• Child Health Nursing Research
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• v.23 no.3
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• pp.364-374
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• 2017

Purpose: The purpose of this study was to describe feelings and actions of nurses following withdrawal of life-sustaining treatment from children being cared for by the nurses. Methods: Data were collected by in-depth interviews with 7 nurses from different hospitals where children receiving nursing care had life-sustaining treatment withdrawn. The interviews were conducted from August 2016 to February 2017 when all data were saturated. Interviews lasted 30~90 minutes and were conducted 2~3 times per participant. Data were analyzed using Giorgi's phenomenological research methodology. Results: The following factors constituted experiences of nurses working in pediatric wards when life-sustaining treatment was withdrawn from children: "agony and conflict in the aspects of care", "heavy mind and regret for exhausting care", "intentionally avoiding parents' sadness", "comforting sadness in the heart" and "orientation in the role of caring for children undergoing withdrawal of life-sustaining treatment." Conclusion: Findings indicate that support systems and intervention programs need to be developed so that nurses can understand and wisely deal with experiences of withdrawal of life-sustaining treatment from children who receive care from nurses.

• Journal of Home Health Care Nursing
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• v.27 no.1
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• pp.82-91
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• 2020

Purpose: This study aimed to explore the factors influencing attitudes toward withdrawal of life-sustaining treatment (WLST) in adolescents. Methods: This study used a descriptive research design. A structured questionnaire was administered to 185 adolescents. Data were analyzed based on t-tests, analysis of variance, Pearson's correlation coefficient, and multiple regression using the IBM SPSS 20.0. Statistical package. Results: There was a negative correlation between attitudes toward WLST and respect for life (r=-.188, p=.010). Knowing about life-sustaining treatment (β=-0.30, p<.001), experience of WLST education (β=0.21, p=.003), experience of respect for life education (β=-0.16, p=.021), and experience of death (family or acquaintance) (β=-0.13, p=.039) explained 16.7% (F=8.39, p<.001) of the variance in attitudes toward WLST. The respect for life did not affect attitudes toward WLST (β=-0.07, p=.347). Conclusion: The study findings suggest that WLST in adolescents is different from that of adults. Further research is needed to develop strategies for sound and positive attitudes toward WLST in adolescents.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.397-418
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• 2012

• Journal of Digital Convergence
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• v.15 no.8
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• pp.257-265
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• 2017

The purpose of this study was to investigate the degree of awareness of the concept of 'hospice palliative medical care' and decision of 'life-prolonging medical care' by the general public subjects. A survey was conducted on 346 participants and officials who participated in an event held in September 2016. As a result of the research, the subjects' responses results to the life-prolonging medical care decision showed that people with religion wanted natural death compared to people without religion, and had more active attitude toward decisions related to dignity death. Religion is an important factor that can influence perceptions of life and death, believing that afterlife is after death, so it is possible to take a more firm stance on the extension of meaningless life at the last minute. Therefore, in order to stabilize the hospice care and prescription medical decision law to the general public and to improve the quality of the death and the dignity of life, it is necessary to develop awareness through various educational programs in consideration of age, education level. In addition, education and promotion should be strengthened so that the general public can fully understand the knowledge of hospice palliative care and health care and government standardization and policies for hospice personnel and breeding programs will be urgent.

• Journal of Hospice and Palliative Care
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• v.21 no.2
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• pp.51-57
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• 2018

Purpose: End-of-life (EoL) decisions are challenging and multifaceted for patients and physicians. This study was aimed to explore how EoL care is practiced for patients with a do-not-resuscitate (DNR) order. Methods: We retrospectively analyzed medical records of patients who died after agreeing to a DNR order in 2016 at a university hospital. Characteristics including cause of death, intensity of EoL care, and other factors were reviewed and statistically analyzed. Results: Of total 375 patients, 170 patients (45.3%) died with malignancies, and 205 patients (54.6%) with other causes involving the central nervous system (19.2%), pulmonary (14.7%), cardiologic (6.7%) and infectious (6.4%) conditions. Both the cancer and non-cancer patient groups showed a short duration from DNR to death (median 3 days vs 2 days, P=0.629). An intensive care group comprising patients who received one or more intensive treatments such as ventilator (n=205) showed a higher number of non-cancer patients and a shorter duration from DNR to death than a group that withheld treatment before DNR (P<0.05). Conclusion: EoL decisions were made very late by both cancer and non-cancer patients. About half of the patients did not have cancer, and two-thirds of them decided DNR during intensive treatment. To make a good EoL decision, a shared decision making with patients should be done at an earlier stage.

• Journal of East-West Nursing Research
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• v.23 no.1
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• pp.1-8
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• 2017

Purpose: This study aimed to provide basic data of nursing student's knowledge and attitudes towards the withdrawal of life-sustaining treatment. Methods: Nursing students from two universities in J province participated in this study. The descriptive statistics, t-test, one-way ANOVA, Scheffe test and Pearson's correlation coefficient were used to analyse the data. Results: The nursing students' knowledge of the withdrawal of life-sustaining treatment was 7.42 out of 16. The participants' attitude toward the withdrawal of life-sustaining treatment was 50.03 out of 95 which was 2.64 in its mean rating. Regarding their knowledge of the withdrawal of life-sustaining treatment, nursing students whose family members experienced the life-sustaining treatment had significantly higher knowledge than those students whose not (p<.001). Those participants who support patients or their families' right to decide the withdrawal of life-sustaining treatment had positive attitude toward the withdrawal of life-sustaining treatment (p=.007). In addition, the knowledge of and attitude toward the withdrawal of life-sustaining treatment showed significant correlations (r=.639, p<.001). Conclusion: The findings of this study suggest that systematic and professional education is needed for nursing students to equip positive attitude toward the withdrawal of life-sustaining treatment in nursing practice.

• The Korean Society of Law and Medicine
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• v.13 no.2
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• pp.285-308
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• 2012

The Korean supreme court said that Mrs Kim who was in a persistent vegetative state had a right to die if she had a presumed will or assumption of dying against Severance hospital in 2009. Presumed would be vague and can not be subjective to conjecture though, the court had a developed trial on the case. I recommend the higher valued notion such as the 'right to decide on the life extension' is more logical than assumptive will. To achieve this recommendation, I will search right to life, right to decision, human dignity and find the good relationship between them. In conclusion, I will announce that if PVS patients without advanced directives aren't able to express their will and no one could not assume their right to die in spite of meaningless life extension. So only the due and strict procedure about the extinction of meaningless PVS patients will allow them to sacrifice themselves or remove life extension ventilators. Also active euthanasia would be possible under the strict procedure of making advanced directives and the act of helping active euthanasia additionally, the crime of abetting suicide would not be executed in the legal scope.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.85-98
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• 2010

Purpose: This study was aimed to investigate the awareness and attitudes towards withdrawal of the life-sustaining treatment among nurses, physicians, and the families of intensive care unit (ICU) patients in general hospitals. Methods: The data were collected using a questionnaire from 80 ICU nurses, 80 physicians, and 80 families of ICU patients in general hospitals. Data were collected from February 22nd to May 31st, 2010. Rusults: ICU nurses, physicians, and families of ICU patients felt that objective and ethical guidelines were needed in making a decision to withdraw the life-sustaining treatment. The main reason for withdrawal of the life-sustaining treatment was found that the patients could not recovered despite many efforts. The role of nurses in decision making process on withdrawal of the life-sustaining treatment was considered very positive from the view of physicians and family members. The most important role of nurses for those patients in ICU was found to try their best to care for the patients. Conclusion: ICU nurses should play a major coordinating role in communication among patients, their families, and medical teams. Also, an appropriate roles of nurses in the process of the withdrawal of the life-sustaining treatment should be established.

• The Korean Society of Law and Medicine
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• v.10 no.1
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• pp.263-305
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• 2009

Is it lawful to withhold or withdraw life-sustaining treatment applied to a patient in a terminal condition or permanent unconscious condition? In Korea, there are no such laws or regulations which control affairs related to the withholding or withdrawal life-support treatment and active euthanasia as the Natural Death Act or the Death with Dignity Act in the U. S. A. And in addition there has had no precedent of Supreme Court. Recently Supreme Court has pronounced a historical judgment on a terminal care case. The court allowed the withdrawal of life-sustaining treatment from a patient in a permanent unconscious state. Fundamentally the court judged that the continuation of that medical treatment would infringe dignity and value of a patient as a human being. And the court required some legal grounds to consider such withdrawal or withholding of medical care lawful. The legal grounds are as follow. First, the patient is in a incurable and irreversible condition and already entered a stage of death. Second, the patient executed a directive, in advance, directing the withholding or withdrawal of life-support treatment in a incurable and irreversible condition or in a terminal condition. Otherwise, at least, the patient's will would be presumed through his/her character, view of value, philosophy, religious faith and career etc. I regard if a patient is in a incurable and irreversible condition or in a terminal condition, the medical contract between a patient and a doctor would be terminated because of the actual impossibility of achievement of it's purpose. So I think the discontinuation of life-sustaining care would be legally allowed without depending on the patient's own will.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.109-122
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• 2023

Purpose : This study aims to explore nursing activities after the decision to discontinue life-sustaining treatment, awareness of a good death, and perception of life-sustaining treatment decisions among nurses in intensive care units (ICUs) at tertiary general hospitals. Methods : Participants were 173 nurses working in two tertiary general hospitals. The data were collected using structured questionnaires and analyzed using an independent t-test, paired t-test, one-way ANOVA, Scheffé's test, and Pearson's correlation coefficient. Results : Participants were 173 nurses working in two tertiary hospitals. The nursing activity increase was the greatest in the spiritual domain, and the physical domain was where the activities decreased the most. There were significant associations between Awareness of good death (Clinical) and Perception of life-sustaining treatment decision(r=.26, p <.001), Awareness of good death (Closure) and Perception of life-sustaining treatment decision(r=.36, p <.001), and Awareness of good death (Personal control) and Perception of life-sustaining treatment decision(r=.49, p <.001). Conclusion : Based on the results, systematic education programs and job training are required to improve the awareness regarding good death and perception of life-sustaining treatment decision for nurses in ICUs where discontinuing life-sustaining treatment decisions are made.