A Study of the Attitudes of Patients, Family Members, and Physicians toward the Withdrawal of Medical Treatment for Terminal Patients in Korea

Abstract

A survey was conducted from September to December 2008 to examine the attitudes of patients, family members, and physicians toward the withdrawal of medical treatment for terminal patients and other related issues. The subjects for the study were 91 cancer patients, 96 family members of cancer or other terminally ill patients, and 140 physicians. Most subjects acknowledge the need for an appropriate regulatory framework for the withdrawal of treatment for terminal patients. However, some discrepancies were found among the different groups (patients, family members, physicians) in this study. Patients showed a stronger preference for the withdrawal of treatment than did family members. Also, most patients claimed they wanted to receive the diagnosis of a terminal illness from their physician, while most family members seem to think it is their own duty to convey such a diagnosis to the patient. Both groups prefer co-decision-making about the withdrawal of treatment over individual decision-making by the patient. However, most family members admit that they do not know much about the patient’s wishes and lack the time for sufficient conversation with the patient. Physicians are skeptical of the authenticity of the decisions made by family members, and some physicians also regard hospital ethics committees as being ineffective for resolving these issues. The results of this study paint a unique picture of clinical culture in Korea, where family members still exert strong influence on clinical decision-making and little information is shared between patients, family members, and physicians. The study points to a need for greater public education in Korea on the practical and ethical issues surrounding the withdrawal of treatment for terminal patients.

Completion rate of physician orders for life-sustaining treatment for patients with metastatic or recurrent cancer: a preliminary, cross-sectional study

“…It was their spouses that patients most often chose to have the discussion with, and doctors were preferred over offspring or siblings. This is consistent with the results of previous studies [8–10]. Regarding the reason for preparing POLST, a significant proportion of the participants (34.7%) answered that they did so at their doctor’s recommendation.…”

Family Members' Knowledge and Attitude Toward Life-Sustaining Treatment Decisions for Patients in the Intensive Care Unit

“…Relieving the physical pain of the patient was the second most highly rated role of ICU nurses. Pain is considered as one of the most demanding difficulties that terminally ill patients experience 19 . In the LST decision-making process, the role of nurses is vital.…”

“…Pain is considered as one of the most demanding difficulties that terminally ill patients experience. 19 In the LST decision-making process, the role of nurses is vital. Nurses who are most aware of the condition of the patient are expected to perform various roles while supporting patients and their family caregivers during the end-of-life process.…”

“…Before the implementation of the new act in South Korea, the number of decisions to withhold or withdraw LST were low, although ICU patients' family members had a negative attitude toward the use of LST for life prolongation 7 . Literature indicates that knowledge may influence attitude toward the use of LST for patients 17-19 . However, little is known about knowledge and attitude of ICU patients' family members since the enactment of the act.…”

“…7 Literature indicates that knowledge may influence attitude toward the use of LST for patients. [17][18][19] However, little is known about knowledge and attitude of ICU patients' family members since the enactment of the act.…”