The Korea Herald

피터빈트

[Editorial] Dying with dignity

More hospices needed to accommodate patients

By KH디지털2

Published : Jan. 11, 2016 - 17:46

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The National Assembly has passed the “well-dying” bill, which would allow terminally ill patients to refuse meaningless life-sustaining treatments and die with dignity. With the law slated to go into effect in 2018, the government needs to ensure that all facilities necessary for its implementation are put in place before then.

The law has been a long time coming. It came more than 18 years after two doctors at a Seoul hospital were punished in 1997 on charges of aiding a murder after stopping life-extending treatments on a terminally ill patient at the request of his wife.

Legislation similar to the Korean bill has already been enacted in many other countries, including the United States (1976), Taiwan (2000) and the United Kingdom (2005).

The law is strictly limited in scope. It is applicable only to patients who have entered the dying process, showing no prospect of recovery. Such patients can refuse four types of life-prolonging treatment — CPR, mechanical ventilation, hemodialysis and anticancer drug administration.

To benefit from the law, patients need to fill out an advance medical directive, a legal document informing that they do not want the use of any life support when death is imminent. Doctors can also produce such documents by recording their conversations with the patients. When a patient is in a state of coma due to an unexpected accident, their family members can order discontinuance of medical treatments if they reach such a consensus.

While the law is applied to strictly limited cases, it can still stir up controversy as suspending life-sustaining treatment can be seen as a form of disrespect for people who value filial piety highly.

Critics are also worried that the law can be abused under the pretext of giving patients the right to die with dignity.

But statistics show that more than 90 percent of the elderly oppose meaningless medical treatments designed simply to keep terminally ill patients alive.

Every year about 50,000 terminal patients die in pain in Korea. It is right to give them the choice to end their lives naturally without artificial life-prolonging treatments.

Now, the government has much work to do to implement the law. It has to develop the advance medical directive form that patients must fill out to specify their wishes regarding end-of-life care. It also needs to designate the registrar of the forms. 

Another important task is to encourage construction of hospices. Currently there are about 1,000 hospices in Korea, accommodating only about 14 percent of terminally ill cancer patients. When the well-dying law goes into effect, demand for hospices will surge.