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KMID : 1025620210240030271
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Korean Journal of Medical Ethics
2021 Volume.24 No. 3 p.271 ~ p.285
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Making Decisions for Unbefriended Patients on Life-Sustaining-Treatment in South Korea: Healthcare Providers’ Experiences
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Choi Ji-Yeon
Jeon Hee-Jung
Lee Il-Hak
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Abstract
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Purpose: This study attempts to clarify the difficulties faced by healthcare professionals in South Korea in making and implementing Life-Sustaining Treatment (LST) decisions for vulnerable patients who lack legally competent proxy decision-makers.
Materials and Methods: First, a keyword analysis was performed on the official responses of the National Health Agency of Korea to 750 questions from healthcare workers. Second, a survey probing the difficulties that healthcare professionals face in making LST decisions was administered to the ethics committee members of 246 medical institutions.
Results: From the keyword analysis, 139 keywords were categorized into ten subcategories. The survey had a 32.5% response rate, and of the respondents, 41.98% faced difficulties in making decisions for unrepresented patients because of the absence of family members or due to inadequate evidence. Among these patients, 82.35% did not have decision-making ability at the time of need and 85.29% had no family members to consult with.
Conclusion: Four categories of “unbefriended” patients were identified in this study. Additionally, in uncovering evidence on how LST decisions are implemented and creating a category of “unbe-friended patients,” this study underscores the need to expand the scope of legal proxies under the LST Decisions Act.
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KEYWORD
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proxy, clinical ethics, decision making, end-of-life decision, Life-Sustaining Treatment Decision Act
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