The Interpretation of "Expert Consensus on Legal Issues Related to End-of-life Decision Making" / 中国医学伦理学

In recent years, the issue of end-of-life decision making has received broad attention. More and more people have been appealing for the respect for terminal patients’ wishes in decision making. Many scholars have proposed the application of advance medical decision to ensure the autonomy of terminally ill patients. Given that advance medical decision does not have legal effect in China, the Beijing Health Law Society proposed the "Expert Consensus on Legal Issues Related to End-of-life Decision Making" in July 2022. This consensus provides clear guidance on how to make medical decisions for terminally ill patients, based on the principle of respecting the patient’s wishes within the framework of current laws and regulations. The consensus aims to provide guidance for both doctors and patients about how to respect patients’ own wishes and protect their autonomy, as well as to provide reference for future law and policy formulation on related issues.

Critical Care Nurses' Perception of Life-sustaining Treatment at End of Life: A Content Analysis / 중환자간호학회지

PURPOSE: The purpose of this study was to describe what critical care nurses perceived about life-sustaining treatment at end of life.METHODS: A qualitative content analysis method was utilized. The unit of analysis was interview text obtained from fifty critical care nurses of a general hospital.RESULTS: Seven categories in two content areas were abstracted. In the negative perception area, the following five categories were abstracted: patients' suffering, dying with damaged dignity, patients' isolation from family members, regret about choosing life-sustaining treatment, and family members' burden. In the positive perception area, the following two categories were abstracted: willingness to sustain life and duty as family members.CONCLUSIONS: Nurses have better competencies pertaining to understanding patients' responses and suffering than any other health care professions do. Nurses should play an important role in advocating for patients and their family in the process of end-of-life care decision making.

Agenda for End-of-Life Decision-Making in Korea

After a year of court trials initiated by the immediate family of a patient in a permanent vegetative state, the National Supreme Court of Korea ruled that the family have the right to decide for the removal of ventilator from the patient. This was a particularly significant court case that established a precedent for the Korean society as a whole, since there currently is no statutory framework regarding rights to self-determination to refuse any extraordinary means of treatment in Korean legal system. While much of Korean healthcare providers and the government itself have focused on designing and developing a comprehensive blueprint for Advance Health Directives for patients, the recent outcome has created an important opportunity for all parties of the Korean society. Therefore, the Korean government and legislature will need to systematically study and establish a procedural preparation for legislation. The providers will also have to carefully examine the moral and ethical dimensions of Advance Directives to promote the patients' interests in accordance with civil rights of the patients. Lastly and most importantly, the individuals must reflect on our own moral values, regardless of their current health. To exercise their own will and to relieve their relatives from difficult decisions, they must also educate themselves about living will and healthcare proxy, and elucidate their value history with family. No one can exactly lay out the course of life to death, but it is possible to steer the final journey of life to a more humane death. A society must value the life itself, but the journey to death should also be made humane by respecting one's own choice.