JIN YU YOUNG2026年4月17日首尔郊外的城南市，一家医院里的急救人员。 Jun Michael Park for The New York TimesFive days after 4-year-old Kim Dong Hee had his tonsils removed, he started vomiting blood. He passed out before an ambulance arrived.四岁的金东希（音）在接受扁桃体切除手术五天后开始吐血。在救护车赶到之前，他就已经失去了意识。As he was being raced to the hospital where he had his tonsillectomy, near Busan, South Korea’s second largest city, doctors told the paramedics that the emergency room was full. The nearest available E.R. was more than 10 miles away. The trip felt like an eternity to his mother, Kim So Hee. “My vision went white and my head went blank,” she said.当他被紧急送往位于韩国第二大城市釜山附近、为他实施手术的医院时，医生却告知急救人员，急诊室已满。最近的可接收患者的急诊室在十几二十公里外。对他的母亲金素熙（音）来说，这段路仿佛无比漫长。“我眼前一片空白，脑子里一片茫然，”她说。By the time a doctor saw Dong Hee, about 30 minutes after the initial call, his airways had been blocked by blood and he had suffered severe brain damage from a lack of oxygen. He remained in a vegetative state and died five months later.从最初拨打急救电话到医生见到金东希，时间已经过了大约30分钟，此时他的气道已被血液堵塞，因为缺氧而出现了严重的脑损伤。此后，他一直处于植物人状态，五个月后去世。Despite being one of the wealthiest countries in Asia, South Korea has a buckling emergency-care system. A chronic shortage of E.R. doctors, fewer legal protections for physicians than in other rich nations and a quirk in the emergency response system — paramedics must wait for hospital permission before transporting a patient to an E.R. — have led to delays that can be fatal.尽管韩国是亚洲最富裕的国家之一，它的急救体系却不堪重负。急诊室医生长期短缺、法律对医生的保护不如其他富裕国家，以及急救响应系统的一个特殊规定——急救人员必须获得医院许可才能将病人送往急诊室——都导致了可能致命的延误。These hospital rejections — called “E.R. runaround,” “ambulance pingpong” or E.R. “merry-go-round” by the local news media — have become more acute in recent years, government data shows. President Lee Jae Myung has described the failures as systemic.政府数据显示，这种被韩国新闻媒体称为“急诊室推诿”、“救护车乒乓球”或急诊室“旋转木马”的医院拒收现象近年来愈发严重。韩国总统李在明将这些问题称为系统性失败。“Patients are dying on the streets, unable to find an E.R. for hours on end,” he said at a cabinet meeting in December and ordered his Health Ministry to fix the system.他在去年12月的一次内阁会议上说：“患者连续几个小时却不到可以接收的急诊室，甚至因此命丧街头。”他要求卫生部门解决这一问题。It will not be easy.但这绝非易事。金素熙（音）永远失去了儿子东希（音），此前急救人员被告知他们试图前往的第一家急诊室已满。金东希出现了严重的脑损伤，随后一直处于植物人状态，并在五个月后去世。The average time it takes for major trauma patients to be accepted by an E.R. has doubled since 2019 — the year Dong Hee had his tonsils removed — to 16 minutes and 30 seconds, according to data released by Representative Yang Bu-nam, who is part of a committee that oversees the National Fire Agency.根据国会议员杨富男公布的数据（他是负责监管消防厅的委员会成员），2019年以来，也就是金东希做扁桃体切除手术的那年，重伤患者被急诊室接收所需的平均时间已翻倍，达到16分30秒。Last year, the data show, there were more than 1,000 instances when ambulances had to call over 20 hospitals before finding beds for their patients.数据显示，去年发生了超过1000次救护车在为患者寻找床位时不得不拨打20家以上医院电话的情况。In October, a woman in her 60s was hit on a crosswalk by a cargo truck in the city of Changwon. An ambulance arrived on the scene quickly but the medics — who called 30 hospitals — could not find an E.R. willing to accept her and she died a couple of hours after the accident, according Representative Yang.去年10月，昌原市一名60多岁的女子在人行横道上被一辆货车撞倒。救护车迅速赶到现场，但急救人员联系了30家医院，都找不到愿意接收她的急诊室。据杨富男说，她在事故发生数小时后去世。South Korea has universal health care and its medical system is considered above average among wealthy nations. But it has fewer doctors per capita than most developed nations and many doctors prefer to specialize in fields that pay more than emergency care, such as dermatology and plastic surgery.韩国拥有全民医保，其医疗体系在富裕国家中也被认为处于中上水平。但韩国的人均医生数量低于大多数发达国家，而且许多医生更倾向于选择收入更高的专科领域，如皮肤科和整形外科，而不是急诊医学。On top of this, patients seeking care at hospital emergency rooms for “low acuity” conditions can lead to overcrowding, “causing delays in treating high-risk patients,” according to Chris James, a senior health economist at the Organization for Economic Cooperation and Development.此外，经合组织高级卫生经济学家克里斯·詹姆斯指出，因“轻症”前往医院急诊室就诊的患者也会占用资源，“从而延误对高风险患者的治疗”。The country’s 119 dispatch system mirrors the U.S. fast response system, where paramedics typically have the authority to determine the best hospital for a patient’s needs. But in South Korea, they must first get permission to arrive from hospitals, which can refuse patients for reasons including staff shortages and an excess of patients.韩国的119调度系统类似于美国的快速响应体系，在美国，急救人员通常有权根据患者情况决定送往哪家医院。但在韩国，急救人员必须先获得医院的接收许可，而医院可以以人手不足、患者过多等理由拒绝接收。This, paramedics say, leaves them scrambling to secure a patient’s admission in the race against the “golden time,” or the period in which a critical patient must receive care before suffering permanent damage or even death.急救人员表示，这使得他们必须在与“黄金时间”——即重症患者在遭受永久性损伤甚至死亡之前必须得到救治的窗口期——赛跑的过程中，手忙脚乱地为患者争取入院机会。When this happens, “you feel yourself starting to shrink as the stress builds,” said Kim Sung-hyun, who has been a paramedic for over a decade.在发生这种情况的时候，“随着压力越来越大，你会有一种无力感，”从事急救工作十多年的急救人员金成贤（音）说。急救人员金成贤（音）在首尔一处应急安全中心。急救人员必须先致电医院并获得接收许可后才能前往。他们可能会被多家急诊室拒绝。“If we leave this situation as it is, patients will continue to die,” Representative Yang said at an interview at his office in Seoul.“如果这种状况继续下去，患者还会不断死亡，”杨富男议员在首尔的办公室接受采访时说。He is pushing for a legal amendment that would grant paramedics the authority to designate hospitals for emergency patients. Separately, the Health Ministry launched a pilot program last month in two provinces and one city that designates specific hospitals as priority destinations for emergency patients.他正在推动一项法律修正案，赋予急救人员为急诊患者指定接收医院的权力。与此同时，韩国保健福祉部上个月在两个道和一个市启动了试点项目，将特定的医院指定为急诊患者的优先接收单位。Some E.R. doctors have opposed these plans. “Forcing us to take in patients might reduce the number of rejections on paper, but does little to ensure they receive the care they actually need,” said Kim Changyu, a resident at a hospital E.R. in Seoul.一些急诊科医生反对这些计划。“强制我们接收患者或许能在纸面上减少拒收数量，但对确保他们真正获得所需治疗帮助不大，”首尔一家医院急诊科的住院医师金昌裕（音）说。E.R. doctors also worry about legal liability. Physicians in South Korea face criminal charges for medical negligence at rates that are significantly higher than in other wealthy nations, according to studies.急诊医生还担心法律责任。研究显示，韩国医生因医疗过失面临刑事指控的比例明显高于其他富裕国家。“The fear of litigation or losing our licenses is what forces us to turn patients away,” Dr. Kim said. “We are human, too.”金昌裕医生说：“对打官司或吊销执照的恐惧正是迫使我们拒收患者的原因。我们也是人。”Other doctors, like Changwoo Han, a professor of preventive medicine at Chungnam National University, are in favor of the pilot program because it would expedite the transfer of urgent patients, and put paramedics and hospitals on the same page.其他一些医生支持这个试点项目，比如忠南大学预防医学教授韩昌宇（音），因为这样可以加快急重症患者的转运，让急救人员和医院实现步调一致。Many of the doctors’ concerns surfaced during an 18-month junior doctors’ strike that ended in September 2025.医生们的诸多担忧在2025年9月结束的一场持续18个月的实习医生和住院医生的罢工中浮出水面。While the core of that dispute was centered around a government proposal to increase the number of medical school students, doctors’ grievances included tough working environments, low wages in departments like emergency care and a lack of legal protection for physicians working with critical patients.虽然这场争议的核心是政府提出增加医学院招生人数的计划，但医生的不满还包括恶劣的工作环境、急诊等科室较低的薪资，以及在救治危重患者时缺乏法律保障。Mr. Lee’s government has taken a more conciliatory tone with the medical community and agreed to scale back plans for medical school admissions.李在明政府对医学界采取了更为安抚的态度，并同意缩减医学院扩招计划。The majority of E.R. patients in South Korea do not call for an ambulance but are walk-ins, according to government figures. That is a testament to the quality of care people get, but even walk-in patients are often turned away.根据政府数据，韩国大多数急诊患者并非通过救护车送医，而是自行前往。这在一定程度上体现了医疗服务的可及性，但即使是自行前来的患者也常常被拒之门外。国会议员杨富男正在推动修改法律，赋予急救人员为急诊患者指定接收医院的权力。根据政府数据，韩国大多数急诊患者并非乘坐救护车到达，而是自行前往。In the summer of 2024, Andrea Kwon, who works in marketing in Seoul, developed a fever and sore throat that lingered for weeks. Then, her skin turned yellowed, her stomach began to bloat and the mere smell of food triggered nausea. After visiting several neighborhood clinics, she was diagnosed with liver stones and was advised to go to an E.R.2024年夏天，在首尔从事市场营销工作的安德里亚·权出现了持续数周的发烧和喉痛。随后，她的皮肤开始发黄，腹部胀大，光是闻到食物味道就感到恶心。在看了几家社区诊所后，她被诊断出肝结石，并被建议去看急诊。Ms. Kwon, who said she is in her 20s, went to one only to be told to go home as no liver specialists were available. A referral to another hospital brought similar news.自称20多岁的权女士去看急诊，却被告知没有肝病专科医生，让她回家。转到另一家医院，得到的答复也差不多。By that point, she was feeling so ill she could not walk properly. “I was terrified. I felt completely helpless,” she said. Eventually, Ms. Kwon was able to get an appointment with a specialist at a hospital who diagnosed her with the Epstein-Barr virus, an infection that can sometimes attack the liver.到那时，她已经病得连路都走不稳了。“我非常害怕，感到完全无助，”她说。最终，权女士在一家医院预约到了专科医生，被诊断出感染了EB病毒——这种感染有时会攻击肝脏。While the government and doctors quibble over policy, patients and their families say lives are being put at risk. Some have turned to the courts in hopes of seeking justice for loved ones who they believe died because of rejections at E.R.’s.在政府和医生为政策争论不休的同时，患者及其家属表示，生命正被置于危险之中。一些人已经诉诸法庭，希望能为他们认为因急诊室拒收而去世的亲人讨回公道。In December 2019, Ms. Kim, Dong Hee’s mother, filed a criminal complaint against the doctors and hospital that refused to accept her son.2019年12月，金东希的母亲金女士对拒绝收诊的医生和医院提起了刑事控告。Last year, a court ruled that the doctors were not guilty of professional negligence. But it said some were guilty of violating medical law and that one had falsely claimed that the emergency room was busy with another patient.去年，法院裁定医生们不构成职业过失罪。但裁定其中一些人违反了医疗法，并指出有一名医生谎称急诊室正忙于救治另一名患者。“The verdict is truly disastrous. Medical professionals know better than anyone that the result of refusing a patient could be death,” said Ms. Kim, who plans on appealing the verdict. “Everything is backward.”“这个判决简直太糟糕了。医护人员比谁都清楚，拒收患者的后果可能是死亡，”计划上诉的金女士说道。“一切都颠倒了。”Ms. Kim now lives with her parents and younger son in Busan. Her husband, Dong Hee’s father, died after a yearslong battle with leukemia in 2022. “Dong Hee was a bright, brave and precious child,” she said. “He was the hope that kept his father fighting for his life.”目前，金女士与父母及小儿子住在釜山。2022年，她的丈夫、金东希的父亲在与白血病抗争多年后去世。“东希是个聪明、勇敢而珍贵的孩子，”她说，“他是支撑他父亲与病魔抗争的希望。”金素熙与她的小儿子在釜山步行回家。Jin Yu Young是时报驻首尔记者兼研究员，报道韩国和国际突发新闻。翻译：杜然点击查看本文英文版。