Experiences of Life-Sustaining Treatment Decisions among Patients with Terminal Cancer

Abstract

INTRODUCTION 1. Background Due to advances in medical technology, most deaths in South Korea occur in medical institutions rather than in private residences [1], according to official annual statistics. The issue of using life-sustaining treatments to prolong life to a meaningless point arose as a topic of civic discourse in Korean society after the Boramae hospital incident in 1997 and later after the 2008 Grandma Kim incident. These incidents resulted in calls for proper policies to mitigate this issue [2], which led to the enactment and enforcement of the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life (hereinafter referred to as the Act on Decisions on Life-Sustaining Treatment) beginning on February 4, 2018.This act provides a legal basis for patients to make the decision to withhold or withdraw from life-sustaining treatment (hereinafter referred to as decisions on life-sustaining treatment). Since the law was enacted, a total of 60,939 terminal patients have prepared life-sustaining treatment plans as of

Decision and Practice of End-of-Life Care in Lung Disease Patients with Physicians Orders for Life Sustaining Treatment

“…That is, it was confirmed that terminal cancer patients had complicated feelings and worries about their families ahead of death, but they accepted their fate and felt peaceful because of their decisions about life-sustaining treatment. However, although they appreciated the implementation of a system for life-sustaining treatment, they also described the system's drawbacks, such as lack of accessibility or explanation [16]. A study on elderly patients with terminal chronic cardiopulmonary disease reported that initial decisions on life-sustaining treatment were reversed an average of 5 days after each deci-…”

“…In a qualitative study of terminal cancer patients, decisions on life-sustaining treatment were expressed in categories of “having complicated feelings,” “making choices to protect everyone,” “accepting and preparing for death,” “feeling distress,” “pursuing spiritual wellbeing,” and “evaluating a new system.” That is, it was confirmed that terminal cancer patients had complicated feelings and worries about their families ahead of death, but they accepted their fate and felt peaceful because of their decisions about life-sustaining treatment. However, although they appreciated the implementation of a system for life-sustaining treatment, they also described the system’s drawbacks, such as lack of accessibility or explanation [ 16 ]. A study on elderly patients with terminal chronic cardiopulmonary disease reported that initial decisions on life-sustaining treatment were reversed an average of 5 days after each decision [ 17 ].…”