By Lee Kyung-min
More terminally ill patients will be able to refuse life-sustaining treatment sooner, following a recommendation by a committee under the health and welfare minister, Wednesday.
Following the recommendation of a 15-member deliberative body looking into hospice and palliative care, patients who doctors conclude have only a few months left to live will be able to sign a document refusing treatment. This followed criticism against the current law under which only those who have a few days left are allowed to make such a decision, a requirement which fails to reflect the reality of patients at that stage being unable to fully communicate.
Patients will also be able to refuse treatments including the provision of oxygen, nutrients, water and pain-alleviating medication. Currently, they are allowed to refuse only cardiopulmonary resuscitation, chemotherapy, mechanical ventilation and blood dialysis.
Only one doctor’s opinion is required to pronounce whether a patient at a hospice is approaching death. Previously, at least two doctors had to agree.
The reduction in the number of doctors required was recommended given the facility focuses on pain alleviation and attending to a patient’s emotional and spiritual needs, not on treatments aiming to improve their condition. Hospices are sought by those who would rather spend their last days of life in a home-like environment rather than a hospital.
The recommendation is part of efforts to better implement “death with dignity,” a law seeking to better protect patients’ individual autonomy set to go into effect Feb. 4 next year.
The law was set up reflecting criticism that doctors face criminal charges if they fail to provide life-sustaining treatments, with patients’ wishes in the most critical decisions of their lives remaining irrelevant. This, patients have long claimed, undermines their rights to autonomy, and only increases the financial burden on their families.
But under the new law, terminally ill patients who are in full control of their mental faculties are allowed to ask that treatment be halted.
At least two members of their family must agree to cease treatment in cases where patients are unable to make the decision themselves.
In both cases, the treatment is halted only when at least two doctors agree that the patients have no chance of recovering.