End-of-life Decision in Korea

There are more than 65,000 cancer deaths per year in Korea. To what extent should we continue aggressive treatment in terminal patients? In the course of clinical care of a critically ill patient it may become clear that the patient is inevitably dying, the goal of medical treatment should not be to prolong the dying process without benefit to the patient or to others. Further intervention which will do no more than prolong the active dying process is often described as "futile." Even though hospice is widely accepted in Korea, there is still controversy about withholding or withdrawing life-sustaining treatment. Conflicts between the parties may interrupt satisfactory decision-making and adversely affect patient care, family satisfaction, and physician-clinical team functioning. When further intervention to prolong the life of a patient becomes futile, physicians have an obligation to shift the intent of care toward comfort and closure. However, there are necessary value judgments involved in coming to the assessment of futility. In this context, Korean society needs consensus agreement on futility issue, based on our own social values.