The Situation of Life-Sustaining Treatment One Year After Enforcement of the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life in Korea: Data of National Agency for Management of Life-Sustaining Treatment
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Purpose The “Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End-of-Life” was enacted on February 3, 2016 and went into effect on February 4, 2018 in Korea. This study reviewed the first year of determination to life-sustaining treatment (LST) through data analysis of the National Agency for Management of Life-Sustaining Treatment. Materials and Methods The National Agency for Management of LST provided data between February 4, 2018 and January 31, 2019 anonymously from 33,549 patients. According to the forms patients were defined as either elf-determinants or family-determinants. Results The median age of the patient was 73 and the majority was male (59.9%). Cancer patients were 59% and self-determinants were 32.1%. Cancer patients had a higher rate of self-determinants than non-cancer (47.3% vs. 10.1%). Plan for hospice service was high in cancer patients among self-determinants (81.0% vs. 37.5%, p < 0.001). In comparison to family-determinants, self-determinants were younger (median age, 67 years vs. 75 years; p < 0.001) and had more cancer diagnosis (87.1% vs. 45.9%, p < 0.001). Decision of withholding or withdrawing of LSTs in cancer patients was higher than non-cancer patients in four items. Conclusion Cancer patients had a higher rate in self-determination and withholding or withdrawing of LSTs than non-cancer patients. Continued revision of the law and education of the public will be able to promote withdrawing or withholding the futile LSTs in patients at end-of-life. Further study following the revision of the law should be evaluated to change of end-of-life care.
Abstract
Purpose The “Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End-of-Life” was enacted on February 3, 2016 and went into effect on February 4, 2018 in Korea. This study reviewed the first year of determination to life-sustaining treatment (LST) through data analysis of the National Agency for Management of Life-Sustaining Treatment. Materials and Methods The National Agency for Management of LST provided data between February 4, 2018 and January 31, 2019 anonymously from 33,549 patients. According to the forms patients were defined as either elf-determinants or family-determinants. Results The median age of the patient was 73 and the majority was male (59.9%). Cancer patients were 59% and self-determinants were 32.1%. Cancer patients had a higher rate of self-determinants than non-cancer (47.3% vs. 10.1%). Plan for hospice service was high in cancer patients among self-determinants (81.0% vs. 37.5%, p < 0.001). In comparison to family-determinants, self-determinants were younger (median age, 67 years vs. 75 years; p < 0.001) and had more cancer diagnosis (87.1% vs. 45.9%, p < 0.001). Decision of withholding or withdrawing of LSTs in cancer patients was higher than non-cancer patients in four items. Conclusion Cancer patients had a higher rate in self-determination and withholding or withdrawing of LSTs than non-cancer patients. Continued revision of the law and education of the public will be able to promote withdrawing or withholding the futile LSTs in patients at end-of-life. Further study following the revision of the law should be evaluated to change of end-of-life care.
참고문헌 (20)
- Heo DS, "Overview and current issues", Korean J Med, 77(Suppl 4), pp.S1026~S1034 (2009)
- 고윤석, "연명치료 중지에 관한 지침의 특징과 쟁점", 대한의사협회지, 54(7), pp.747~757 (2011), 대한의사협회
- 허대석, "환자의 자기결정권과 사전의료지시서", 대한의사협회지, 52(9), pp.865~870 (2009), 대한의사협회
- Oh DY, "CPR or DNR? End-of-life decision in Korea cancer patients : a single center’s experience", Support Care Cancer, 14, pp.103~108 (2006)
- Yun YH, "The attitudes of cancer patients and their families toward the disclosure of terminal illness", J Clin Oncol, 22, pp.307~314 (2004)
- Kim DY, "Do-not-resuscitate orders for terminal patients with cancer in teaching hospitals of Korea", J Palliat Med, 10, pp.1153~1158 (2007)
- Lee JK, "Surrogate decision-making in Korean patients with advanced cancer : a longitudinal study", Support Care Cancer, 21, pp.183~190 (2013)
- "Supreme Court Decision 2002Do995 decided Jun 24, 2004" (2002)[URL]
- "Supreme Court Decision 2009Da17417 decided May 21, 2009" (2009)[URL]
- "Act on Decisions on LifeSustaining Treatment for Patients in Hospice and Palliative Care or the End-of-life" (2016)[URL]
- 통계청 인구동향과, "2018년 사망원인통계", 대한의사협회지, 63(5), pp.286~297 (2020), 대한의사협회
- 공봉한, "Experience of Advance Directives in a Hospice Center", Journal of Korean Medical Science, 30(2), pp.151~154 (2015), 대한의학회
- 홍지형, "Adopting Advance Directives Reinforces Patient Participation in End-of-Life Care Discussion", Cancer Research and Treatment, 48(2), pp.753~758 (2016), 대한암학회
- 김정선, "Implication of the Life-Sustaining Treatment Decisions Act on End-of-Life Care for Korean Terminal Patients", Cancer Research and Treatment, 52(3), pp.917~924 (2020), 대한암학회[DOI]
- Heo DS, "End-of-life decision in Korea", J Korean Med Assoc, 51, pp.524~529 (2008)
- Oh DY, "Discrepancies among patients, family members, and physicians in Korea in terms of values regarding the withholding of treatment from patients with terminal malignancies", Cancer, 100, pp.1961~1966 (2004)
- Amblas-Novellas J, "Identifying patients with advanced chronic conditions for a progressive palliative care approach : a cross-sectional study of prognostic indicators related to end-of-life trajectories", BMJ Open, 6, pp.e012340~ (2016)
- "Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End-of-life" (2018)[URL]
- Wiegand D, "In their own time : the family experience during the process of withdrawal of life-sustaining therapy", J Palliat Med, 11, pp.1115~1121 (2008)
- "Monthly statistics" (2020)[URL]