As material life becomes increasingly abundant, people have begun pursuing attractive appearances, ideal body shapes, and outstanding figures, leading to the rapid expansion of the medical beauty market. With continuous advancements in medical technology, the medical beauty industry has also entered a stage of高速 growth. However, since medical beauty technology is still in its development phase and the quality of medical beauty services in the market varies greatly, legal disputes in the medical beauty industry are emerging endlessly. In terms of litigation pathways, medical beauty disputes often involve the concurrence of liability for breach of contract and tort liability. Patients may choose either as the basis for their claims. The applicable civil legal norms are primarily the Civil Code’s Contract Book, Tort Liability Book, and the provisions of the “Regulations on the Handling of Medical Accidents.”

In reality, incidents of medical beauty institutions without proper qualifications arbitrarily conducting medical beauty activities are common. These include medical beauty service providers without licenses illegally conducting medical beauty activities, medical beauty institutions exceeding their registered scope, principal physicians not meeting requirements, and medical personnel not meeting employment requirements. The number of medical dispute cases arising from illegal medical practice in the medical beauty service industry has surged. Seven departments including the National Health and Family Planning Commission and the Ministry of Public Security jointly conducted a special campaign to crack down on illegal medical beauty activities from May 2017 to April 2018. Article 61 of the “Regulations on the Handling of Medical Accidents” provides: “Illegal medical practice causing personal injury to patients does not constitute a medical accident; if it violates criminal law, criminal liability shall be pursued according to law; regarding compensation, the victim may directly file a lawsuit with the people’s court.” Therefore, “illegal medical practice” is difficult to characterize as medical conduct in civil law theory, preventing patients from claiming compensation under the “Regulations on the Handling of Medical Accidents” and medical damage compensation rules, and they can only apply general tort liability provisions. After the Consumer Protection Law was enacted, patients sought new remedies. The Consumer Protection Law does not limit the qualifications of operators. Under this law, patients can obtain higher compensation amounts, especially when medical beauty institutions engage in fraudulent conduct as defined in Article 55 of the Consumer Protection Law, where they face triple punitive damages.

Currently, there is no consensus in academia or practice regarding whether the Consumer Protection Law applies to medical beauty disputes and the relationship between its application and other legal norms. Therefore, this article analyzes and explores consumer protection pathways in medical beauty disputes through judicial case studies.

01

Current Judicial Status of Consumer Protection Law Application in Medical Beauty Disputes

Due to the influence of traditional medical relationship theory, the question of whether the Consumer Protection Law applies in medical beauty dispute cases remains unanswered in theory, and there is no unified adjudication rule in judicial practice. To examine the extent and effect of the Consumer Protection Law’s application in such cases, the author analyzed publicly available medical beauty cases from the China Judgments Online platform.

The author collected nearly 100 medical beauty dispute cases involving the issue of Consumer Protection Law applicability. These cases mainly involve three types of causes of action: medical service contract claims, tort damage liability claims, and claims for life, health, and bodily rights. Among the target cases studied, the vast majority of courts supported the application of the Consumer Protection Law, with only a small minority opposing it.

In cases where patients brought claims based on medical service contracts, some courts characterized the medical beauty service provider’s wrongful conduct as “breach of contract,” specifically manifested as the institution lacking relevant qualifications, failing to provide corresponding services after charging fees, or surgical results not meeting agreed standards (e.g., (2018) Yu 01 Min Zhong No. 19033, (2020) E 0502 Min Chu No. 207, (2019) Shan 0112 Min Chu No. 16517). Some courts characterized the wrongful conduct as “violation of prohibitive legal provisions,” mainly manifested as “the medical institution lacking relevant qualifications,” applying Article 52 of the Contract Law regarding invalidity of contracts (e.g., (2020) Min 06 Min Zhong No. 8, (2019) Jing 0108 Min Chu No. 17385, (2018) Liao 0302 Min Chu No. 4984). In cases with “medical service contract dispute” as the cause of action, most courts characterized the medical beauty service provider’s wrongful conduct as “consumer fraud,” holding that medical beauty services fall within the scope of lifestyle consumption. The wrongful conduct was characterized as consumer fraud, mainly manifested as issues with the medical beauty institution’s qualifications, exceeding its business scope, false advertising, unauthorized operational changes during surgery, unauthorized substitution of imported products with domestic products, and failure to fulfill adequate disclosure obligations. Consequently, these courts applied Article 55 of the Consumer Protection Law regarding “refund plus triple damages” (e.g., (2020) Yue 0307 Min Chu No. 12153, (2019) Hu 01 Min Zhong No. 7623, (2019) Chuan 01 Min Zhong No. 14077).

02

Judicial Decision Analysis of Consumer Protection Law Application in Medical Beauty Disputes

Reasoning of the Courts

By reviewing relevant medical beauty dispute cases where the applicability of the Consumer Protection Law was a key point of contention, the author analyzed and summarized the reasoning of courts adopting different positions on this issue.

The main reasons for courts supporting the application of the Consumer Protection Law are twofold:

First, the purpose of patients choosing medical beauty services is not for medical treatment due to illness but to improve their external appearance through surgery to satisfy personal lifestyle consumption needs. Moreover, patients have full freedom of choice when selecting medical beauty institutions, consistent with the characteristics of lifestyle consumption behavior;

Second, the vast majority of medical beauty institutions are distinctly for-profit in nature, and their public welfare attributes have gradually diminished, supporting patients in invoking the Consumer Protection Law to protect their lawful rights and interests.

For example, in the case of Wang Mengfei v. Beijing Heyan Qiongxia Medical Beauty Clinic Co., Ltd. (medical service contract dispute) ((2023) Jing 01 Min Zhong No. 884), Wang believed that the defendant had engaged in fraud as defined in the Consumer Protection Law and, based on the Consumer Protection Law, filed a lawsuit in the first-instance court requesting triple compensation of the service fees from Heyan Qiongxia Beauty Clinic. The parties disputed whether the Consumer Protection Law applied to this case. Regarding this point of contention, the first-instance court held that considering whether the Consumer Protection Law could apply: First, current laws, regulations, and judicial interpretations do not prohibit patients from filing medical service contract dispute lawsuits based on the contractual relationship between the parties. Second, the contract involved was a medical beauty service contract; the medical party was a private beauty clinic, a market entity operating for profit; prices were determined by Heyan Qiongxia Beauty Clinic itself, not government-guided prices; fees were not included in the basic medical insurance pooling scope; and the purpose of treatment was facial beautification, which constitutes lifestyle consumption rather than therapeutic consumption. Therefore, the Consumer Protection Law could apply. The second-instance court shared the same view.

The main reasons for courts opposing the application of the Consumer Protection Law are:

First, the use of traumatic or invasive medical techniques to repair and reshape a person’s appearance and various body parts constitutes medical conduct. Health authorities have also made corresponding provisions regarding the qualifications of medical beauty institutions and practitioners. Therefore, such disputes should first be handled under the Tort Liability Book of the Civil Code concerning “medical damage liability”;

Second, medical conduct does not conform to the characteristics of consumption behavior. Medical institutions should not be categorized as operators, nor should patients be categorized as consumers. The results of medical conduct cannot be judged based on the need for lifestyle consumption.

For example, in the case of Zhongshan Medical University “Family Doctor” Medical Cosmetic Surgery Hospital v. Miao (medical service contract dispute), the plaintiff Miao, based on Article 55 of the Consumer Protection Law, requested the court to order the defendant cosmetic surgery hospital to bear triple punitive damages. The second-instance court ultimately ruled that the Consumer Protection Law did not apply. The second-instance court held that Article 2 of the Consumer Protection Law provides: “Consumers purchasing or using commodities or receiving services for the purpose of lifestyle consumption shall have their rights and interests protected by this Law; matters not covered by this Law shall be protected by other relevant laws and regulations.” Accordingly, as a special law, the Consumer Protection Law’s scope of application should be limited to “lifestyle consumption” purposes. Medical beauty services provided by medical institutions that have obtained medical institution practice licenses with approval from health administrative departments are essentially medical conduct and do not fall within the scope of lifestyle consumption. Therefore, the punitive damages liability under Article 55 of the Consumer Protection Law should not apply.

Scope of Compensation

Regarding the scope of compensation, there is a difference between cases where the Consumer Protection Law applies and those where it does not.

When no personal injury has yet been caused to the patient, the scope of compensation in cases supporting the application of the Consumer Protection Law is: refund of service fees and triple punitive damages of the service fees. The scope of compensation in cases not supporting the application of the Consumer Protection Law is: compensation or proportional compensation for losses caused by the wrongful conduct, such as necessary medical expenses, appraisal fees, or actual expenditures. When no medical expenses have been incurred, service fees are often treated as losses.

When personal injury has been caused to the patient, the scope of compensation in medical beauty cases applying both the Consumer Protection Law and other legal norms includes: compensation or proportional compensation for losses, refund of service fees, punitive damages, mental distress damages, and follow-up treatment costs. The scope of compensation in medical beauty cases not supporting the application of the Consumer Protection Law includes: compensation or proportional compensation for losses, refund of service fees, mental distress damages, and follow-up treatment costs. The difference lies in whether punitive damages are added. Medical beauty service fees are often very high, and surgical failure often requires continued treatment and repair. Whether punitive damages can be obtained to cover losses is crucial for consumers.

[Summary]

Through comparative analysis, it is found that on the issue of whether the Consumer Protection Law applies to medical beauty disputes, court decisions vary across different regions. The main reason for different decisions is the inconsistent characterization of the nature of medical beauty services.

If a court tends to strictly confine medical beauty services within the scope of medical conduct, it will determine that medical beauty conduct should be governed by laws regulating medical conduct, such as the Tort Liability Book of the Civil Code, the “Regulations on the Handling of Medical Accidents,” and the “Interpretation on Issues Concerning the Application of Law in Cases of Personal Injury Compensation.” Ultimately, it will conclude that medical beauty conduct, as medical conduct, is not consumer conduct and should not be regulated by the Consumer Protection Law.

If a court recognizes the commodity characteristics of medical beauty services, it will proceed from the perspective that patients are consumers and medical beauty institutions are operators, characterizing the patient’s receipt of medical beauty services as general consumer conduct, and consider it as consumption behavior regulated by the Consumer Protection Law, ultimately determining that the Consumer Protection Law applies to the medical beauty service dispute.

However, since the law does not provide a clear definition of the nature of medical beauty services, courts lack a fixed reference standard when making this determination. Whether to characterize it as general medical conduct or general consumer conduct depends entirely on the court’s own tendencies, leading to two completely different outcomes for the same type of case in judicial practice.

Nevertheless, after summarizing and comparing a certain number of relevant cases, the author found that currently, most courts tend to hold that the Consumer Protection Law should apply to medical beauty disputes. Moreover, cases where the Consumer Protection Law applies result in higher compensation amounts than cases where it does not apply. Therefore, when a medical beauty dispute occurs, if the patient believes that the medical beauty institution has engaged in fraud as defined in the Consumer Protection Law, they may consider claiming punitive damages based on the Consumer Protection Law to better compensate for their losses.

03

Author’s View—Medical Beauty Services Fall Within the Scope of the Consumer Protection Law

Article 2 of China’s Consumer Protection Law provides: “Consumers purchasing or using commodities or receiving services for the purpose of lifestyle consumption shall have their rights and interests protected by this Law.” This provision defines the scope of the Consumer Protection Law as “lifestyle consumption relationships formed by consumers due to lifestyle consumption behavior.”

In economics, consumption refers to the consumption and expenditure of goods and services by humans to satisfy material and spiritual life needs. With economic development, the content and levels of consumption are also becoming increasingly diverse. Understanding consumption from different perspectives leads to different classifications. For example, based on different consumption purposes, consumption behavior can be divided into production consumption and lifestyle consumption. The former refers to the consumption of means of production and labor in production, which is intermediate consumption resulting in the production of new services and products. The latter refers to the use and consumption of products and services to satisfy personal or family life needs, constituting final consumption. Additionally, based on different consumption content, consumption behavior can be divided into material consumption, spiritual consumption, and ecological consumption. Material consumption refers to human consumption of goods existing in material form, reflecting human needs in biological attributes. Spiritual consumption is a uniquely human need, representing the pursuit of morality, intellect, and aesthetics, reflecting human needs in ideology. Ecological consumption refers to the ideal and requirement of harmonious coexistence between humans and nature, manifested in the need and pursuit of ecological consumer goods such as green food and green clothing.

Based on the above consumption theory and the particularity of the medical beauty industry, the author believes that medical beauty service providers are operators, medical beauty patients are consumers, and the medical beauty service relationship is a lifestyle consumption relationship falling within the scope of the Consumer Protection Law. The reasons are as follows:

In the process of medical beauty services, there is no compulsory medical treatment relationship or quasi-management relationship typically found in general doctor-patient relationships. From the perspective of consumption subjects, medical beauty service providers and patients are equal civil subjects with a medical beauty service contract relationship. Consumer-oriented medical beauty institutions are privately operated and distinctly for-profit, falling within the category of operators under the Consumer Protection Law. From the perspective of consumption purpose, it is to satisfy consumers’ aesthetic psychological needs, not for disease treatment, and does not fall within the scope of basic medical care. Currently popular non-basic medical services such as cosmetic procedures,整形, and weight loss, while exceeding the scope of “survival needs,” still fall within the scope of “lifestyle needs” and constitute spiritual consumption. From the perspective of consumption characteristics, consumers of consumer-oriented medical beauty are similar to ordinary consumers. They can choose medical beauty institutions and specific cosmetic projects based on their own wishes, consistent with the characteristics of general lifestyle consumption behavior. From the perspective of consumption subject status, medical beauty institutions implement自主 pricing, with generally high fees, exhibiting strong commercial and market-oriented characteristics. Applying the Consumer Protection Law increases the compensation liability of medical beauty institutions, fully leveraging the deterrent effect of the law, which is conducive to urging medical beauty institutions to standardize their practice and better protecting the lawful rights and interests of patients.