Background: In order to promote the dignity of terminal patients, and improve end-of-life care (EOL care) in Korea, consensus guidelines to the withdrawal of life-sustaining therapies (LST) were published in October, 2009. The aim of this study was to assess the current perception of the guideline among internal medicine residents and to identify barriers to the application of the guidelines.Methods: The study was designed prospectively on the basis of data from e-mail survey. We surveyed 98 medical residents working in 19 medical centers.Results: 75.5% of respondents agreed with withdrawing (WD) of LST and 33.3% (33/98) of respondents were unaware of the guideline. Although 58.1% of all respondents had taken an EOL care class in medical school, about 30% of residents did feel uncomfortable with communicating with patients and surrogates. The most important obstacle for decision of WD of LST was the resident's psychological stress. 39.8% of medical residents felt guilty or failure after a patient's death, and 41.8% became often or always depressed in a patient's dying.Conclusions: In order to protect and enhance the dignity and atitonomy of terminal patients, the improvement of the medical training program in the hospitals and the tnore concern of educational leaders are urgent.

In February 2018 the “Act on Decisions on Life-sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life” (hereafter the “Life-Sustaining Treatment Decisions Act”) went into effect in South Korea.” In order learn the lesson for Korean physicians’ practice in end-of-life care, we reviewed the debates surrounding the passage of similar legislation in the US. In particular, we examined the debates concerning the “Patient Self-Determination Act,” which was implemented in the US in 1991. We systemically searched for related medical articles on PubMed online and reviewed 17 articles that were retrieved through this search. One of the main findings of this review is that most of the articles expressed support for the Patient Self-determination Act on the grounds that it would enhance patient autonomy. In contrast with this, the Korean medical society criticized the Life-Sustaining Treatment Decisions Act on the grounds that it would undermine physician authority and limit respect for patient autonomy. This reflects the fact that Korean physicians are unfamiliar or uncomfortable with the idea of respecting patient autonomy as a way of furthering the patient’s best interests. In this article I argue that the reasons for welcoming the provisions of the Life-Sustaining Treatment Decisions Act are not only legal, but also medical and ethical: the law can improve the end-of-life care that is given in healthcare settings. However, in order to achieve this goal, patients must be fully informed about their rights and physicians should initiate discussions about advance care planning, as part of general health care, before serious illness arises.

This article explores the social responsibilities of healthcare professionals (HCPs) during the COVID-19 pandemic, especially those concerning the stigmatization of individuals and the infringement of privacy. In the context of public health crises like the current COVID-19 pandemic, HCPs have the dual responsibility of respecting the rights and interests of individuals and at the same time protecting and promoting public health. While contact-tracing is considered an essential public health tool, it can conflict with the rights and interests of individuals. Furthermore, the fact that exposure to infectious diseases can lead to social stigmatization and discrimination complicates efforts to protect public health during infectious disease outbreaks. The tension between respecting the rights and interests of individuals and protecting public health requires the careful attention of HCPs. This article argues for the development and implementation of ethical frameworks or models concerning the dual responsibilities of HCPs in the context of infectious disease outbreaks.