Patients, families asking for ‘death with dignity’

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Patients, families asking for ‘death with dignity’

At the end of December last year, a 75-year-old woman surnamed Park was carried into ASAN Medical Center after a skin infection worsened. Though doctors put her on antibiotics, her condition deteriorated rapidly and she was transferred to the intensive care unit 18 days after her admission.

Park was first put on a respirator, but as it was not providing enough oxygen, she had to undergo a procedure known as extracorporeal membrane oxygenation to inject oxygen directly into her bloodstream.

Though Park held on for 10 more days, many of her vital organs, including her lungs, heart and kidneys, were failing. Park’s family said that they wanted to put an end to her suffering, and asked the hospital to take her off life support.

ASAN held a meeting of its Medical Ethics Committee, which determined that Park had no chance of recovery and that she should be taken off life support. Not long afterwards, Park died.

Park’s family satisfied all the five requirements that must be met to request the suspension of life support: her chances of recovery were negligible, doctors were unable to alleviate her pain, it would be meaningless to maintain her condition, her quality of life was low and the hospital expenses were overly burdensome for her family.

These requirements are part of the guidelines for “death with dignity” established by the Korea Academy of Medical Sciences, the Korean Medical Association and the Korean Hospital Association after the Kim Ok-gyeong case grabbed headlines last year.

Kim was a 77-year-old comatose woman who was the first Korean to have her life support terminated. The Supreme Court ruled that her artificial respirator should be removed on June 23 last year, but doctors discovered she could breath on her own shortly afterward, and she died 201 days later on Jan. 10 at Yonsei Severance Hospital.

Since then requests for death with dignity have surged. Between July and December last year, 40 patients died after being taken off life support at Seoul National University Hospital alone. Among them, 10 had filled out “do not resuscitate” forms, while the rest came at their families’ request.

At ASAN, four patients were granted death with dignity at their own request according to the guidelines, while two passed away at Samsung Medical Center. None have died at Severance Hospital since Kim.

“The rate at which critically ill patients request DNR has increased by about 25 percent,” said Heo Dae-seog, a professor at Seoul National University Medical School. “Nowadays, doctors also inform the patients in detail about their current conditions and problems that they and their families may encounter from continuing on life support when there is no chance of recovery.”

Death with dignity has become a practical reality of Korean health care, but the law is still catching up. The Ministry of Health and Welfare gathered a committee of religious groups, medical organizations and lawyers to discuss standards for the practice in December, but the committee has still not reached an agreement.

By Shin Sung-sik []
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