On June 5, the Ministry of Health and Welfare held a workshop for civilian members of the 7th National Bioethics Committee and presented the issue of expanding the timing for discontinuing life-sustaining treatment as a key agenda item. The intent is to allow the discontinuation of life-sustaining treatment—currently limited to patients in the terminal phase—to be applied to terminally ill patients as well. Previously, the Minister of Health and Welfare had also stated in media interviews that she would bring forward the issue of accelerating the timing for discontinuing life-sustaining treatment into public discourse.
Similar trends are emerging within the medical community and the National Assembly. On May 14, the Korean Academy of Medical Sciences and the Korea Medical and Bio Journalists Association held the 5th Media Forum on the Act on Decisions Regarding Life-Sustaining Treatment. At the forum, participants argued that the current restriction of life-sustaining treatment withdrawal to the terminal phase is causing confusion in clinical settings and that the system should be revised to allow such decisions to begin earlier. An amendment to allow the implementation of decisions to discontinue life-sustaining treatment for terminally ill patients is also pending in the National Assembly.
These developments have raised concerns within the Church. At a meeting held on May 30, the Bioethics Advisory Committee of the Archdiocese of Seoul addressed the proposal to expand the timing for implementing decisions to discontinue life-sustaining treatment to include the terminal stage as a key agenda item and highlighted the issues involved.
The Church’s objection is not to the discontinuation of life-sustaining treatment itself. The Church teaches that medical care which causes excessive suffering or burden to the patient, or which is disproportionate to the expected outcome, may be withheld or discontinued.
However, this does not imply recognition of an individual’s right to choose death. The Church believes that if the timing for discontinuing life-sustaining treatment is brought forward, even balanced medical care necessary to save the patient’s life could be discontinued. Furthermore, the Church cautions against the possibility that this trend could lead to the exercise of self-determination—such as the notion that “one can choose death”—and ultimately to discussions on assisted suicide.
Current law limits the scope of decisions to discontinue life-sustaining treatment to “patients in the terminal stage.” Since continuing active treatment for patients in the terminal stage is generally considered disproportionate care, significant ethical issues regarding the discontinuation of life-sustaining treatment have not been prominently highlighted until now.
A workshop for civilian members of the 7th National Bioethics Committee is being held on June 5. Courtesy of the Ministry of Health and Welfare
In contrast, the prognosis for terminally ill patients varies depending on their disease and condition, making it difficult to make medical judgments regarding the appropriateness of treatment. In particular, for non-cancerous diseases, there are cases where patients survive for several years even after a terminal diagnosis has been made, further increasing the uncertainty of such judgments. Furthermore, expanding the scope of application could place greater emphasis on the patient’s right to self-determination than on the medical judgment of healthcare professionals.
The director of the Catholic Institute of Bioethics) stated at a meeting of the Bioethics Advisory Committee, “Current law applies life-sustaining treatment to patients in the terminal stage and includes judgments regarding disproportionate treatment.” He added, “However, if the scope of application is expanded to include the terminal stage, would medical interventions such as mechanical ventilation—which merely prolong the process of dying without providing therapeutic benefit—truly be considered life-sustaining treatment?”
