines are worked out, including those related to the appointment of members.

The original death certificate touched off controversy as soon as it was made public last September by Baek’s family members. The category of death was listed as illness, which was a clear error in terms of the guidelines for medical certificate drafting made by the KMA and others. According to those guidelines, a patient’s death is regarded as due to external causes in cases of injury due to a traffic accident or other trauma even when the patient is hospitalized for a long period of time. SNU medical students and alumni submitted an opinion calling the cause and category of death “mistaken,” prompting the university’s medical school and college to form a special committee to recommend revision.

But neurosurgery professor Baek Seon-ha, who had been Baek Nam-ki’s family doctor, refused to accept the recommendation. Investigative authorities attempted to use the controversy to carry out an autopsy, which they were forced to abandon due to objections from Baek Nam-ki’s family and the public.

Under questioning during a parliamentary audit in October, National Health Insurance Service chairperson Sung Sang-chul and Health Insurance Review & Assessment Service director Son Myeong-se, both physicians, responded that Baek’s death was due to external causes. But Baek Seon-ha remained unbending his opinion even during the audit.

at the hospital in Seoul’s Yeongeon neighborhood

Woo Seok-kyun, co-representative of the group Physicians for Humanitarian Action, complained that the hospital “has not given a proper apology even after revising its mistaken death certificate.”

“As the person who caused the autopsy controversy by listing the death on the certificate as being due to illness, Baek Seon-ha should be dismissed, and hospital director Suh Chang-suk should take responsibility and step down,” Woo said.

Baek Nam-ki was attending a popular indignation rally near Gwanghwamun Square in downtown Seoul on Nov. 14, 2015, when he was struck by a jet from a police water cannon. Suffering serious injuries to his head when he struck the asphalt, Baek was treated in SNU Hospital’s critical care unit for around 11 months before passing away in late Sep. 2016.

“Nine months have passed since my father died, but at least the cause of death has been corrected now,” Baek’s older daughter Doraji, 35, told the Hankyoreh in a June 15 telephone interview.

“We had been putting off filing a death notice, but now we plan to go early next week to file it with a copy of the death certificate,” she added.

By Kim Yang-joong, medical correspondent and Park Su-ji, staff reporter

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