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Making Decisions for Unbefriended Patients on Life-Sustaining-Treatment in South Korea: Healthcare Providers’ Experiences

  • Korean Journal of Medical Ethics
  • Abbr : 의료윤리
  • 2021, 24(3), pp.271~285
  • DOI : 10.35301/ksme.2021.24.3.271
  • Publisher : The Korean Society For Medical Ethics
  • Research Area : Medicine and Pharmacy > General Medicine
  • Received : March 4, 2021
  • Accepted : May 24, 2021
  • Published : September 30, 2021

Jiyeon Choi ORD ID 1 Heejung Jeon ORD ID 1 Ilhak Lee ORD ID 1

1연세대학교

Accredited

ABSTRACT

Purpose: This study attempts to clarify the difficulties faced by healthcare professionals in South Korea in making and implementing Life-Sustaining Treatment (LST) decisions for vulnerable patients who lack legally competent proxy decision-makers. Materials and Methods: First, a keyword analysis was performed on the official responses of the National Health Agency of Korea to 750 questions from healthcare workers. Second, a survey probing the difficulties that healthcare professionals face in making LST decisions was administered to the ethics committee members of 246 medical institutions. Results: From the keyword analysis, 139 keywords were categorized into ten subcategories. The survey had a 32.5% response rate, and of the respondents, 41.98% faced difficulties in making decisions for unrepresented patients because of the absence of family members or due to inadequate evidence. Among these patients, 82.35% did not have decision-making ability at the time of need and 85.29% had no family members to consult with. Conclusion: Four categories of “unbefriended” patients were identified in this study. Additionally, in uncovering evidence on how LST decisions are implemented and creating a category of “unbe-friended patients,” this study underscores the need to expand the scope of legal proxies under the LST Decisions Act.

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