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KMID : 0856920220250010001
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Journal of Hospice and Palliative Care
2022 Volume.25 No. 1 p.1 ~ p.11
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Problems Related to the Act on Decisions on Life-Sustaining Treatment and Directions for Improvement
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Heo Dae-Seog
Yoo Shin-Hye
Keam Bhumsuk
Yoo Sang-Ho
Koh Youn-Suck
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Abstract
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The Act on Decisions on Life-Sustaining Treatment has been in effect since 2018 for endof- life patients. However, only 20~25% of deaths of terminally ill patients comply with the law, while the remaining 75~80% do not. There is significant confusion in how the law distinguishes between those in the terminal stage and those in the dying process. These 2 stages can be hard to distinguish, and they should be understood as a single unified “terminal stage.” The number of medical institutions eligible for life-sustaining treatment decisions should be legally expanded to properly reflect patients’ wishes. To prevent unnecessary suffering resulting from futile life-sustaining treatment, life-sustaining treatment decisions for terminal patients without the needed familial relationships should be permitted and made by hospital ethics committees. Adult patients should be permitted to assign a legal representative appointed in advance to represent them. Medical records can be substituted for a patient’s judgment letter (No. 9) and an implementation letter (No. 13) for the decision to suspend life-sustaining treatment. Forms 1, 10, 11, and 12 should be combined into a single form. The purpose of the Life-sustaining Medical Decisions Act is to respect patients’ right to self-determination and protect their best interests. Issues related to the act that have emerged in the 3 years since its implementation must be analyzed, and a plan should be devised to improve upon its shortcomings.
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KEYWORD
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Death, Palliative medicine, Hospice care, Terminal care, Patient self-determination act, Personal autonomy
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