Institutional Ethics Committees for Decisions on Life-sustaining Treatment in Korea: Their Current State and Experiences with their Operation*,**

Abstract

Institutional Ethics Committees are responsible for reviewing, consulting, and educating about matters related to life-sustaining treatment, these committees should play a substantial role in implementing the Act in each hospital. However, there are few such committees and their operations have been limited in many respects. In this article we report on a survey that was carried out to assess the difficulties faced by 63 committee administrators. We also conducted focus-group interviews with seven medical professionals or administrators working in health care institutions in which a committee has been established. Subjects were asked about the difficulties these committees face in advising on foregoing life-sustaining treatment. The operational problems that were reported include the following: difficulties in accessing patients’ records of decisions concerning life-sustaining treatment, obstacles in using Shared Ethics Committees, legal and administrative complexities in diagnosing the end-of-life process, the lack of expertise of committee members and administrators, manpower shortages on the committees, and medical professionals’ negative views of the Act’s procedures for life-sustaining treatment decision-making. In order to deal with these problems, we suggest the following solutions: improving the accessibility of patients’ life-sustaining treatment decisions, encouraging the use of Shared Ethics Committees, defining the qualifications and training requirements for Committee members, establishing better communications among committee members; creating an educational system for medical professionals in order to improve their understanding of the committees’ role; and developing standard operating procedures for the committees.

Research Trends on Doctors’ Competencies in Korea Using Text Network Analysis

“…This increased focus can be attributed to the full implementation of the endof-life decision-making system in Korea in February 2018, leading to a significant rise in discussions on this topic before and after its introduction. Of the 280 articles retrieved using the keyword "end-of-life decision-making, " 218 were published in 2017 or later, covering topics such as a review of the end-of-life decision-making system [41], comparisons with overseas end-of-life decision-making laws [42], and differences in perceptions of end-of-life decision-making [43].…”

Trends in Nursing Research on Life-Sustaining Treatment in South Korea after the Enforcement of the Act on Decisions on Life-Sustaining Treatment

“…As the human lifespan has been extended, there have been controversies in medicine on life-sustaining treatment due to issues related to human dignity and ethical considerations [ 1 ]. In 1997 at Boramae Hospital, a guardian requested discharge of a patient kept alive on a ventilator for economic reasons [ 2 ]. In this case, the patient died after a ventilator was removed upon the request of the guardian who signed a pledge not to raise any legal issues, and medical professionals were charged with aiding murder.…”

“…In this case, the patient died after a ventilator was removed upon the request of the guardian who signed a pledge not to raise any legal issues, and medical professionals were charged with aiding murder. In 2008, guardians requested discontinuation of life-sustaining treatment for an individual known as Grandmother Kim, who suddenly lost consciousness and entered a vegetative state during a lung cancer test, which led to a judgment permitting death with dignity [ 2 ].…”