• The Korean Society of Law and Medicine
• /
• v.10 no.1
• /
• pp.263-305
• /
• 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 Academy of Nursing
• /
• v.31 no.2
• /
• pp.279-291
• /
• 2001

Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.

• The Korean Society of Law and Medicine
• /
• v.25 no.1
• /
• pp.193-222
• /
• 2024

From a global trend, discussions on the patient's death with dignity are gradually progressing from the issue of withdrawal of life-sustaining treatment to the issue of whether to allow assisted death and its requirements. Several states in the United States and Western European countries such as Canada, Belgium, and the Netherlands have institutionalized treatment to accelerate the time of death through the assistance of doctors. In France, after a long period of raising and reviewing issues, discussions on related legislation are taking place at a slower pace than in other European countries. In France, social discussions and legislative attempts on death with dignity have been actively conducted since the late 20th century. The Leonetti Act of 2005 prohibited the continuation of meaningless treatment against the will of patients, and after the Clay-Leonetti Act of 2016, it was legalized to administer intensive and continuous sedatives to patients until death. However, unlike many neighboring European countries, treatment that speeds up the time of death itself is still prohibited in France, even if the patient wants. As the existential and universal question of whether to allow dying patients to die painlessly with the help of a doctor has recently emerged as an important issue, a number of lawmakers have submitted legislation to legalize assisted death. This paper examines the legislative process developed in relation to patients' rights to dignified death in France, and compares and reviews French legislation that attempts to legalize assisted death with the amendment to the Korean Life-Sustaining Treatment Act.

• Journal of Digital Convergence
• /
• v.13 no.12
• /
• pp.413-422
• /
• 2015

This study is to grasp fundamental data to prepare the policy about death with dignity(DwD) by grasping perception type of the middle-aged about DwD. 32 middle-ages test Q-sort with 30 statements which is related to DwD. The result of analysis shows that subjective perception types are permission type, opposition type, and limited permission type. First, 'permission type' indicates that DwD by self-determination of patients should be accepted; it is necessary to patients with extreme pain. Second, 'opposition type' insists that there will be more people dying unfairly; a trend to make light of human life could be in everywhere if DwD is permitted. Third, 'limited permission type' agrees with permitting DwD but insists on preparing specific legal system before that. The subject, DwD, itself seems not to be able to draw a complete agreement from people, but national opinions should be reflected during the process of DwD system.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.16 no.1
• /
• pp.72-82
• /
• 2010

Purpose: The purpose of this study is to understand the meaning of dignified dying expressed by undergraduate nursing students. Method: Data were collected by in-depth interviews with fifteen nursing students. Conventional qualitative content analysis was used to analyze the data. Result: There were six major themes and eleven sub-categories from the analysis. Six major themes include death with no artificial life support, obedient death as a human nature, death with family members, meaningful death, no self destructive death, and sympathized death receiving from health care providers. Conclusion: The result of this study suggests that the nursing curriculum related to dignified dying can be developed and may affect the teaching and learning settings to improve end-of-life care performance among undergraduate nursing students, as well as, students in human service areas and health care providers.

• Journal of Korean Society for Quality Management
• /
• v.51 no.4
• /
• pp.531-550
• /
• 2023

Purpose: The unique nature of life-and-death healthcare services sets them apart from other service industries. While many studies exist on the relationship between healthcare services and customer satisfaction, most of them focus on mildly ill patients, ignoring the differences between critically ill and non-seriously ill patients. This study discusses the actual quality of healthcare services for patients who are facing life-threatening illnesses and are on life support, as well as their right to protection and dignity. Methods: The survey conducted to 149 patients with the four major illnesses: cancer, heart disease, brain disease and rare and incurable disease, those who have experiences with senior general hospitals. Results: The basic statistics of this study are adequate to represent the four major critical illnesses, and the reliability and validity of this study's hypotheses, which were measured by multiple items, were analyzed, and the internal consistency was judged to be high. In addition, it was found that the convergent validity was good and the discriminant validity was also secured. When examining the goodness of fit of the hypotheses, the SRMR, which is the standardized root mean square of residuals that measures the difference between the covariance matrix of the data variables and the theoretical covariance matrix structure of the model, met the optimal criteria. Conclusion: The academic implications of this study are differentiated from other studies by moving away from evaluating the quality of healthcare services for mildly ill patients and focusing on the rights and dignity of patients with life-threatening illnesses in four senior general hospitals. In terms of academic implications, this study enriches the depth of related studies by demonstrating the right to protection and dignity as a factor of patient-centeredness based on physical environment quality, interaction quality, and outcome quality, which are presented as sub-factors of healthcare quality. We found that the three quality factors classified by Brady and Cronin (2001) are optimized for healthcare quality assessment and management, and that the results of patients' interaction quality assessment can be used to provide a comprehensive quality rating for hospitals. Health and human rights are inextricably linked, so assessing the degree to which rights and dignity are protected can be a superior and more comprehensive measurement tool than traditional health level measures for healthcare organizations. Practical implications: Improving the quality of the physical environment and the quality of outcomes is an important challenge for hospital managers who attract patients with life and death conditions, but given the scale and economics of time, money, and human inputs, improving the quality of interactions and defining them as performance indicators in hospital quality management is an efficient way to create maximum value in the short term.

• The Korean Society of Law and Medicine
• /
• v.9 no.2
• /
• pp.77-107
• /
• 2008

In Republic of Chaina (Taiwan), Natural Death Act named "Anning Huauhe Yiliao Tiaoli" which means palliative and hospice care act was enacted in year of 2000. And enforced in the same year. Many scholars say that Taiwan's Act took Many U.S.A.'s acts such as 'Federal Patient Self-Determination Act 1990', 'California Natural Death Act 1976' and 'Washington Natural Death Act 1979' for a model. Taiwan's Act adopts a few outstanding systems - 'advance declarations' including 'living will' and 'durable power of attorney for health care', 'family-determination system' for a patient who is in a persistent unconscious state. This paper disusses this Act. 'The content is as follow: 1. A background of legislation. 2. The purpose of legislation. 3. The concept of terms. 4. Patient's self-determination. 5. Subrogated determination by family. 6. Keeping documents. 7. Punitive provision. 8. The relationship with euthanasia. 9. Controversial issues.

• Korean Journal of Adult Nursing
• /
• v.23 no.5
• /
• pp.482-493
• /
• 2011

Purpose: This study was conducted to compare and identify the mediating effect of family communication in the impact of death anxiety and personal meanings of death on the attitude of dignified death near the end-of-life among Korean mid-life and old people. Methods: A cross-sectional study was conducted with 287 mid-life and old people in Seoul, Busan, and Daegu City. Data were collected through self-report questionnaires which were standardized instruments from November 2010 to March 2011. Data were analyzed by using SPSS/WIN 14. Results: The results of the study indicated that there were statistically significant differences in level of death anxiety, personal meaning of death, and the dignified death between mid-age and old-age people. In addition, family communication had full mediating effects among the mid-age, while it had partial mediating effects among the old-age in the relationships between death anxiety, personal meaning of death, and the attitude of dignified death. Conclusion: Based on the findings of the study, implications for the intervention of the dignified death and preferences for care near the end-of-life among mid-life and old people and recommendations of further study were provided.

• Journal of Korean Public Health Nursing
• /
• v.34 no.2
• /
• pp.251-262
• /
• 2020

Purpose: This study attempts to provide basic data for establishing and implementing an advanced directive (AD) system that helps identify dignified death attitudes and reduces death anxiety of the preliminary, through preparation of an AD. Methods: Data were collected from 135 preliminary elderly aged 55 to 64 years, recruited from health centers and welfare facilities. All data were analyzed using SPSS 22.0. Results: Overall scores of the participants were 2.26±0.64 for death anxiety scale, and 3.16±0.44 for dignified death attitude. Scores of individuals who prepared an AD were determined to be 2.19±0.64 for death anxiety, and 3.34±0.44 for dignity of death. The difference in scores obtained for dignified death attitude was significantly higher for the group that signed an AD, as compared to the group with no AD (F=14.81, p<0.001). Conclusions: Results of this study reveal that preliminary elderly who sign an AD have a higher dignified death attitude score as compared to subjects who do not sign an AD. Additionally, the former group of participants desire a dignified end to their life. This indicates a necessity to promote public campaigns for ADs, and to develop educational programs that assist the elderly to prepare for a dignified death and make autonomous decisions.

• Korean Journal of Social Welfare
• /
• v.62 no.4
• /
• pp.325-347
• /
• 2010

To provide a satisfactory life for the elderly females who are the most impoverished among the elderly social strata, this study is geared towards, and focused on, the exploration on their attitudes towards death. For the purpose of this study, in-depth interviews with females aged 65 and over, who are officially classified as the beneficiary of national fundamental livelihood security, have been conducted. Then, the results from these interviews have been compiled and analyzed through qualitative research methods. As a result of this research, the attitudes of the destitute elderly females towards death are categorized into several themes, such as 'Feeling close to the death through a hard life', 'Positive acceptance of the death', 'Relying on funeral services from government and religious organization', 'Hoping for a death with dignity'. The attitudes of death means to them that 'they can get out of a hard life', and elderly female beneficiaries were positive in their acceptance of this meaning. Those who could obtain funeral services as a part of assistance from government and a religious organization did not feel stressful about their funeral arrangements. However, there were individuals who didn't know if their funeral services would be covered by the government. They were unsure if a funeral service would be held for them, or they would have nobody to hold a funeral for them. Accordingly, they were worried about that. The poor elderly females were unhealthy and indigent, and so, they had death anxiety. Therefore, based on the study results above, some ideas regarding elderly welfare are proposed to enable poor elderly females to face their deaths with dignity.