Proposal for End-of-Life Care Policy for Dignified End-of-Life

Abstract

As Korean society rapidly ages, the focus on quality of life and dignified end-of-life care becomes increasingly significant. The Life-Sustaining Treatment Decision Act, enacted in 2016 and implemented in 2018, ensures patients’ right to self-determination, allowing them to forgo futile life-sustaining treatments. This law stipulates the conditions and procedures for discontinuing such treatments, aiming to enhance patients’ quality of life. Since its implementation, the Life-Sustaining Treatment Decision System has seen notable achievements, including an increase in the number of advance directive registrations and the expansion of medical ethics committees within healthcare institutions. However, there remains a need for consistency in policy execution and improvement in the level of care provided. Currently, the Ministry of Health and Welfare and the National Agency for Management of Life-Sustaining Treatment oversee the system, supported by advance directive registration centers and medical ethics committees. Despite these efforts, challenges such as a lack of understanding, confusion between futile life-sustaining treatments, euthanasia, and dignified death, and low installation rates of medical ethics committees persist. Addressing these issues requires fostering a culture of active public participation, improving medical professionals’ awareness and involvement, and promoting advance care planning. Additionally, enhancing information systems, strengthening legal and institutional foundations, and integrating with social welfare systems are crucial. Ultimately, the Life-Sustaining Treatment Decision System is a vital framework that respects patients’ right to self-determination and helps them conclude their lives with dignity. It is essential to integrate medical and social welfare services and community resources while expanding patient and family involvement. Enhancing the system’s transparency and fairness through the participation of various stakeholders will build public trust. The development of this system aims to ensure that all patients can experience a dignified end-of-life.