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Terminally ill can choose dignity

Act lets patients and their doctors forego life-extending methods
Oct 26,2017
A terminally ill female cancer patient has filled out a form for Physician Orders for Life-Sustaining Treatment (Polst), making her the first person to choose to die with dignity since the National Assembly passed an act allowing the suspension of life-prolonging treatment on February 2016, the Ministry of Health and Welfare and Korea National Institute for Bioethics Policy (NIBP) announced Tuesday.

The Hospice, Palliative Care and Life-sustaining Treatment Decision-making Act will come into full effect next February, when medical staff will be permitted to suspend life-prolonging treatment.

But from Monday, the government allowed ten medical centers, including Seoul St. Mary Hospital, Korea University Guro Hospital and Severance Hospital, to offer terminally ill patients the option not to receive life-prolonging treatment from February by signing Polst forms.

A Polst form is a document signed by both patient and doctor to acknowledge that the doctor has agreed to accept the patient’s will to stop receiving life-prolonging treatment. A doctor may persuade a patient to sign the form, or vice versa, before submitting it to the NIBP. Prior to signing a Polst form, the doctor must explain to the patient the state of his or her illness and possible treatment methods, as well as the procedures involved in suspending life-prolonging treatments.

Only patients who have been assessed as being incurable and terminally ill by the doctor in charge, and another doctor specializing in the field of the patient’s illness, may sign Polst forms.

Once a Polst form has been signed and a patient nears death, the medical staff will suspend life-prolonging treatments, including CPR, hemodialysis, the administration of anticancer drugs and the use of respirators. Patients will continue to receive water and basic nutrition.

From Monday, some institutions also began allowing patients to sign forms for Advance Medical Directives (AMD), which, unlike Polst forms, are signed by relatively healthy patients who want to forego life-prolonging treatment if their conditions worsen, in case they cannot do so later on. According to the Ministry of Health and Welfare and NIBP, 37 people as of Tuesday have filled out AMD forms.

The ministry announced that it will make a report next month on the number of patients who have signed up for the Polst and AMD forms. The act follows 20 years of controversy surrounding the issue of “death with dignity” in Korea, following a 1997 incident when hospital employees were indicted for abetting homicide after allowing a terminally ill patient to be released.

BY SHIN SUNG-SIK [kim.eunjin1@joongang.co.kr]