실제 말기암 환자의 진료 과정을 통해 살펴본 한국의사전돌봄계획 현황
The Current Status of Advance Care Planning in Korea, Examined through the Experience of a Terminally Ill Cancer Patient
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Since the enactment, in South Korea, of the “Life-Sustaining Treatment Decisions Act,” public awareness of decisions regarding life-sustaining treatment has grown. However, healthcare providers continue to face challenges in making timely decisions and engaging in advance care planning. The medical literature on end-of-life decision-making in Korea often relies on hypothetical scenarios or translated cases from foreign journals, most of which focus narrowly on resolving conflicts that arise during the decision-making process. In practice, however, the difficulty terminally ill patients face in making appropriate decisions about life-sustaining treatment stems from more than just isolated moments in the progression of their disease. The challenge is shaped by a complex interplay of factors, including differing perspectives or conflicts among patients, their families, and healthcare professionals. Additionally, system issues—such as cognitive biases and fragmented coordination between healthcare providers—further complicate the decision-making process. This article describes the clinical journey of a patient with advanced cancer who progressed to the terminal stage and ultimately passed away. This case sheds light on the underlying factors that hinder the effective implementation of advance care planning and life-sustaining treatment decisions in clinical settings in Korea.
Abstract
Since the enactment, in South Korea, of the “Life-Sustaining Treatment Decisions Act,” public awareness of decisions regarding life-sustaining treatment has grown. However, healthcare providers continue to face challenges in making timely decisions and engaging in advance care planning. The medical literature on end-of-life decision-making in Korea often relies on hypothetical scenarios or translated cases from foreign journals, most of which focus narrowly on resolving conflicts that arise during the decision-making process. In practice, however, the difficulty terminally ill patients face in making appropriate decisions about life-sustaining treatment stems from more than just isolated moments in the progression of their disease. The challenge is shaped by a complex interplay of factors, including differing perspectives or conflicts among patients, their families, and healthcare professionals. Additionally, system issues—such as cognitive biases and fragmented coordination between healthcare providers—further complicate the decision-making process. This article describes the clinical journey of a patient with advanced cancer who progressed to the terminal stage and ultimately passed away. This case sheds light on the underlying factors that hinder the effective implementation of advance care planning and life-sustaining treatment decisions in clinical settings in Korea.