• Journal of Hospice and Palliative Care
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• v.20 no.3
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• pp.159-166
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• 2017

According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.10
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• pp.243-249
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• 2019

This study examined the patient's advantage and respect self-decision to protect human dignity and values, who are on the pathway of the hospice palliative care and death process. The study subjects were the elderly who had signed the advance medical directives at C Christian religious facilities in S region. The survey period was started on July 1st, 2019 and lasted for ten days. The study resulted in four topics and eight sub-topics on the motivation for preparing advanced medical directives. The four topics were 'for children', 'fear of pain', 'want to clear my life', 'felt the necessity', and the sub-topics were 'don't want to make a burden to children', 'don't want to make a worry of medical expenses', 'fear of pain', 'have experience of taking caring of painful death process', 'relaxed mind', 'importance of self-decision', 'have known it before but now decided', and 'it is the new information and decided'. This research is meaningful in that it can form the basis for improving well-dying education programs for the good death of the elderly and supplementing effective systems for preparing advance medical directives.

• 한국노년학
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• v.29 no.1
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• pp.51-69
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• 2009

The purpose of this study was to identify the effects of death education on attitudes toward death and depression for older adults. A death education program consisted of needs of death education, alternatives for dignity on death, not ending death(I, II), hospice(I, II), and 9 patterns of death(I, II, III). Participants in this study were 38 older adults aged 60 years or older. Attitudes toward death and depression scales for Korean elders were employed. The data collection and intervention were performed from January to June, 2008. The subjects participated in a death education program for 1 time per week during 10 weeks. The data were analyzed with t-test, and Pearson correlation coefficients with SPSS/Window 14.0. After the intervention, the subjects showed significant difference in attitudes toward death compared to that of pre-intervention. The subjects after the intervention showed no statistical differences in change of depression compared to that of pre-intervention. Also, attitudes toward death were negatively related with depression both before and after interventions, but the change of relation was not significant. The findings of this study contributed to extend the base of program developments on death education enhancing attitudes toward death among Korean older adults.

• Journal of the Daesoon Academy of Sciences
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• v.28
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• pp.37-72
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• 2017

The purpose of this article is to study the prospect of implementing a public common practice of ethics based on the 'Reordering Works of Heaven and Earth.' The 'Reordering Works of Heaven and Earth' demonstrated the prospect of a public common practice of ethics through the shared public action that would connect and mediate both the public domain and the private domain. In addition, the 'Reordering Works of Heaven and Earth' of Gucheon Sangje (九天上帝) provided us with a complete transformation, meaning the opening of a new era, transforming heaven and earth from their state in the Prior World to their optimized state in the Later World. This culminates in a new manifestation of a peaceful world revealed a prosperity and the prospect of common happiness and common order for the public. In addition, the 'Reordering Works of Heaven and Earth' has a public value as a religious culture that responds to social change and social needs. The 'Reordering Works of Heaven and Earth' revealed the prospect of a public common practice of ethics, placed importance on creating a new foundation, and restoring phenomena back to its original order. The 'Reordering Works of Heaven and Earth' presented various multi-faceted, multi-layered outlets of soteriology while exploring solutions to public issues and revealing human dignity. Through the new construction of Heaven and Earth, Gucheon Sangje had intervened in projects for human relief. The public ethical indicators of 'the actor' here are in line with those of the 'Non-action Tao' of Laozi. As the cosmos enters into the new epoch, humans have living together with the previous cosmic principle. Now we can expect the Prior World to open into a different era as humans embrace a cosmic life of 'Non-action Tao.' The active conjunction of the virtues of yin and yang is an idea of horizontal communication related to reordering of the universe. The harmonious union of divine beings and human beings suggests the way of enabling vertical communication. The resolution of grievances for the mutual beneficence of life is an ethics of peace that aims at achieving coexistence and prosperity. The private realization of Tao and the completion of the Tao in the world suggest the prospect of a common practice of ethics as means of implementing human dignity.

• Journal of Legislation Research
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• no.41
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• pp.87-123
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• 2011

Korea is expected to become an 'aged society' with more than 14 percent of the public aged 65 years or more by 2018. The rapid aging is giving rise to various problems within the society along with falling birthrate in a short period of time. In this context, the role and function of laws on welfare for the aged must be particularly emphasized. Also the Senior Citizens Welfare Act is of great importance as it provides social welfare service on the basis of functional connection with social insurance and public assistance. First, this paper looks into the history of laws related to welfare for the elderly such as the Senior Welfare Act, the Act on Long-term Care Insurance for Senior Citizens and the Basic Old Age Pension Act as well as the findings of earlier studies. In the second place, it will break down such laws by main components aiming to examine details of the laws and questions raised regarding them and to seek ways to achieve improvement with an emphasis on health care, old age income security, housing welfare(assisted living facilities), job security for the aged. The Senior Welfare Act offers substance of social welfare service for the elderly. Income security, health and medical care, welfare measures through long-term care and assisted living facilities, social participation by working are the key elements and all of them should be closely associated to ensure citizens get sufficient public support in their old age. For this purpose, the Senior Welfare Act is under a normative network with laws such as Act on Long-term Care Insurance for Senior Citizens and Basic Old Age Pension Act. Current laws on welfare for the aged including Senior Welfare Act are not sufficiently responsive to the aged society of the 21st century. Income security combined with decent social participation, health and medical care closely connected with long-term care system, efficient expense sharing between government and local government, enhancement of effectiveness of welfare measures can be considered as means to improve current welfare system so that the elderly can enjoy their old age with dignity and respect.

• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.309-341
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• 2009

According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.