[Column] What kind of death are you preparing?

Song Kil-won

The author is chief pastor at Chungran Church and head of Hi Family.

Koreans say the very end is the beginning of the end. It could be the wisdom of our ancestors. Let’s think about the word juksari, which combines life and death. Just like married life and housekeeping life, life and death were considered one. It is an amazing philosophy of life engraved in language.

But what about the scene of our lives with such beautiful language? The Life-Sustaining Medical Decision Act, which took effect in February 2018, celebrated its fifth anniversary this year. What has changed so far? The advance life-sustaining care intention statement was the first turning point of death with dignity in Korean society. As of the end of last year, 1.57 million people have registered, accounting for 3.6 percent of the adult population aged 19 or older and 13.1% of the adults aged 65 or older.

The problem is that out of the 256,377 people who chose to stop life-sustaining treatment, 212,515 — 83 percent — made the decision at the last minute. Eight out of 10 parted even without saying, “I love you.” This cannot be considered death with dignity. People prepare for the college entrance examination through 12 years in school and make multiple attempts, but Korea is backward when it comes to preparing for death.

Koreans suffer from various diseases for 17 years, from age 66 to 83, one-fifth of their lives. They die slowly and gradually with mechanical devices and nourishment through tube feeding. They mostly face their death not at home but in nursing homes, ERs or intensive care units. This happens to three out of four Koreans.

The rate of people dying in hospitals in the Netherlands is 29.1 percent. Korea’s rate is far higher than Sweden’s at 42 percent, the U.S. at 43 percent and the UK at 49.1 percent. As of 2020, 23 percent of Koreans who died of cancer used hospice care — lower than Taiwan’s 30 percent and even lower than 50.7 percent in the U.S. and 95 percent in the UK.

Edward Jenner, a British physician in private practice, paid attention to the fact that the woman who contracted cowpox while milking a cow did not get smallpox. He had a question, “How come milkmaids don’t get smallpox?” He was different from an average person who would ask, “Why do people get smallpox?” One creative question saved mankind from smallpox.

Korea has the lowest “death index” among the OECD countries. The way out of this shameful label begins with changing the question from “how to live” to “how to die.” Poet Lee Moon-jae wrote, “You have to save death / bring death next to life / to the inside of life.” The moment you talk about well-dying instead of well-being, there will be a change in perception. You can happily welcome death when you bring death into your daily life and be familiar with it. That’s what is meant by juksari.

I work with the Salvation Army to operate the Ambulance Wish Foundation. It grants the final wishes of the “transportation vulnerable” before death. Some children suffer from cancer. Young children understand and accept death. When they take the last journey, their parents are obstacles. They ask, “Are you saying I should give up my child?” In the U.S., coworkers donate their vacation days. The parents get to have time to care for the children, thanks to their generous coworkers. They most often travel to make memories. It is quite different from how Koreans do.

Sleep is a death you will wake up from, while death is a sleep you cannot wake up from. This is why death is called an eternal sleep and sleep is called a deep sleep. Sleep and death are strangely similar. Just as good sleep guarantees health, prepared death makes life dignified. Who said death was a failure? All lives will eventually die. True failure is a sudden death.

Now you have to ask this question. “Can I also die with dignity?” Only then will there be more “preparatory” funerals, not funerals after death. They refer to the “ending party” to reconcile with others while being alive, say farewell, and share warm food with them. The upcoming Easter is asking us, “What kind of death are you preparing?”

Translation by the Korea JoongAng Daily staff.