Living wills catching on in Korea

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Living wills catching on in Korea

Lee Kuan Yew, Singapore’s founding prime minister who died last month, wrote in his 2013 autobiography that doctors should leave him alone if he becomes ill and couldn’t move, and his life shouldn’t be extended by life support equipment, he said.

Lee passed away as he desired. He drew up an official document stating his wishes for his final days, a so-called “advance directive” or living will.

With an increase in interest in dying with dignity, the number of Koreans drawing up living wills is on the rise. Those documents usually refuse any life-extending treatments such as cardiopulmonary resuscitation, hemodialysis or anticancer drugs.

The movement is being led by the Korean Initiative for Advance Directive (KIAD), which says it receives 30 to 40 inquiries a day. Last year, the association received 5,344 inquiries and distributed samples of living wills that could be filled in with a person’s name and then signed. KIAD co-president Hong Yang-hee explained that “about 70 percent of those who took the forms are known to have filled them in.”

KIAD estimates about 28,000 people in Korea have drawn up living wills and the figure has shown a steady increase from 22,970 in 2011.

A 70-year-old surnamed Kim, who lives in Seongnam, Gyeonggi, was diagnosed with stomach cancer and had surgery. That prompted Kim to think about his death, which he hadn’t really done before. After learning about advance directives, he also drew one up.

“I don’t want to end my life surrounded by a forest of medical equipment,” Kim said. “I think it’s the least I can do for my family because this one document will lessen their burden.”

According to KIAD, most people who draw up advance directives do so after witnessing relatives suffer at the end of their lives, sometimes because of life support equipment. According to a KIAD survey, 58.8 percent of respondents said they wanted living wills after witnessing such events.

Mr. Son, 71, who lives in Incheon, is one of them. He decided to write a living will after watching his wife die of cancer, a process that was drawn out through use of a respirator.

“That was when I decided that I must not be subjected to any resuscitation, hemodialysis or vasopressor,” Son said.

KIAD is currently keep on file advance directives of 9,514 people. The largest portion of those people, 47 percent, are in their 70s, followed by people in their 60s and 80s.

Advance directives are not legally binding because Korea doesn’t have a law to give them legal force. Doctors and sometimes children of sick people insist on medical treatments the patients have refused.

The National Bioethics Committee proposed a bill in 2013 to give options for dying with dignity and the use of advance directives, but it is stuck in the National Assembly.

The living wills are only effective now when both medical staff and a patient’s relatives respect their terms.

“People must let their children know they are making advance directives and explain the reason,” said Yu Myeong-suk, an instructor at the North Gyeongsang Well-Dying Research Center. “The best way to do it is telling them that they will receive medical treatments as much as possible, but follow the directives if the situation is irreversible.”

Hong added, “The bill regarding dying with dignity should be legislated as soon as possible to let more people complete their advance directives and reduce the unnecessary expense of life-extending treatments.”

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