Abstract
IntroductionEnd-of-life (EOL) treatment issues have recently gained societal attention after the Korean Supreme Court’s ruling that the presumed wishes of an elderly woman in a persistent vegetative state (PVS) should be honored. We tried to evaluate what Koreans thought about controversial issues regarding EOL treatments.MethodsWe surveyed Koreans with the following questions: 1) are ventilator-dependent PVS patients candidates for end-of life treatment decisions? 2) Is withholding and withdrawing EOL treatment the same thing? 3) In an unconscious, terminally ill patient, whose wishes are unknown, how should EOL decisions be made? 4) How should we settle disagreement amongst medical staff and the patient’s family on EOL decisions?ResultsOne thousand Koreans not working in healthcare and five hundred healthcare professionals responded to the survey. Fifty-seven percent of Koreans not working in healthcare and sixty seven percent of Korean healthcare professionals agreed that ventilator-dependent PVS patients are candidates for EOL treatment decisions. One quarter of all respondents regarded withholding and withdrawing EOL treatment as equal. Over 50% thought that EOL treatment decisions should be made through discussions between the physician and the patient’s family. For conflict resolution, 75% of Koreans not working in healthcare preferred direct settlement between the medical staff and the patient’s family while 55% of healthcare professionals preferred the hospital ethics committee.ConclusionsUnsettled issues in Korea regarding EOL treatment decision include whether to include ventilator-dependent PVS patients as candidates of EOL treatment decision and how to sort out disagreements regarding EOL treatment decisions. Koreans viewed withholding and withdrawing EOL treatment issues differently.
Highlights
End-of-life (EOL) treatment issues have recently gained societal attention after the Korean Supreme Court’s ruling that the presumed wishes of an elderly woman in a persistent vegetative state (PVS) should be honored
For the question that asks if ventilator dependent PVS patients are candidates for EOL treatment decisions, 57% of the general population and 67.4% of healthcare professionals believed so
For the question that asked how EOL treatment decisions should be made when the patient’s wishes are unknown, more than half of both the general population and healthcare professionals suggested that the ‘presumed’ wishes of the patient should be honored through the discussion between family and Healthcare professional (n = 997) professional (n = 503)
Summary
End-of-life (EOL) treatment issues have recently gained societal attention after the Korean Supreme Court’s ruling that the presumed wishes of an elderly woman in a persistent vegetative state (PVS) should be honored. The decision process to withdraw/withhold end-of-life (EOL) treatments in terminally ill patients is a difficult and controversial issue [1,2,3]. EOL treatments in terminally ill patients became a hot issue in Korea due to a case of an older woman in a persistent vegetative state in February 2008. The dispute between the family who wanted to honor her presumed wishes and discontinue EOL treatments and the hospital gained public attention. The final legal decision by the Supreme Court, which occurred on 21 May 2009, to honor the patient’s presumed wishes and allow discontinuation of life supporting treatments was a contravention to previous judicial precedents.
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