The Need for Public Debate on the Activation of Terminality
10.35301/ksme.2025.28.1.35
- Author:
Dolil SHIN
1
;
Chang-O KIM
Author Information
1. Home Visit Doctor, Home-Based Medical Center, Dolbom Clinic, Seoul, Korea
- Publication Type:Commentary
- From:
Korean Journal of Medical Ethics
2025;28(1):35-39
- CountryRepublic of Korea
- Language:English
-
Abstract:
While cancer patients typically pass away within a few months of being deemed incurable, patients with other chronic illnesses, such as severe dementia, experience a slow decline in their condition over several years despite active treatment. Since it is not always easy to determine when the endof-life phase begins for any patient, it is common for the excessive treatment that is characteristic of the disease progression phase to carry over to the end-of-life phase. This article follows the clinical course of a non-cancerous patient who survived for several years after being declared incurable. In this case, the terminality process was not activated, which allowed life-extending treatment to be continued and led to delays in advance care planning. This article addresses the question of how terminality can be activated so that advance care planning can be initiated in a timely fashion. The following two proposals are discussed: a) that hospice/palliative care teams should introduce end-oflife family education before starting secondary chemotherapy, and b) that advance care planning for older adults should be initiated at the time of applying for long-term care insurance.
