Choose your own deathIn July 2016, American artist Betsy Davis, who was suffering amyotrophic lateral sclerosis (ALS), sent an email to friends to invite them to a party. It was the last ceremony before her eternal journey. Toward the end of the party, she took medicine prescribed by her doctor and peacefully quit life. This is the death which many people want — peaceful and painless — in short, “well-dying.”
Well-dying is a neologism which means preparing one’s own death with dignity. This is not a rare case. There are already many discussions about dignified deaths in many countries around the world.
Korea is no exception to this trend. According to a survey conducted in 2015, 77% of the respondents agreed to stop lifesaving treatment if there are family agreements. Based on this opinion, Korea’s ‘Well-dying Act’ was passed on Jan. 8 2016.
The bill provides patients with chronic illness the right to cease life-long treatment at their last moments. If the physician determines that the patient’s will is sufficiently represented according to the criteria, the medical staff can suspend life extension measures that are considered to be pointless, such as CPR, hemodialysis, administration of anticancer drugs, and wearing of respirators. Pain relief and basic nutrition should be continued.
It is encouraging, but we are not ready for a dignified death yet.
First of all, there are loopholes in the law itself. The law applies only to patients with extremely limited diseases. Currently, the stated diseases are cancer, AIDS, chronic obstructive respiratory disease, chronic liver cirrhosis. Although additional diseases can be added by Ministry of Health and Welfare, it seems too narrow to cover all the other chronic disease patients who need the method.
A more realistic obstacle is the lack of hospice facilities. The National Cancer Center predicted a total of 70,000 cancer patients will die in 2015. However, the number of palliative care beds is only 939. It means 75 patients must compete over each bed.
Even if a patient meets the criteria set in the law, hospice care is indispensable for the duration of the dying process. Because, unlike Betsy who chose active death by drugs, the Well-Dying Act in Korea does not directly permits the death of the patient but only stops medical care. For example, in the case of Grandmother Kim, which triggered the discussion of Korea’s dignified death in 2009, she survived for more than 200 days after her family’s consent to stopping the life sustaining treatment.
We must supplement the loopholes in the law and expand the hospice facilities. But more fundamentally, we must further expand human self-determination toward death. If a human being expresses a clear intention about their own death, they should be able to end their life in the most dignified and verified way possible.
An institutionalized death selection with a thoughtful verification process could bring the closed impulse about death to the bright side. We can understand patients’ wants and give them alternatives as long as we can. Patients will know what they can do and get what they really want. Eventually, well-dying leads to well-being.
Everyone has the right to choose how they die, just as they can decide how to live. We are definitely not ready yet, but we should be.
Student at Hankuk University of Foreign Studies