Ensure dignity in dying

The National Assembly has done something good for a change. On Wednesday, the Health and Welfare Committee passed a bill on palliative care at the end of life, after separately holding other subcommittee meetings entirely dedicated to legislation that would offer relief for terminally ill patients by allowing them to forgo life-sustaining treatment. The bill requires review from a higher legal subcommittee and approval during the plenary session.

The bill is designed to ensure dignity in dying as much as in living. As many as 50,000 people - or about 17 percent of deaths per year - die slowly and alone in the intensive care unit.

End-of-life options in Korea narrowed after an incident in 1997, at Boramae Hospital in Seoul. Two doctors were convicted of abetting murder when they agreed to release a patient with irreparable brain damage upon his wife’s request. Since then doctors and hospitals have practiced extreme caution when it comes to decisions that could potentially lead to medical disputes. A patient no longer has a say over his or her own life after diagnosis, despite the fact that a recent poll showed that 92 percent of the country’s senior population opposes life-sustaining care.

In 2009, the Supreme Court delivered a milestone ruling, paving the way for legal voluntary euthanasia by allowing a 77-year-old woman, who had been hospitalized in a coma for 459 days, to be taken off life support. The National Bioethics Committee in 2013 followed up by recommending that terminally-ill patients and their families should have the right to withdraw life-prolonging treatments in certain circumstances. The withdrawal or withholding of life-sustaining treatment could fall under the definition of passive euthanasia.

The bill proposes to reinforce the hospice infrastructure. Because only 13 percent of late-stage cancer patients receive hospice care, it is important to raise awareness and increase quality end-of-life care. If the Assembly had taken care of the bill earlier, the government could have secured the funds to increase hospice facilities and staff from next year on. But because lawmakers dragged their feet, those changes will take effect in 2018.

There is a lot of work cut out for the government. It must outline insurance coverage terms for life-prolonging treatment as well as a template for prior consent from the patient in case he or she cannot make the decision. But, at the very least, the legislature must pass this bill within the year.

JoongAng Ilbo, Dec. 10, Page 34