1.The Right to Die in Dignity and Comfort.
Journal of the Korean Medical Association 2007;50(5):390-391
The right to die in dignity and comfort is one of the gravest concerns due to the ever-increasing number of patients with incapacitating illnesses who experience a prolonged painful death, and to the modern trend to place an emphasis on the improvement of quality of life whenever possible. According to the guidelines issued by the Korean Medical Association in 2002, in cases of incurable illnesses, such as terminal stage cancer, meaningless life-maintaining management may be terminated to allow patients to die with dignity. However, the Korean Ministry of Health and Welfare maintains the stance that such guidelines overtly support the institutionalization of "passive euthanasia", and that those who follow such guidelines should be charged with murder, in accordance with the requirements of the existing Korean law. Given that, any one of us may be confronted with such a miserable death, we all have a compelling interest in the revision of the existing legislation, perhaps by using the "U.S. Living Will Registry" as a model.
Euthanasia
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Homicide
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Humans
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Institutionalization
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Jurisprudence
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Living Wills
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Quality of Life
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Right to Die*
2.Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward.
Der Sheng SUN ; Yeon Joo CHUN ; Jeong Hwa LEE ; Sang Hyun GIL ; Byoung Yong SHIM ; Ok Kyung LEE ; In Soon JUNG ; Hoon Kyo KIM
Korean Journal of Hospice and Palliative Care 2009;12(1):20-26
PURPOSE: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. METHODS: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. RESULTS: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. CONCLUSION: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.
Advance Directives
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Hospice Care
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Hospices
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Humans
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Internal Medicine
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Linear Energy Transfer
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Living Wills
3.PILL series. Not that way: advance care planning.
Singapore medical journal 2015;56(1):19-quiz 22
Advance care planning (ACP) is a process of discussion of healthcare decisions with regard to a patient's future health and personal care, should they become unable to make or communicate their own decisions in the future. ACP can be as simple as a chat about the patient's end-of-life wishes with their trusted loved ones, and may involve their doctors, organisations and trained facilitators. The process can be documented with available online resources, such as structured tools. Family physicians, with whom patients share unique therapeutic relationships, are in the best position to introduce and start the ACP conversation with their patients.
Advance Care Planning
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Cultural Characteristics
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Decision Making
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Humans
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Living Wills
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Physicians, Family
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Professional-Patient Relations
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Singapore
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Terminal Care
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methods
4.Agenda for End-of-Life Decision-Making in Korea.
Journal of the Korean Medical Association 2009;52(8):734-737
After a year of court trials initiated by the immediate family of a patient in a permanent vegetative state, the National Supreme Court of Korea ruled that the family have the right to decide for the removal of ventilator from the patient. This was a particularly significant court case that established a precedent for the Korean society as a whole, since there currently is no statutory framework regarding rights to self-determination to refuse any extraordinary means of treatment in Korean legal system. While much of Korean healthcare providers and the government itself have focused on designing and developing a comprehensive blueprint for Advance Health Directives for patients, the recent outcome has created an important opportunity for all parties of the Korean society. Therefore, the Korean government and legislature will need to systematically study and establish a procedural preparation for legislation. The providers will also have to carefully examine the moral and ethical dimensions of Advance Directives to promote the patients' interests in accordance with civil rights of the patients. Lastly and most importantly, the individuals must reflect on our own moral values, regardless of their current health. To exercise their own will and to relieve their relatives from difficult decisions, they must also educate themselves about living will and healthcare proxy, and elucidate their value history with family. No one can exactly lay out the course of life to death, but it is possible to steer the final journey of life to a more humane death. A society must value the life itself, but the journey to death should also be made humane by respecting one's own choice.
Advance Directives
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Civil Rights
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Delivery of Health Care
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Health Personnel
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Human Rights
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Humans
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Korea
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Living Wills
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Persistent Vegetative State
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Proxy
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Supreme Court Decisions
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Ventilators, Mechanical
5.A Study on the Organ Transplantation According to the Law of Organs Transplantation.
Sung Suk HAN ; Joong Ho KIM ; Hyun Ja HONG
The Journal of the Korean Society for Transplantation 2003;17(2):203-219
PURPOSE: 2003, Advances in medical-surgical technologies, histo-compatibility and immunosuppressive drugs, such as FK-506, MMF, have caused a dramatic increase in the rates of successful organ transplantation (TP). As the waiting list of patients requiring TP grows, there is a subtle donation. What is worse, its increased issues of ethics, for instance, definition of brain death, consent of living donation, paid organ donation, decreased altruism, living will, justice of sharing organ. Therefore, This study was done to develop on legal, ethical and philosophical for whole procedure of organ transplantation which is a life-saving treatment improvement the quality of life. METHODS: A survey questionnaire was used and received responses from TP doctors(59) and nursing coordinators(46) at 53 hospitals where TP were being done for this study. The basic data in TP were collected, 1) to identity the staffs in charge of TP and their jobs in the hospital, 2) committee of hospital ethics (CHE), 3) committee of brain death confirmation definition (CBDCD), 4) to research what consideration are appropriate donors and recipients, 5) the facility of hospital for TP, 6) to analyzed awaiting solution the problems for TP. The data were analyzed using SAS-program by descriptive statistics, t-test, ANOVA and Pearson correlation coefficient. RESULTS: The jobs of TP nursing coordinators were not only to give nursing information but also to take care of donors and recipients (62.8~84.4%). The job of TP has not been identified between CHE and CBDCD (62.8%). The mean score of CHE's members was 6.33 persons. The mean scores of the problems regarding the law of TP was 2.88 (full score:4). The high items of the problems regarding the law of TP were "the decreased TP, donation and brain death because of KONOS (Korea Network for Orgen Sharing) which operated TP". The mean score of the improvements regarding the law of TP was 2.97 (full score:4). The highest item of the improvements regarding the law of TP was "Compensation of loss should be paid by the KONOS. The procedure of confirm is a loose legal. Therefore that is concern about commercialization of human organ. Definition of brain death is rigid regulation. Sharing organs are a fair dealing. The problems were significantly correlated with the improvements (P<0.0001). CONCLUSION: The finding of the study suggested that a TP should manage donors and recipients in line with legal, ethical, philosophical, humanistic aspects. Various viewpoints, the CHE should be enacted from the principle of human dignity, conducted by CBDCD of professional members and the nursing coordinators played an important role. It is suggested that TP might meet the request of the time so that KONOS should be changed with the other organization of newly methods and responsibility.
Altruism
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Brain Death
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Ethics
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Ethics, Institutional
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Humans
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Jurisprudence*
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Living Wills
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Nursing
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Organ Transplantation*
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Personhood
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Quality of Life
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Surveys and Questionnaires
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Social Justice
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Tacrolimus
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Tissue and Organ Procurement
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Tissue Donors
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Transplants*
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Waiting Lists