J Korean Med Assoc.  2019 Jul;62(7):350-357. 10.5124/jkma.2019.62.7.350.

Ethical and legal consideration on medical realities and ethical debates about withholding or withdrawing treatment in end-of-life care

  • 1Korea National Institute for Bioethics Policy, Seoul, Korea. rosamhk@nibp.kr


It is natural for all human beings to die; hence, death is an inevitable event. However, advances in medical technology are changing the meaning of natural death. These advanced treatments provide the capability to intervene at the time of death and to reshape the circumstances around natural death, by sustaining human life. However, it is extremely difficult to judge when treatment is futile for the patient's best interests. It is therefore recommended to make time to discuss the concept of medical futility during the course of caring for a critically ill patient. Despite the expectations and efforts of the patient, the patient's family, and medical staff, the patient will eventually, have a "╦ťhopeless' medical condition. Most discussions about decision-making in end-of-life treatment have neen ethical debates focused on the patient's self-determination and best interest in the context of concepts such as euthanasia or death with dignity. However, such discussions are insufficient for resolving the wide variety of circumstances that occur in clinical settings. Instead, the various ethical dilemmas inherent to end-of-life care should be approached by educating medical teams, patients, and their families about how to recognize medical futility. Furthermore, it is important to optimize the balance between the rights of patients and the responsibility of physicians.


Medical futility; Withholding treatment; Withdrawing treatment; Self determination; Euthanasia

MeSH Terms

Critical Illness
Medical Futility
Medical Staff
Personal Autonomy
Right to Die
Withholding Treatment*
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