J Korean Med Assoc.  2019 Jul;62(7):358-368. 10.5124/jkma.2019.62.7.358.

Court decisions and legal considerations about the withdrawal of the life-prolonging medical care

• Park JT

• KMID: 2452638
• DOI: http://doi.org/10.5124/jkma.2019.62.7.358

Abstract

The Supreme Court decision made on May 21, 2009 about the withdrawal of futile life-prolonging medical care from a persistently vegetative patient provided a legal basis for patients to consent to death with dignity, and also spurred a lively debate in Korea. The legal grounding of this decision was based on the principles of human dignity, worth, and the right to pursue happiness articulated in the Article 10 of the Constitution. The Death with Dignity Act was legislated to regulate decisions about life-prolonging medical care on February 3, 2016, after extensive debate and a focus on consensus that led to two revisions. However, the issue has not been completely resolved. First, the definition of the process of dying is unclear, because the points that determine whether a patient is dying are different from a simple assessment of whether an artificial ventilator should be attached or detached. Second, the purpose of this law is the protection of human dignity, worth, and the right to pursue happiness. However, nutrition, fluids, and oxygen must continue to be supplied, even after cessation of life-prolonging medical care. Is providing a continuous supply of nutrition, fluids, and oxygen a reasonable way to satisfy the goals of Article 10 of the Constitution? Third, if the withdrawal of life-prolonging medical care is possible based on the family's agreement without the patient's input, what is the legal value of advance directives? In conclusion, it may be necessary to partially revise the law regulating decisions on the withdrawal of life-prolonging medical care through further debate.

Keyword

Persistent vegetative state; Life prolonging care; Definition of the process of dying; Death with dignity

MeSH Terms

Advance Directives
Consensus
Constitution and Bylaws
Happiness
Humans
Jurisprudence*
Korea
Oxygen
Persistent Vegetative State
Personhood
Right to Die
Supreme Court Decisions
Ventilators, Mechanical
Oxygen

Reference

1. Seoul High Court Decision. 98No1310 (Feb 7, 2002).

2. Supreme Court Decision. 2009Da17417 (May 21, 2009).

3. Supreme Court Decision. 93Da60953 (Apr 15, 1994).

4. Supreme Court Decision. 93Da52402 (Feb 10, 1995).

5. Supreme Court Decision. 96Da37862 (Jul 22, 1997).

6. Supreme Court Decision. 92Da25885 (Apr 15, 1994).

7. Supreme Court Decision. 2001Da27449 (Jan 11, 2002).

8. Supreme Court Decision. 2009Do14407 (Jun 26, 2014).

9. Supreme Court Decision. 79Do1387 (Sep 24, 1980).

10. Supreme Court Decision. 2014Da230535 (Feb 15, 2017).

11. Supreme Court Decision. 2015Da9769 (Jan 28, 2016).

12. Recher HF, Saunders DA. Tribute to David William Goodall DSc, AM: advocate and ecologist par excellence (4 April 1914to 10 May 2018). Pac Conserv Biol. 2019; 25:v–vii.

13. In re Quinlan, 355 A. 2d 647 (NJ 1976).

14. Cruzan v. Director, Missouri Department of Health. 497 U.S. 261. 1990.

15. Perry JE, Churchill LR, Kirshner HS. The Terri Schiavo case: legal, ethical, and medical perspectives. Ann Intern Med. 2005; 143:744–748.

16. Lewis A. Reconciling the case of Jahi McMath. Neurocrit Care. 2018; 29:20–22.