Journal List > J Korean Med Assoc > v.52(9) > 1042202

Heo: Patient Autonomy and Advance Directives in Korea

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".

Figures and Tables

Table 1
Acceptance of ventilator in terminal cancer patients
jkma-52-865-i001

*concordance rate for the application of a ventilator between physicians and families: 39.3% (37/94).

Table 2
DNR in Korea
jkma-52-865-i002
Table 3
Discrepancy between survey results and practice
jkma-52-865-i003

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