For Koreans, ‘good death’ means comfort, easing burden on family, study shows

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A growing number of Koreans now see a “good death” less as a family-centered moment and more as one free of pain and financial strain, a shift highlighted in a study by the Korea Institute for Health and Social Affairs (KIHASA).

The report, published in the latest issue of the institute’s journal, Health and Social Welfare Review, analyzed responses from 1,021 adults aged 19 and older who took part in an online survey conducted between April 23 and May 7, 2024. Led by Oh Jong-min of Ewha Womans University’s School of Medicine, the research examined public attitudes toward death and preparations for one’s final years.

Results showed that an overwhelming 97 percent of respondents considered minimizing physical pain essential to a good death, followed by easing families’ financial burden at 96.2 percent and sparing them from prolonged caregiving at 95.3 percent.

These figures show that growing openness to hospice care here is driven less by acceptance of palliative medicine than by harsh financial realities. The data is also supported by a rise in so-called “caregiving tragedies” — a wave of murder-suicides fueled by the physical and financial exhaustion of families navigating a frayed social safety net.

Despite widespread reflection on mortality, only 45.7 percent of adults said they had discussed future medical care or final wishes with family members. Nearly 79 percent reported thinking occasionally or often about their own death or dying process, including 85.2 percent of women and 79.7 percent of married respondents, compared to 71.7 percent of men and 74.4 percent of singles.

While nearly all respondents saw the easing of survivors’ financial burdens as essential, fewer than a third — just 29.8 percent — said having family physically present at their deathbed was “very important,” underscoring a striking shift in cultural values.

Reflecting this pragmatic turn, the study found rising openness to hospice and palliative care.

More than 81 percent said they would consider using such services if terminally ill — particularly women (84.4 percent) and higher-income households (88.3 percent). Among those who were hesitant, about half cited cost concerns, while 43.5 percent said they associated hospices with the final stage of life.

Notably, more than 91 percent of respondents said they would choose to discontinue life-prolonging medical procedures in end-of-life situations, with older adults expressing the strongest preference. Among those aged 65 and above, the rate rose to 94.7 percent, compared to 89 percent among those under 65.

According to the National Agency for Management of Life-Sustaining Treatment, as of December last year, more than 3.2 million Koreans had registered advance directives refusing life-prolonging treatment — a record since the enactment of the Life-Sustaining Treatment Decision Act in 2018. Women accounted for roughly two-thirds of all registrants, and nearly one in four seniors aged 65 or older has signed such documentation.

Researchers emphasized that concerns about pain and the desire to lessen economic or emotional burdens on family members are deeply tied to how Koreans define dignity in death.

The research said the government “should conduct quantitative analyses on the cost-effectiveness of hospice care and provide the public with clear information on pain management and other aspects of discontinuing life-sustaining treatment.”