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A Study on the Life-sustaining Treatment Decision-making and End-of-Life Care Experiences of Intensive Care Nurses after the Enforcement of the Life-sustaining Treatment Decision-making Act

  • Journal of the Korea Bioethics Association
  • 2020, 21(2), pp.31-53
  • DOI : 10.37305/JKBA.2020.12.21.2.31
  • Publisher : The Korean Bioethics Association
  • Research Area : Interdisciplinary Studies > Interdisciplinary Research
  • Received : November 27, 2020
  • Accepted : December 23, 2020
  • Published : December 31, 2020

Kyongjin Ahn ORD ID 1,  Kong, Byung-Hye 2,  Song, Yoonjin 3

1서울과학기술대학교
2조선대학교
3전남대학교

Accredited

ABSTRACT

Despite recent developments in medical and biotechnology, most people die while undergoing intensive life-sustaining treatments in emergency rooms or intensive care units. Amid these social practices, the “Grandmother Kim case” opened a forum for public debate about the necessity to improve social awareness and about the legalization of life-sustaining treatments that are indiscriminately applied to dying patients. As a result, the “Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatments for Patients at the End of Life” was enacted and has been in effect since February of 2018. The ‘Life-sustaining Treatment Decision-making Act’, currently in effect, was enacted for the purpose of comprehensively considering the patient's autonomy regarding the application of life-sustaining treatments and the quality of death through hospice and palliative care during the medical decision-making process at the end of life. However, because this law does not properly consider the reality of the medical setting in the intensive care unit environment and the various dilemma situations that arise during the actual intensive care unit life-sustaining treatment decision process, this law has fundamental limitations in securing a dignified death for patients. The purpose of this study is to examine the various experiences of intensive care unit nurses in life-sustaining care decisions-making and end-of-life care after the implementation of the Life-sustaining Treatment Decision-making Act ultimately to determine whether the law is properly operating in accordance with the purpose of its enactment in the actual medical field. In addition, by grasping the significant strengths and weaknesses of related systems which have arisen since the implementation of the Life-sustaining Treatment Decision-making Act, this study attempts to derive improvement measures pertaining to life-sustaining treatment decision-making for the dignified death of patients and end-of-life care environments. This study is expected to provide important research data for both institutions and those involved in policy development, leading to practical improvements of end-of-life care environments. However, since this study focused on the experiences of nurses in the intensive care unit of a local general hospital, there are limits to generalizing the results of this study.

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This paper was written with support from the National Research Foundation of Korea.
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