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KMID : 1025620200230040279
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Korean Journal of Medical Ethics
2020 Volume.23 No. 4 p.279 ~ p.299
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The Influence of New Legislation on the Withdrawal of Life-Sustaining Treatment on the Perceptions and Experiences of Residents in a Tertiary Hospital in Korea
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Kim Yeon-Joo
Lim Chae-Man
Shim Tae-Sun
Hong Sang-Bum
Huh Jin-Won
Oh Dong-Kyu
Koh Youn-Suck
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Abstract
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Since February 2018, the “Act on Decisions on Life-sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life” (LST Decisions Act) has been in force in South Korea. Whether the law is serving its original purpose is unclear, especially in the views of current resident physicians. This study was designed to investigate the perceptions, experiences, and difficulties in carrying out decisions on life-sustaining treatment (LST) of residents in a tertiary referral hospital in Korea. An anonymous survey was conducted on residents from six departments ? internal medicine (IM), general surgery (GS), obstetrics and gynecology (OBY), pediatrics (PED), orthopedic surgery (OS), and neurology (NR) ? to explore their awareness of the law, practical experiences on withholding LST, and difficulties in implementing the LST Decisions Act. The survey was conducted twice, on the first and second year of the enforcement of the law. A total of 267 residents from six departments (139 on the first and 128 on the second survey) completed the questionnaire. The perceptions of resident physicians on the Act was comparably high, and procedural complexity remained as the main problem in managing LST decisions. The level of education and awareness of end-of-life care decisions were significantly associated with patient mortality in each department. Our results suggest that in order for the objectives of the LST Decisions Act to be realized, the residents in each of the departments investigated in this study require further education concerning the Act.
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KEYWORD
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Act on End-of-life care, life-sustaining treatment, residency, legal processes
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