Legal and Ethical Issues Regarding End-of-Life Care in Korea

Abstract

Korea legislated withdrawing or withholding life-sustaining treatment after the Korean Supreme Court Decision on Grandma Kim’s Case. However, the Proposal for Legislation by the Korean National Bioethics Committee and the Supreme Court decision have some limitations. Both limits the patient’s ability to decide to withdraw or withhold life-sustaining treatment to cases involving a dying patient who is about to die. The Hospice and Life-sustaining Treatment Act also reflected this limitation. Only POLST signed by competent patients themselves is fully respected as a patient’s wishes. The Supreme Court decision reveals theoretical confusion between the principle of respecting autonomy and that of a patient’s best interest. Even though the Proposal and the Act outline certain procedures for surrogate decision-making, they may be problematic in that they place a heavy weight on family members’ decision making. This limitation should be overcome with ethical, legal, and sociological studies. Despites this limitation, any legislation based on the Proposal was needed in Korea. Building a medical system with better palliative care or hospice care should be emphasized to prevent the abuse of withdrawal of life-sustaining treatment. The values of familism should be balanced with those of autonomy.