Patients can choose right to die starting from February 4
By Lee Kyung-min
More terminal patients who doctors concluded have only a few days left to live will be able to make autonomous end-of life decisions following the full implementation of the law under which they can refuse four expensive life-sustaining treatments on Feb. 4. The Ministry of Health and Welfare said Sunday that it will allow patients or their families to refuse four treatments _ cardiopulmonary resuscitation, chemotherapy, mechanical ventilation and blood dialysis based on the Provider Orders for Life-Sustaining Treatment (POLST), through which the ministry has sought to encourage healthcare providers to communicate with patients on specific medical orders regarding their health if a person becomes unable to do so.
Forty-seven people have died after refusing the treatment over the three-month trial run participated in by seven private and three state-run hospitals since last October. They were among 107 terminal patients who signed the POLST, most of whom were end-stage cancer patients. Others suffered from chronic obstructive pulmonary disease, which causes severe breathing problems, symptoms of which include shortness of breath, wheezing and chronic coughing.
Meanwhile, 9,336 people have signed an “advance healthcare directive,” also known as a living will, a legal document in which a person dictates what specific actions should be taken regarding their health when they become unable to make decisions for themselves due to illness or incapacity. Most of them were over 70 years of age. Most of them lived in Seoul, followed by Gyeonggi Province and Chungcheong Province. The nearly five-fold increase from 2,197 last November reflects more people seeking to make autonomous end-of-life decisions while they are still in full control of their mental faculties, given patients can become unable to express their wishes when their illness progresses. It also reflects concerns expressed by most bed-ridden patients who are reluctant to be financial burdens to their family members.
Those over 19 who wish to sign POLST or “advance healthcare directive” must seek in-depth consultation with government-approved hospitals with experts in the bioethics sector to initiate the procedure. General queries can be answered by non-profit organizations advocating for patients’ “right to choose.”
A deliberative body chaired by the vice health minister is continuing efforts to expand the program to better honor the wishes of patients and their families. “More than 75 percent of the deaths occur at hospitals,” said Vice Health Minister Kwon Deok-cheol. “The government measure will help terminal patients exercise their rights and change the healthcare paradigm towards providing the care the patients want, not what medical institutions want them to have.” The body is seeking to recommend increasing the number of medical treatments patients can refuse such as the provision of oxygen, nutrients, water and pain-alleviating medication.