Journal Browser Advanced Search Help
Journal Browser Advanced search HELP
J Korean Med Assoc. 2018 Aug;61(8):509-521. Korean. Review. https://doi.org/10.5124/jkma.2018.61.8.509
Lee SM , Kim SJ , Choi YS , Heo DS , Baik S , Choi BM , Kim D , Moon JY , Park SY , Chang YJ , Hwang IC , Kwon JH , Kim SH , Kim YJ , Park J , Ahn HJ , Lee HW , Kwon I , Kim DK , Kim OJ , Yoo SH , Cheong YS , Koh Y .
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul Red Cross Hospital, Seoul, Korea.
Public Health Medical Service, Seoul National University Hospital, Seoul, Korea.
Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea.
Korea National Institute for Bioethics Policy, Seoul, Korea.
Education Center for Public Health & Medicine, National Medical Center of Korea, Seoul, Korea.
Department of Family Medicine, Incheon St. Mary's Hospital, Incheon, Korea.
Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.
Hospice and Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
Department of Family Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Bobath Memorial Hospital, Seongnam, Korea.
Division of Oncology, Department of Internal Medicine, Catholic University St. Vincent's Hospital, Seoul, Korea.
Department of Hematology-Oncology, Ajou University Hospital, Suwon, Korea.
Department of Medical Education, Ewha Womans University College of Medicine, Seoul, Korea.
Department of Medical Humanities, Dong-A University College of Medicine, Busan, Korea.
Department of the History of Medicine and Medical Humanities, Seoul National University College of Medicine, Seoul, Korea.
Department of Medical Humanities and Ethics, Hanyang University College of Medicine, Seoul, Korea.
Department of Family Medicine, Dankook University College of Medicine, Cheonan, Korea.
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. yskoh@amc.seoul.kr
Abstract

In Korea, the Hospice, Palliative Care, and Life-sustaining Treatment Decision-making Act was enacted in February 2016 in order to ensure that the patient's self-determination in end-of-life care processes is respected. To enhance physicians' understanding of this act and to provide proper criteria for medical judgment in variety of clinical settings, consensus guidelines were published in November 2016. In this article, the characteristics of these guidelines and related issues regarding the definitions of ‘the end stage of disease’ and ‘last days of life’ and the criteria for medical judgment are presented and summarized. According to the guidelines, the term ‘end stage of disease’ refers to a state in which there is no possibility of a fundamental recovery and the symptoms are expected to worsen within months. The terms ‘the last days of life’ and ‘the final days of life’ refer to a state in which, despite treatment, the patient's condition is worsening and death is impending, with no possibility of recovery. The attending physician and another relevant specialist should both judge a patient's medical condition as either ‘end stage of disease’ for hospice/palliative care or ‘the last days of life’ for dying patient care according to the law. Caregivers should provide appropriate medical information to eligible patients for palliative or ‘end stage of disease’ care through advance care planning. Therefore, it is critically necessary that caregivers understand the legitimate process of hospice/palliative and dying patient care based on the patient's wishes and best interests. Physicians should apply these consensus guidelines to eligible patients considering their clinical course and the patients' wishes.

Copyright © 2019. Korean Association of Medical Journal Editors.