By Kim Jae-heun
Sixty hospitals began halting life-sustaining treatments for patients who want to end their lives naturally, Sunday.
The so-called “Provider Orders for Life-Sustaining Treatment” (POLST),’ is different from “death with dignity” or euthanasia where doctors are actively involved in assisting the patient to end their life.
POLST only stops the medical care under a doctor’s supervision. The patient or their family also has to agree that they will no longer receive life-sustaining treatment.
It is distinguished from euthanasia in that the patient has to have no chance of survival and they have time to face death “naturally” before a doctor stops the treatment.
The practice was enabled by a law enacted in February last year. Following this, 10 medical institutes ran a pilot program in an attempt to detect any major problems. Starting Sunday, the 60 hospitals were authorized to practice it.
According to POLST and following enforcement ordinances, patients who wish to stop life-sustaining treatment can make the request, which the hospital’s medical ethics commission will review, following a confirmed diagnosis from a doctor.
When the request is accepted, doctors can stop providing anticancer treatment, hemodialysis, cardiopulmonary resuscitation or artificial respiration.
Healthy people can also make a request in advance of any possible future terminal illness.
Applicants should be adults and must visit the designated institution to receive counseling. The registered advance directive and POLST will be uploaded on the hospital’s data system that the affected people can find online at lst.go.kr. People registered can change or withdraw their request at anytime.
Those who have successfully registered an advance directive will later have to confirm this with a doctor when they become terminally ill and want to stop life-sustaining treatment.
The POLST practice has critical setbacks though when it comes to unconscious patients.
Critics say it will be very difficult to practice POLST on such individuals.
The patient’s will is the most important in POLST and there is no problem when they have registered it on their own. But it becomes a problem when family members want to make the request on behalf of the patient _ two family members must confirm the patient’s interest. However, critics say this will be easier said than done.
Doctors and medical service providers have voiced concern that they are too tightly scrutinized under the law.
“It requires so much paper work and if I miss one piece, I can be punished,” an official from the Korean Medical Association. According to the law, doctors can be punished with up to three years in prison or fined up to 30 million won when they practice POLST against a patient’s interest, make fraudulent documents or leak personal information.