A terminally ill patient who chose to withdraw life-sustaining treatment died last week, marking Korea’s first legitimate case.

In January last year, the National Assembly passed a law that allows terminally ill patients with no prospect of recovery to refuse life support.

The patient in his 50s, who suffered from gastrointestinal cancer, refused to receive four life-prolonging treatments -- CPR, mechanical ventilation, hemodialysis and anti-cancer drug administration -- by signing a Physician Order for Life-Sustaining Treatment about a month ago. 

Even if patients stop life support, they continue to get nutrition, water and treatment to relieve pain.

Thirteen hospitals began trial operations of end-of-life care last month to consult with terminally ill patients and their family members before the “well-dying” law takes effect in February next year. Only seven people have signed the POLST.

A total of 1,648 people, mostly healthy, have signed Advance Medical Directives, in which they specified whether they will receive life-sustaining treatment or hospice care when they are dying. Anyone aged 19 or older can sign an Advance Medical Directive.

Medical experts say it will take some time for the end-of-life care system to be put in place, as hospitals lack professional counselors and the paperwork is excessive.

“Many people don’t know about life-sustaining treatment. It’s hard to explain even the basic concepts,” said a professor of medicine at a university hospital taking part in the trial operation of end-of-life care.

“There can be disputes between medical staff and the patient’s family over who is responsible for a patient’s death. The government needs to work more on the details of the law before it goes into effect.”

The government plans to increase the bioethics-related budget to educate the public about end-of-life care.

In 1997, two doctors at a Seoul hospital were indicted for murder after they removed a respirator from a terminally ill patient at the request of his wife. The doctors were later punished on charges of aiding murder.

In 2009, the Supreme Court ordered a hospital to remove a comatose patient’s respirator, noting that continuing treatment just to prolong life without the hope of recovery violates an individual’s dignity.

The 78-year-old woman died in January 2010, 200 days after being removed from life support, though doctors had expected her to die in less than three hours.

It marked the first court-approved case of death with dignity in Korea. 

By Kim So-hyun (sophie@heraldcorp.com)