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Signification and Challenges of the Act on Life-Prolongation Determination - With focus on Patient-Oriented Medical Care

연명의료결정법의 의미와 과제 - 환자 중심 의료를 중심으로

  • Kim, Yong (Institute of Science and Technology Studies, Korea University)
  • 김용 (고려대학교 과학기술학연구소)
  • Received : 2018.05.14
  • Accepted : 2018.06.05
  • Published : 2018.06.30

Abstract

Background: The Purpose of this study is to look into the signification and challenges of the Act on life prolongation determination of a patient who is going under hospice palliative medical care and a deathbed process (hereinafter referred to as "the Well-Dying Act") from a position of a patient. Methods: To improve the problems exposed in the process of enforcement of the Well-Dying Act, it's important to find a solution point after looking into improvements from a position of a patient through communication in line with the intent of law enactment. Hereupon, this study intended to look into improvements through the interviews with family members of a patient, and doctors. Results: it was found that improvements include reduction in the domain of family for consent to an interruption of life prolongation medical care, necessity of establishment of a medical institution ethics committee for implementing the Well-Dying Act, simplification of the relevant form, abolition of a criminal penalty clause, and introduction of an authorized agent, etc. Conclusion: This study thinks that it stands to reason to limit the domain of family for consent to an interruption of life prolongation medical care to a patient's spouse, parents and children in principle; nevertheless, when all these persons are not existent, reasonable is the way to impose a duty of getting unanimous consent to a patient's well-dying from all direct lineal ascendants and descendants of the patient on a relevant medical institution.

Keywords

References

  1. Epstein AS, Prigerson HG, O'Reilly EM, Maciejewski PK. Discussions of Life Expectancy and Changes in Illness Understanding in Patients With Advanced Cancer. Journal of Clinical Oncology 2016;34(20):2398-2403. https://doi.org/10.1200/JCO.2015.63.6696
  2. Trevino KM, Zhang BH, Shen MJ. Accuracy of Advanced Cancer Patients' Life Expectancy Estimates: The Role of Race and Source of Life Expectancy Information. Cancer 2016;122(12): 1905-1912. https://doi.org/10.1002/cncr.30001
  3. LEE JW, KEAM BS, HEO DS, PARK HY, HONG JU. The Roles of Hospital Ethics Committee and Clinical Ethics Consultation Teams. Korean Journal of Medical Ethics 2017; 20(4):353-358.
  4. Eitzel MV, Cappadonna JL, Lang CS. Citizen Science Terminology Matters: Exploring Key Terms. Citizen Science: Theory and Practice 2017;2(1):1-20. https://doi.org/10.5334/cstp.96
  5. Yun YH, Kwon YC, Lee MK. Experiences and attitudes of patients with terminal cancer and their family caregivers toward the disclosure of terminal illness. Journal of Clinical Oncology 2010;28(11):1950-1957. https://doi.org/10.1200/JCO.2009.22.9658
  6. Tanco K, Rhondali W, Perez-Cruz P. Patient Perception of Physician Compassion After a More Optimistic vs a Less Optimistic Message, JAMA Oncology 2015;1(2):176-183. https://doi.org/10.1001/jamaoncol.2014.297
  7. Weeks JC, Ctalano PJ, Cronin A. Patients' Expectations about Effects of Chemotherapy for Advanced Cancer, The New England Journal of Medicine 2012;367:1616-1625. https://doi.org/10.1056/NEJMoa1204410
  8. Mack JW, Smith TJ. Reasons Why Physicians Do Not Have Discussions About Poor Prognosis, Why It Matters, and What Can Be Improved. Journal of Clinical Oncology 2012;30(22): 2715-2717. https://doi.org/10.1200/JCO.2012.42.4564
  9. Sadananda BN. Death in the hospital: Breaking the bad news to the bereaved family. Indian J Crit Care Med. 2013;17(3):178-181. https://doi.org/10.4103/0972-5229.117067
  10. Lee IH. Perspective on Patient End-of-Life Decision Act and Clinical Ethics Service. Bioethics 2017;18(1):35-45.