초음파검사 시행주체에 관한 법적쟁점과 판례의 법리적 고찰

This paper provides a systematic review of the divergent administrative interpretations and inconsistent court rulings regarding the authorized practitioners of ultrasound examinations in South Korea. Under Article 27(1) of the Medical Service Act, healthcare professionals are prohibited from performing medical acts beyond their licensed scope. However, the legal boundaries for ultrasound performance remain a subject of intense conflict among various practitioners, including physicians, Korean medicine doctors (KMDs), nurses, nursing assistants, and medical technologists. The study analyzes key judicial precedents that illustrate these legal discrepancies. While physicians are inherently authorized, the Supreme Court (2016Do21314) recently affirmed that ultrasound use by KMDs falls within their licensed scope. Conversely, rulings for nurses remain contradictory: the Suwon High Court (2022Nu10357) recognized it as a permissible nursing act, while the Seoul High Court (2022Nu31299) ruled it as a violation. In contrast, radiological technologists have been consistently recognized as authorized practitioners under the same Seoul High Court ruling (2022Nu31299). For nursing assistants and emergency medical technicians (EMTs), courts have generally ruled such acts as unauthorized, though exceptions exist for EMTs regarding cardiac ultrasounds in specific contexts. The consequences of these inconsistencies are severe, leading to criminal convictions for Medical Service Act violations, administrative sanctions such as license suspensions, and the reclamation of National Health Insurance (NHI) reimbursements. To mitigate interprofessional conflict and enhance public health, this paper proposes three primary solutions: establishing a coordinated resolution framework among healthcare professional groups, enacting legislative amendments to clarify the scope of practice, and utilizing the NHI reimbursement system as a regulatory mechanism to standardize practice. By harmonizing these legal and policy-based approaches, the healthcare system can achieve greater legal certainty and patient safety.