As a new view of life,death with dignity involves the behavior that dominates the interests of individual life.Due to the influences of Chinese traditional culture,professional ethics,policies and laws,medical service supplies and other factors,the social implementation of death with dignity has brought many ethical problems.The improper social implementation of death with dignity will infringe on citizens' right to life and human dignity.In view of this problem,we should pay attention to the education of citizens' view of life and death,improve the specific operation procedures of death with dignity,and enhance the supply capacity of hospice care services in designing the system of death with dignity,so as to better safeguard and protect the basic rights and interests of citizens.
Humans ; Right to Die/ethics*

The decision to withdrawal of life-sustaining management for dying patients is one of the most difficult challenges in modern medical ethics. Due to the advances in medical science and technology, terminally ill patients can survive longer than ever expected before. More specifically, artificial ventilation, nutrition, and recently developed drugs constitute the cores of life -sustaining management for dying patients. The issues of patients' autonomy, medical paternalism and sanctity of life are related with this particular problem. Korean Supreme Court recently approved the request of a permanent vegetative status patients' family to terminate the artificial ventilation and allow the patient to die. Korean Medical Association is currently seeking to establish the guideline. Korean government and parliament are also looking for a way to enact the law. However, religious sector including Catholic Church and a significant proportion of the population have opposed the legalization of euthanasia. A careful study in other countries' legislations related to the care for dying patients would help to establish the consensus in the nation.
Advance Directives ; Consensus ; Ethics, Medical ; Euthanasia ; Humans ; Jurisprudence ; Paternalism ; Right to Die ; Terminally Ill ; Value of Life ; Ventilation

This year on May 21st, the full panel of the Supreme Court in Korea had first made a judgment on 'withdrawal of life-sustaining management'. In this case, where a 76 -year-old patient was represented by her children, while being in a persistent vegetative status, the Supreme Court ruled that if a patient is in an irreversible condition with imminent death and the discontinuation of treatment can be approved as the patient's self -determination, while such action will not be allowed in any other special circumstances. This judgement presented the general criteria and process of withdrawal of life -sustaining management in Korea for the first time. The Supreme Court also brought about the specific requirements of advance directives and decided that in case where legal proceedings are not taken, the hospital ethic committee constiting of medical specialists should decide whether the patient is in an irreversible condition. However, the judgment vaguely defined the concept of 'irreversible death-imminent condition' and did not clearly examine the relations between the patient's right on self-determination and the duty of the national government to protect the life of the people, and the discretionary power of the doctor.
Advance Directives ; Child ; Ethics Committees, Clinical ; Ethics, Institutional ; Euthanasia ; Federal Government ; Humans ; Judgment ; Korea ; Patient Rights ; Right to Die ; Specialization

A recent High Court's decision regarding the withdrawal of life supporting medical treatment (artificial ventilator) from an elderly female patient in the terminal stage has opened up a new era of the "euthanasia dispute" in Korea. With this decision, the legitimate withdrawal of life supporting treatment became possible under certain conditions and the Korean Medical Association is working toward the establishment of practical guidelines for the terminal-stage patients. However, there are still very few debates on the cases of pediatric patients in the terminal stage or suffering from fatal diseases. For pediatric patients, the core principle of autonomy and following procedure of "advance directives" are hardly kept due to the immaturity of the patients themselves. Decisions for their lives usually are in the hands of the parents, which may often bring out tragic disputes around "child abuse", especially in Korea where parents have exclusive control of the destiny of their children. Some developed countries such as the U.S.A., the U.K. and Canada have already established guidelines or a legal framework for ensuring the rights of the healthcare system regarding children suffering from severe illness, permitting the withdrawal of Life supporting medical treatment (LSMT) in very specific conditions when the quality of life of the children is severely threatened. For the protection of the welfare and interest of the children, we should discuss this issue and develop guidelines for the daily practice of pediatricians.
Aged ; Brain ; Brain Death ; Canada ; Child ; Delivery of Health Care ; Developed Countries ; Dissent and Disputes ; Ethics, Medical ; Euthanasia ; Female ; Hand ; Human Rights ; Humans ; Korea ; Parents ; Quality of Life ; Right to Die ; Stress, Psychological

Patients should be treated with dignity and respect toward the end of their lives, being freed from unnecessary and painful life-sustaining therapy in hospitals. In Korea, the quality of endof-life (EOL) care has been variable, a major factor being the physicians' perception to the care. A firm consensus of EOL care decision-making has not yet explicitly stated in Korean law and ethics until recently. However, movements to make a law of so-called "the death with dignity act" are presently making its way to the National Assembly, initiated by a law case that allowed the hospital to withdraw mechanical ventilator support per request by the patients' family of a permanently vegetative patient. Socially agreed guidelines for EOL care can facilitate clinical decision process and communication between health service provider and the patient or his/her family. At the same time, EOL care should be individualized also in the same line of guideline to meet patient' and patient' family wish regarding the withdrawal of life-sustaining therapy. The painful EOL care experience of the loved one remains in the memory of the relatives who live on. Physicians should identify, document, respect, and act on behalf of the hospitalized patients' needs, priorities, and preference for EOL care. It has been advocated that competent patients can express their right of self-determination on EOL care through advance directives in Western countries. Advance directives are considered as a tool to facilitate EOL decision making. However, there are barriers to adopt the advance directives as a legitimate tool for an EOL decision making in Korea. For one thing, the reality of death and dying is rarely discussed in our society. In addition, the discussion about EOL care with chronically and critically ill patients has been considered as a taboo in the hospitals. In spite of these difficulties, physicians could do better EOL care by the open communication with patients or with their surrogates. Through the communication, physician should set a goal how to manage the EOL patient. The set goal should be shared among the caregivers to achieve the maximum benefit of the patient. The lack of open discussion with patient prior to EOL care results in inappropriate protraction of a patient's dying process. In summary, physicians, who know the clinical significance of delivering treatments to EOL patients, should play a central role in assisting patients' and their families' to make the best decision on EOL care. Moreover, the concerted actions to improve EOL care in our society among general public, professionals, stakeholders for EOL care, and governmental organizations are required to address ongoing social requests, although a policy or a guideline is made in this time.
Advance Directives ; Caregivers ; Complement Factor B ; Consensus ; Critical Illness ; Decision Making ; Ethics, Medical ; Health Services ; Humans ; Jurisprudence ; Korea ; Love ; Memory ; Physician's Role ; Right to Die ; Taboo ; Ventilators, Mechanical