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Propofol for Profit, but Not “Drug Dealing”: Supreme Court Draws a Sharp Line on How Doctors Can Be Charged

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A doctor who secretly administered propofol to over a hundred patients under the guise of cosmetic procedures — pocketing ₩4.1 billion in the process — has had his four-year prison sentence confirmed. But the Supreme Court also clarified an important limitation: a doctor administering controlled substances, even illegally, cannot be prosecuted for drug “sales” under the Narcotics Control Act. Here are the key points.

Issue

When a doctor illegally administers psychotropic drugs to patients for profit, can the conduct be prosecuted both as unlawful administration and as a drug sale under the Narcotics Control Act — or is the charge limited to unlawful administration only?

Facts

  • Doctor A, conspiring with a clinic coordinator, administered propofol and remimazolam to patients with propofol dependency, disguising the sessions as cosmetic procedures.
  • Between 2021 and 2024, A administered psychotropic substances to approximately 100 patients on around 3,700 occasions, collecting a total of approximately ₩4.1 billion.
  • Prosecutors charged A with both unlawful administration of psychotropic substances and drug sales under the Narcotics Control Act.

Rule

  • The Narcotics Control Act distinguishes between different categories of persons authorized to handle controlled substances, and sets out different prohibited conduct for each category.
  • For licensed medical practitioners, the Act prohibits “administering, providing for administration, or issuing prescriptions for narcotics or psychotropic substances for non-medical purposes.”
  • The Act treats “administration” and “sale” as distinct categories of conduct — and does not include “sale” within the list of acts for which a doctor can be held criminally liable under the provision governing medical practitioners.

Lower Court Decisions

  • The trial court sentenced A to four years in prison, a ₩5 million fine, and forfeiture of ₩4.1 billion, but acquitted on the drug sales charge. It reasoned that A never transferred ownership of the drugs to the patients — he simply used substances he owned and managed in the course of performing sedation procedures.
  • The court noted that patients came to the clinic seeking a medical service, not to acquire ownership of propofol.
  • Prosecutors argued that the payments patients made included consideration for the drugs themselves, making it a sale followed by administration. Both the trial and appellate courts rejected this framing.

Supreme Court Decision

  • The Supreme Court (Criminal Division 2, presiding Justice Oh Kyeong-mi) dismissed all appeals on April 15, 2026, and confirmed the sentence.
  • The court held that under the regulatory structure of the Narcotics Control Act, the prohibited “non-purpose acts” applicable to any given category of handler are limited to the types of conduct that handler is otherwise permitted to perform.
  • For doctors, the only permitted conduct under the Act is administering, providing for administration, or prescribing. Since “sale” is not among those permitted acts, it cannot form the basis of a criminal charge against a doctor — even when the doctor acts outside the scope of legitimate medical practice.
  • A doctor injecting a patient with a psychotropic substance is, as a matter of law, performing an “administration” — not a “sale” — regardless of how much money changed hands.

Key Takeaways

  • Under the Narcotics Control Act, the offenses a doctor can be charged with are structurally limited to the conduct types the law permits doctors to perform in the first place. Sale is not one of them.
  • The fact that a patient pays for a procedure does not convert the administration of drugs during that procedure into a drug sale. The economic substance of the transaction does not override the legal characterization of the act.
  • This does not mean the conduct goes unpunished — A still received four years in prison and forfeiture of the entire ₩4.1 billion. The ruling simply clarifies which charge applies.
  • The distinction matters practically: sale charges under the Narcotics Control Act carry heavier penalties and different legal consequences than administration charges.

Why This Matters

This ruling sets a clear boundary on prosecutorial charging strategy in cases involving medical professionals and controlled substances. For prosecutors, it means that the more serious drug sales charge is not available against doctors, even in egregious cases of deliberate misuse for profit. For defense counsel representing medical professionals in narcotics cases, the decision provides a firm statutory basis for challenging sale charges at the outset. More broadly, the case raises questions about whether the current legislative framework adequately addresses the growing phenomenon of clinic-based propofol abuse — a gap that the ruling implicitly signals may require legislative rather than judicial correction.

Article: https://www.lawtimes.co.kr/news/articleView.html?idxno=219357&page=2&total=25035

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