@article{ART003351144},
author={신동일 and Eric L Krakauer and Claire Junga Kim},
title={Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act},
journal={Korean Journal of Medical Ethics },
issn={2005-8284},
year={2026},
volume={29},
number={2},
pages={65-72}
TY - JOUR
AU - 신동일
AU - Eric L Krakauer
AU - Claire Junga Kim
TI - Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act
JO - Korean Journal of Medical Ethics
PY - 2026
VL - 29
IS - 2
PB - The Korean Society For Medical Ethics
SP - 65
EP - 72
SN - 2005-8284
AB - This commentary examines the ethical implications of the mandatory provision of artificial nutrition and hydration (ANH) under Korea’s Act on Decisions on Life-Sustaining Treatment. Building upon a target article derived from a policy research report, we focus on the proposal to incorporate ANH into advance directives and argue that the current legal framework creates serious clinical ethical problems. Although ANH is widely recognized as a medical intervention requiring individualized proportional judgment, the Act effectively mandates its provision even during the end-of-life process. We argue that this rigid approach violates the principles of nonmaleficence, justice, and respect for autonomy by prolonging suffering, producing unequal end-of-life options across institutional settings and according to the type of intervention sustaining patients’ lives, and undermining trust between patients and clinicians. Accordingly, ANH should not be treated as a universal obligation but as a medical intervention subject to proportionality, patient preferences, and clinical judgment. Finally, we argue that active public deliberation is necessary for the ethical and legal incorporation of ANH into advance directives.
KW - artificial nutrition and hydration;advance directives;life-support care;personal autonomy
DO -
UR -
ER -
신동일, Eric L Krakauer and Claire Junga Kim. (2026). Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act. Korean Journal of Medical Ethics , 29(2), 65-72.
신동일, Eric L Krakauer and Claire Junga Kim. 2026, "Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act", Korean Journal of Medical Ethics , vol.29, no.2 pp.65-72.
신동일, Eric L Krakauer, Claire Junga Kim "Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act" Korean Journal of Medical Ethics 29.2 pp.65-72 (2026) : 65.
신동일, Eric L Krakauer, Claire Junga Kim. Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act. 2026; 29(2), 65-72.
신동일, Eric L Krakauer and Claire Junga Kim. "Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act" Korean Journal of Medical Ethics 29, no.2 (2026) : 65-72.
신동일; Eric L Krakauer; Claire Junga Kim. Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act. Korean Journal of Medical Ethics , 29(2), 65-72.
신동일; Eric L Krakauer; Claire Junga Kim. Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act. Korean Journal of Medical Ethics . 2026; 29(2) 65-72.
신동일, Eric L Krakauer, Claire Junga Kim. Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act. 2026; 29(2), 65-72.
신동일, Eric L Krakauer and Claire Junga Kim. "Optimum Use of Artificial Nutrition and Hydration Near the End of Life: Ethics, Advance Directives, Public Deliberation, and Reform of Korea’s Life-Sustaining Treatment Act" Korean Journal of Medical Ethics 29, no.2 (2026) : 65-72.
