Patient Autonomy and Advance Directives in Korea

Dae Seog Heo

doi:10.5124/jkma.2009.52.9.865

J Korean Med Assoc > Volume 52(9); 2009 > Article

Heo: Patient Autonomy and Advance Directives in Korea

Focused Issue of This Month

The Withdrawal of Life-sustaining Management

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2009; 52(9): 865-870.

Published online: September 30, 2009

DOI: http://dx.doi.org/10.5124/jkma.2009.52.9.865

Patient Autonomy and Advance Directives in Korea

Dae Seog Heo, MD

National Evidence-based Healthcare Collaborating Agency, Korea. heo1013@snu.ac.kr

Abstract

There has been a controversy in Korea regarding a 'death with dignity' in comparison to a 'natural death'. However, the issue of patient autonomy is often overlooked. Decision on withholding or withdrawing life-sustaining treatment should be based on the patients' self-determination, prefereably in the form of advance directives. Consensus developed by the National Evidence-based Healthcare Collaborating Agency is as follows: ① a doctor should offer a detailed explanation to patients, including about hospice-palliative care and advance directives, ② when a terminally ill patient expresses reluctance regarding cardiopulmonary resuscitation or an artificial respirator in advance, such medical actions can be removed, with basic nutrition supply and pain control maintained. However, more discussions should be made in the case of a patient in "persistent vegetative state".

Patient autonomy; Advance directives; Terminal patient; Withdrawal of life-sustaining treatment

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