[Viewpoint]Death with dignity

The controversy over euthanasia started up again recently when a father was indicted for murder after he removed a ventilator from his son, who was lying in coma and nearly brain-dead.
Patients who want to die in a dignified way ask for an easy death. In a way, it is natural for a person to accept death as the natural course of a disease, especially after getting the best possible medical care they can.
But euthanasia should be distinguished from mercy killing, in which the person asks to die. There is still some confusion about the definition of euthanasia.
Some years ago, a father turned off the respirator of his daughter, who was in a coma, because he could not afford her medical expenses. There was also a case in which the son of a terminally ill liver cirrhosis patient took legal steps against a medical doctor and his own sister after she removed the father’s life-support.
These are cases which show the indifference and naivete of our society, which hasn’t provided a social safety net even though the burden for medical care keeps getting bigger, while the size of families grows smaller.
Although medical science has developed a great deal, we are not yet prepared to answer basic questions such as how can we better take care of patients and what is the best way for patients to end their lives in a dignified way.
Ten years ago, a patient was withdrawn from Boramae Hospital in Seoul at the request of the patient’s spouse despite objections from the medical doctors. The patient, whose life had been supported by a respirator, died after being taken out of the hospital. The Supreme Court later found the doctors guilty. But the court did nothing to clarify the controversy within the medical community at the time, such as how to make the distinction between a terminally ill patient and a patient who can survive, the criteria that doctors should use to judge the potential recovery of patients, the procedures that should be followed before removing life-support equipment, the effect of advance directives, etc. Therefore, medical professional expect similar legal cases to happen again.
There will be more litigation cases involving euthanasia in the future than in the past, since the number of aged people will increase and people’s life spans will be further extended, while the number of family members who can help other members in sick beds will decrease. How many more medical doctors and patients’ family members need to be arrested before the government and society steps forward to solve this problem?
It is no use trying to find out whose fault it is. Society has hastened its responsibility in the handling of terminally ill patients by passing the responsibility of medical care to their family members.
Now, we have to check our social system and find out why such problems keep occurring. The government, medical community, legal profession, religious circles, civic organizations and press should come forward and establish a committee to help create a favorable social environment and provide legal provisions defining a “desirable and dignified death,” that is agreeable with the cultural traditions and sentiments of the Korean people.
Advanced countries including the United States have already put in place laws that allow a patient to request the removal of mechanical ventilation or to not be resuscitated in case of a medical emergency.
French legislators recently approved a law that would permit terminally ill patients to refuse treatment. Korea’s “Internal Organs, etc. Transplant Act” which stipulates the standards and the procedures that should be followed before judging a person to be brain-dead is another good example.
Because people who file for bankruptcy can repay their personal debts and restore their credit with the help of a credit restoration committee, when people’s ability to bear the burden of medical expenses of terminally ill patients reaches its limit, there should be a system through which they can ask for social and economic help.
If we cannot overcome medical, social and economic obstacles that prevent us from providing proper humane care to terminally ill patients, we may just be forcing meaningless pain on them instead of allowing a dignified death.
There can be innocent victims who commit suicide because they don’t want to put a social or financial burden on their family members. Ordinary citizens, too, should pay attention to the outcome of the controversy, because the issue might affect one of our own family members.
Article 10 of the Constitution stipulates that “All citizens shall be assured human worth and dignity and have the right to pursue happiness.” All citizens should be assured of an easy death that will conclude the inevitable human fate of life and death peacefully. It is time for us to provide a fundamental system that can assure people a dignified death instead of temporarily punishing those involved in euthanasia.

*The writer is the head of the Cancer Control Division of the National Cancer Center. Translation by the JoongAng Daily staff.

by Yun Young-ho