Foreword (October 2024, Health and Welfare Policy Forum)

Abstract

As the subject of ending life with dignity and comfort has become as crucial a social concern as healthy, joyful living, expectations about the end-of-life experience have risen, leading to practical policy responses. With the implementation of the Life-Sustaining Treatment Decision Act in February 2018, standards and procedures have been established to allow terminal patients to decline or discontinue ineffective life-sustaining treatments. By August 2024, an estimated 2.5 million people had specified their preferences for end-of-life medical treatment through advance directives. Furthermore, patients nearing death now have greater self-determination and can make their own decisions rather than relying solely on family choices, thanks to the ‘life-sustaining treatment plan.’ In April 2023, the government established the Second 5-Year Masterplan for Hospice and Life-Sustaining Treatment, envisioning “a society that guarantees all can close life with dignity.” Recently, the National Assembly proposed an amendment bill that would allow patients to refuse or discontinue treatments not just in the imminent-death period but also during the terminal stage, heightening public expectations for greater patient self-determination at the end of life. The October issue of the Health and Welfare Forum revolves around Korea’s Life-Sustaining Treatment Decision Scheme (LSTDS). Seven years after the introduction of the Life-Sustaining Treatment Decision Act and following the recent launch of the second masterplan, it is now time to revisit the current state of the LSTDS, focusing on its achievements and operational details. We analyze the evolving policy environment and social demands, exploring how the scheme can further help individuals conclude their lives with dignity. A significant portion of the October issue addresses tasks outlined in the second masterplan and explores short-term policy options for implementation. We also suggest a long-term direction for advancing the scheme to ensure a dignified end-of-life stage, along with policy options for improving end-of-life care.