In the course of examining the literature on South Korea’s response to managing health misinformation, several distinct themes emerged.

South Korea has consistently made efforts to implement legislative measures aimed at regulating online communications and the dissemination of false information through the internet and social media platforms recognizing the impact of telecommunications on the spread and visibility of information. Challenges have emerged in relation to key provisions of the Acts, specifically Article 53(1) of the Telecommunications Business Act in 99Hun-Ma480, highlighting the inherent tension between individual freedom of expression and protection of the public. On June 15, 1999, the complainant, a student from Hankook Aviation University, posted a message titled ‘Exchange of Gunfire in the West Sea’, ‘Sloppy Kim Dae-Jung!’ on the ‘urgent message board’ of the internet community ‘Chanwoomul’, managed Nownuri, a comprehensive computer network service provided by Nowcom, Inc. On June 21, a Nownuri system manager deleted the post and suspended the student’s service access for a month, acting under directives from the Minister of Information and Communication. On August 11, 1999, the student filed a constitutional complaint against the relevant provisions of the Telecommunications Business Act (specifically Article 53 and parts of Article 71(vii) related to Article 53(3)) and Article 16 of the Enforcement Decree of the Telecommunications Business Act. The student alleged that these provisions infringed on his freedom of expression as well as freedom of science and arts, that the provisions went against due process, and violated the principle against excessive restriction (Global Freedom of Expression n.d.).

The Court’s review was specifically concerned with the constitutionality of Article 53 and parts of Article 71(vii) concerning Article 53(3) of the Telecommunications Business Act, and Article 16 of the associated Enforcement Decree. These provisions govern how telecommunications services are managed and regulate how service providers may control content and user access in response to directives from the Minister of Information and Communication (Constitutional Court of Korea 2002a).

The majority consensus was that a prohibition on communication that could ‘harm the public peace and order or social morals and good customs’ lacked the necessary clarity to be considered legally effective (99Hun-Ma480 2002). The terms ‘public peace and order’ and ‘social morals and good customs’ used in the statutory provisions were held by the majority to be abstract and subjective and did not constitute appropriate guidelines for administrative regulation (Ban on Improper Communication on the Internet Case, 14–1 KCCR 616, 99Hun-Ma480 (Constitutional Court of Korea, 27 June 2002)). However, in their dissenting opinion, Justices, Ha Kyung-chull, Kim Young-il, and Song In-jun, held a different view from the majority on the constitutionality of Article 53(1) and 53(2) of the Telecommunications Business Act, disagreeing with the majority assessment that the relevant provisions were in violation of the Constitution. They maintained that Articles 53(1) and 53(2) did not infringe upon constitutional principles. They contended that these provisions, outlining the criteria for regulating improper communication, do not need to provide explicit definitions of what constitutes improper communication. Instead, they held the view that the task of specifying these details should fall to a presidential decree.

This perspective extended to the evaluation of Article 53(3) of the Act and Article 16 of the Enforcement Decree. They argued that the provisions under scrutiny, responsible for establishing criteria for improper communication that may be regulated, do not need to explicitly define the parameters of the communication, similarly delegating the responsibility of specifying these details to a presidential decree. In their view, the delegation of rule-making authority did not amount to an unconstitutional restriction on freedom of expression, contrary to the majority interpretation.

In terms of regulating the spread of misinformation, the dissenting Justices held the view that regulation is preferable to the absence of any legal framework despite the potential for ambiguity. The approach of employing the enforcement decree to delineate the specifics of improper communication introduces a more tailored approach to oversight. By assigning the responsibility of establishing precise criteria to a decree, the law may be tailored to the specific contexts of misinformation. However, following the reasoning upheld by the majority, shifting the responsibility to define key terms to a decree, the risk is that the criteria for what constitutes improper communication may be subject to the discretion of the executive branch without clear legislative guidance.

This may result in inconsistent application of the law, potentially ineffective limitations for administrative agencies responsible for delegated legislation, or potential abuse of power.

The Court expressed concerns that the ambiguity and comprehensiveness of these concepts could result in the regulation of communication that should not be restricted, potentially violating the rule against excessive restriction. The majority decision highlighted the risk of regulating protected expressions, such as ‘indecent’ expression or media materials harmful to juveniles, which may lead to ineffective limits on the actions of these agencies when enforcing the legislation and should not be completely prohibited in a society that recognizes the value of free expression. The Justices emphasized the importance of ensuring that restrictions on communication are clearly defined and do not unduly limit constitutionally protected forms of expression. Imposing limitations on expression based on potential harm that remained uncertain runs counter to fundamental principles of avoiding excessive restriction on individual liberty. Under-regulation is considered preferable to excessive control, emphasizing the importance of allowing a democratic society's inherent self-correcting mechanisms, such as the competition of ideas, to manage value judgments as opposed to legislative regulation that may interfere with freedom of expression.

Article 47(1) of the Electric Telecommunication Act also faced scrutiny in relation to the dissemination of false information and the criteria for 'the intent to harm the public interest, in cases 2008Hun-Ba157 and 2009Hun-Ba88 due to its ambiguity. In 2008Hun-Ba157, the petitioner was charged with violating Article 47(1) of the Electric Telecommunication Act by posting false information on an internet site claiming that a woman was assaulted by police during a protest. Similarly, the petitioner in 2009Hun-Ba88 was charged with the same offense for posting untrue statements on an internet site alleging that currency exchange was halted due to the Korean foreign reserve being drained, and that the Korean government had instructed major Korean banks and export companies to stop buying dollars. Both petitioners filed motions for a constitutional review of the Instant Provision after their petitions were denied by trial courts. The specific issue under scrutiny in these cases is the constitutionality of Article 47(1) of the Electric Telecommunication Act, referred to as the ‘Instant Provision’, which criminalizes individuals who transmit false communication through electronic communication facilities with the intent to harm public interest (22–2(B) KCCR 684, 2008Hun-Ba157, 2009Hun-Ba88(Consolidated), December 28, 2010).

As this provision penalized individuals for the dissemination of false information with an ‘intent to harm the public interest’ (2008Hun-Ba157, 2009Hun-Ba88 2010), the issue under discussion concerned the clarification of the terms as to what exactly amounts to an intent to harm the public interest. The cases focused specifically on the interpretation of public interest, the intent behind the transmission of false information, and potential impacts on fundamental rights.

The court evaluated whether the abstract nature of the concept of public interest in the Instant Provision violates the principle of nulla poena sine lege (no punishment without a law) and the rule of clarity. The case raised concerns about the potential for arbitrary enforcement and penalization due to a lack of clear guidance on what exactly constitutes harm to the public interest. The complainants contended that the ambiguity surrounding the concept of public interest could result in restrictions on freedom of expression and undermine the rule of law (Constitutional Court of Korea 2010). The majority opinion is concerned with the constitutionality of the law in relation to freedom of expression and the rule of clarity in criminal laws. They held the view that the specific intent requirement of the ‘intent to harm public interest’ narrowed the scope of punishable acts, reducing the need for a higher level of clarity compared to crimes requiring general intent. ‘Public interest’ was interpreted as the interest of the majority of citizens in Korea and the state. They emphasized that the legislative intent behind the provision was clear in targeting acts with the major intent to harm the public interest. They also highlighted that false information should be interpreted generally in order to cover both false contents and false pretenses, asserting that the term ‘false information’ was sufficiently clear and did not violate the rule of clarity. The majority held the view that the Instant Provision was constitutional, contending that the specific intent requirement and the understanding of public interest provided adequate clarity for enforcement without infringing on freedom of expression. However, in a dissenting opinion, Justice Lee, Dong-Heub, and Justice Mok, Young-Joon, raised concerns about the potential for arbitrary enforcement of the law due to the vagueness of the criteria defining harm to public interest. They believed that the ambiguity surrounding the concept of public interest may lead to limitations on the right to freedom of expression and erode the principles of the rule of law. They held the view that the Instant Provision failed to provide a concrete standard for what may constitute harm to the public interest, potentially leading to subjective interpretations and infringements on freedom of expression, concluding the Instant Provision unconstitutional due to its lack of specificity and clarity and potential for excessive restriction on freedom of expression (Constitutional Court of Korea 2002b). Similarly, 97Hun-Ma108 addressed the tensions that exist between freedom of expression and professional practice, and the protection of public health, recognizing that the protection of public health justifies legal restrictions and limitations on freedom of expression in instances, ‘…deemed necessary for national security, maintenance of public order, or promotion of the public interest.’ (Constitutional Court of Korea 2000).

Within the context of regulating the spread of misinformation and regulating online communications, additional provisions under the Act on Promotion of Information and Communications Network Utilization and Information Protection (APICNUIP), also hold various implications. Article 44–3(1) grants information and communications service providers discretionary authority to take temporary measures when they identify information circulating through their networks intruding on privacy, defaming individuals, or violating their rights.

Moreover, Article 70(2) of the Act addresses defamation via false information that is disseminated across information and communications networks, imposing penalties such as imprisonment with labor, suspension of qualifications, or fines. There does exist, however, a significant regulatory gap in addressing the dissemination of false information that targets an unspecified, and widespread audience with a view to impacting the legal interests of both the nation and society (Hwang and Kwon 2017). The Supreme Court’s decision in 2008Da53812 has also faced criticism in various spheres (Jong 2010). The case assessed whether web portal sites Naver, Daum, SK Communications, and Yahoo Korea could be held liable for defamation. The plaintiff was accused in user postings on these sites of persuading his girlfriend to have an abortion, which led to her suicide after a subsequent pregnancy (Supreme Court en banc Decision 2008Da53812). The court upheld judgments against these services for amounts ranging from 5 million SKW to 10 million SKW. While freedom of the press is a fundamental right, media entities are expected to maintain journalistic integrity and ethical standards by verifying facts, offering balanced reporting, and refraining from spreading misinformation or biased opinions that could potentially damage the reputation of individuals or organizations. The decision 2008Da53812 was concerned with the duty of Internet information service providers to delete or block defamatory posts. The majority opinion held the view that providers have a duty to delete unlawful posts where they are specifically recognized or obviously recognized as defamatory. The minority opinion expressed an alternative perspective and highlighted the importance of freedom of expression in limiting the duty of Internet information service providers to delete content. They contended that the service provider should only be required to remove content if the harmful nature of the content is clear and obvious, implying that a direct request from the affected individual should be necessary for action to be taken. Taking the legal context of the Supreme Court Decision 2008Da53812 into account, media companies are obligated to uphold the accuracy of the information they disseminate and to refrain from propagating falsehoods or distorted opinions. Any intermediaries, including online portals, should share liability for illegal content to the same degree as news agencies subject to the following conditions: the nature of the content’s illegality must be unequivocal, the platform or portal must possess knowledge of the content, and the financial or technical capacity to control the content must exist (Supreme Court of Korea 2009). In addition to an obligation to promptly remove such content, these intermediaries—in this case, content hosting platforms and social media portals are also mandated to prevent similar uploads and posts in the future. The decision establishes a precedent potentially impacting how portals handle misinformation about the pandemic. Portals may be required to actively monitor and remove false information, even without specific complaints or reports from individuals, if the falseness of the information can be easily identified. The ruling implied that revenue-earning portals are expected to proactively monitor and delete such content, blurring the lines between their social responsibilities and legal obligations.

In response to the limitations of current laws addressing the issues posed by misinformation and disinformation, the National Assembly has introduced multiple bills with the aim of regulating and managing these issues more effectively. However, the proposed bills are also perceived to have key issues related to the ambiguous nature of the terminology used (Jung et al. 2021). Unclear definitions of concepts like ‘fake news’ or mis-/disinformation (Jung et al. 2021), the potential for unnecessary or excessive regulation (Jung et al. 2021), and the imposition of excessive or stringent legal liability on information and communication service providers have all been highlighted as potential issues. Laws concerning misinformation have remained inconsistent. Legislated responses to managing social issues are often reactive as opposed to proactive. This is particularly applicable to cases of health misinformation The inherent delay in legal measures, coupled with the challenge of regulating online spaces, especially those offering anonymity, raises questions about the material efficacy of legal measures in response to the problems posed by the spread of health misinformation. Protection of the public welfare has been treated as a legitimate justification for limitations on the individual right to freedom of expression. The theme concerning the issues with existing legislation in South Korea point to the inherent difficulty of defining terms and balancing the welfare of the public with individual freedom of expression and the ongoing effort to deal with the evolving media landscape via legal means. The conceptual ambiguity of legal terms makes regulation challenging in cases where decisions need to be rapid and unequivocal, making the legal wrangling over the scope of specific terms an unnecessary impediment to regulatory action.

The government swiftly implemented various public health measures, such as mask mandates and social distancing protocols, but faced challenges in addressing the concurrent infodemic. Policies targeting the spreading of misinformation, such as amendments to telecommunications laws encountered legal, ethical, and logistical barriers. These included concerns over freedom of expression and the effectiveness of legal measures against COVID-19 misinformation. Governmental strategies evolved to encompass collaborative efforts with private sectors and media outlets, suggesting a recognition of the need for more comprehensive approaches. These strategies reflected efforts of the South Korean government to address the limitations of legislation by actively controlling the spread of misinformation while avoiding excessive restriction of freedom of expression. Several government agencies introduced policies that emphasized flexibility and regulating the spread of information in a context-dependent manner. This is exemplified by the KCC’s introduction of a Vaccine Disinformation Reporting Board specifically targeted at COVID-19 vaccine-related false information. An additional development as part of this response was collaboration between different agencies to combat the spread of COVID-19 misinformation, such as the establishment of a ‘Promotion and Fake News Response Council’ involving six different government agencies. Additionally, as part of the response to health misinformation, KISO implemented the ‘Policy on False and Manipulated Information Regarding COVID-19 in 2021’. Article 34 states the obligation for member companies to identify and address false information related to COVID-19 in cases where the ‘member company becomes aware that a post…is being circulated in relation to COVID-19 information, the company may take necessary actions such as deletion’ (KISO 2021b). This obligation applies to (1) posts containing information about COVID-19 such as its existence, treatment, prevention, diagnosis, infection, social distancing, and self-isolation, and (2) in cases where the information has been clearly confirmed as false by the World Health Organization (WHO) or the Disease Control and Prevention Agency (KISO 2021b). Under the remit of Article 34 Member companies are authorized to take necessary actions, such as post deletion, when dealing with COVID-19-related posts meeting specific criteria, including information on the existence, treatment, prevention, diagnosis, infection, social distancing, and self-isolation. Furthermore, if the information has been confirmed as false by reputable sources like the World Health Organization (WHO) or the Disease Control and Prevention Agency, companies are encouraged to act promptly to prevent the spread of misinformation. KISO was instrumental in enforcing these regulations, with a focus on targeting false claims related to ‘vaccine prevention’, ‘treatment’, ‘existence’, and ‘transmission’. From April to October, KISO undertook actions against 1538 false COVID-19-related posts on social media and online portals, demonstrating a proactive approach to combating misinformation and safeguarding public health (KISO 2021a).

A further theme emerged in relation to the self-regulation in the private sector and highlights the proactive approach taken by private sector companies in South Korea with the aim of addressing health misinformation during the COVID-19 pandemic. Domestic sites, such as NAVER and Kakao, implemented their own policies targeting COVID-19 misinformation in alignment with government announcements and the introduction of tools to aid in public awareness. Global platforms with substantial presence in South Korea also made individual efforts to combat the dissemination of false information using various methods with Instagram blocking hashtags related to fake news surrounding the COVID-19 vaccine. Prominent media associations in South Korea developed and adhered to internal guidelines centered around reporting during an epidemic illustrating the benefits of a collaborative approach to misinformation management where private sector companies act to complement governmental strategies. These self-regulatory measures aligned with government strategies and constituted an important part of the South Korean response to health misinformation. However, while this theme highlights the importance of blending government intervention with corporate responsibility and public engagement, further investigation is needed to assess the material effectiveness and long-term sustainability of this type of multi-stakeholder approach to tackling health misinformation, especially in the sphere of rapid online communication.

This theme illuminates the dualistic nature of the strategy employed by South Korea’s institutions in efforts to mitigate the social impact of COVID-19 misinformation, where the focus of institutions was on both the removal of false information while simultaneously informing and educating the public about the false claims and misinformation.

The internet has democratized access to medical knowledge, but there is the potential for claims to spread unchecked among individuals and communities who may lack the necessary language, context, or education to understand the nuanced nature of particular types of information (Burke 2020). This may lead to misguided health decisions based on misunderstandings or mistrust related to healthcare and further foster skepticism towards government and medical authorities (Lăzăroiu et al. 2021). Early studies have suggested that nearly 6000 people were hospitalized and 800 people died due to COVID-19 misinformation (Islam et al. 2020, as cited by WHO 2021c). Health misinformation, often underpinned by rumors, stigmatization, and conspiracy theories, has potentially severe adverse implications for public health especially in instances where they run parallel to or even overpower correct information and reliable sources of messaging and influence individuals’ healthcare-seeking behaviors, potentially dissuading them from undergoing essential measures such as COVID-19 testing or turning to false or untested cures (Bok et al. 2021).

Approaches to managing the spread of misinformation have involved the removal of false content coordinated between the government agencies and private sector companies but also proactive public education efforts. Many of the government strategies were focused on the former, restricting the spread of misinformation through the active removal of false content. For instance, KISO implemented policy frameworks for the removal of COVID-19-related misinformation and introduced policies authorizing the removal of exclusively false or misleading COVID-19-related content, and the Broadcasting Commission acknowledged having taken corrective measures against COVID-19 information. Concurrently, the ‘Promotion and Fake News Response Council’ developed digital content to promote accurate information in collaboration with government agencies as part of their comprehensive measures incorporating digital content such as card news and video clips to promote correct information. Similar efforts have been made in the private sector. Anti-vaccine channels have been blocked on Youtube, and articles containing false information have been flagged on Facebook. While the measures taken were specific to each individual platform, they are similar in that they aim to contain misinformation and prevent their further dissemination. There have been efforts in both the governmental and private sectors to inform/educate the public on correct information. While the removal of misinformation is a direct response, the success of public education initiatives in changing public perceptions remains an area for further investigation as to the nature of their effectiveness and impact on public trust in health communication.

Figure 1 illustrates the course of theme identification undertaken throughout the literature review.

Themes and sub-themes identified following thematic analysis of South Korea’s response to health misinformation