[CON] Patient’s right is non-negotiableDying with dignity
*The National Life Ethics Committee, a presidential advisory panel, has been collecting public feedback on a bill that would legalize euthanasia and set guidelines for ending life-prolonging treatment for the terminally ill. Supporters of the bill, including many medical professionals, say the wishes of families to allow their loved ones to die with dignity should be respected; opponents argue that only patients have the right to decide to forgo life-extending measures.
Medical treatment to extend the life of a patient with an incurable disease needs to stop at some point. But the life-supporting plugs should not be pulled out at random. Any actions taken or decisions made must occur in the best interest of the patient. Even when someone is in the final stage of a fatal illness or on sedatives, physicians must communicate one-on-one and attempt to determine the wishes of the patient with regard to any end-of-life decisions.
Withholding or withdrawing life-prolonging treatment in an irrefutably vegetative state should be allowed not only for economic reasons, but for the rights of all humans to die in dignity. Strictly speaking, it falls under the role and function of medical professionals.
Families and guardians should neither interfere in decisions by medical professionals nor should they make such decisions unilaterally without the consent of the patient. Medical professionals may differ in their opinions on the scope and terms for withholding life-prolonging treatment, but they are in the best position to set the guidelines and make the decision.
But guidelines must be drawn up under strict discretion to prevent abuses motivated by self-interest. The withholding or withdrawal of life-prolonging treatment - whether it be aggressive or passive - must not provide a pretext for euthanasia, mercy killing or physician-assisted suicide. Basic nutrition and sedation must be rendered to keep the patient alive. In order to protect the patient’s dignity and ease the traumatic experience for the family, the withdrawal process should be accompanied by end-of-life hospice care.
Termination of medical treatment must be allowed only when it can be replaced by hospice care to help the patient die peacefully and comfortably. Ceasing life-prolonging medical treatment without ensuring palliative hospice care could put patients and their families in serious jeopardy and cause undo misery.
The medical professional faces a dilemma in withholding and withdrawing life-prolonging practices and treatment when a patient falls into an unconscious state without clear directions on further treatment.
The doctor faces uncomfortable questions of whether he or she should honor the wishes of the family or guardian. The decision to end medical treatment could infringe on the patient’s rights and serve the selfish interests of the family or guardian.
A physician alone should not be placed with the burden and authority to decide how and when to end a human life. In uncertain circumstances, an independent medical ethics committee should be consulted for an objective evaluation of the case.
A decision can be carried out after the outside board reviews the case and delivers a recommendation. The government should assist the committee and bestow it with legal decision-making status.
Translation by the Korea JoongAng Daily staff.
*The author is professor emeritus at Seoul National University.
By Jin Gyo-hoon