Characteristics of Life-Sustaining Treatment Decisions: National Data Analysis in South Korea

Jiyeon Choi; Heejung Jeon; Ilhak Lee

doi:10.1007/s41649-023-00266-1

Characteristics of Life-Sustaining Treatment Decisions: National Data Analysis in South Korea

Asian Bioeth Rev. 2023 Nov 11;16(1):33-46. doi: 10.1007/s41649-023-00266-1. eCollection 2024 Jan.

Authors

Jiyeon Choi¹, Heejung Jeon², Ilhak Lee³

Affiliations

¹ Division of Medical Law and Ethics, Department of Medical Humanities and Social Sciences, College of Medicine, Yonsei University, Seoul, Republic of Korea.
² Department of Nursing, Yonsei University Graduate School, Seoul, Republic of Korea.
³ Department of Medical Humanities and Social Sciences, College of Medicine, Yonsei University, Seoul, Republic of Korea.

PMID: 38213986
PMCID: PMC10776518 (available on 2025-01-01)
DOI: 10.1007/s41649-023-00266-1

Abstract

This study analyzed the national data on life-sustaining treatment decisions from 2018 to 2020 to find out the characteristics of South Korea's end-of-life procedure according to the decision-making approach and process. We collected the data of 84,422 patients registered with the National Agency for Management of Life-sustaining Treatment. We divided the patients into four groups (G1, G2, G3, and G4) according to the decision-making approach. A descriptive analysis of each group was conducted using indicators such as the patient's age, status, diagnosis, and content of forgoing life-sustaining treatment. Additionally, logistic regression analysis was performed by dividing the patients into self-determining (G1, G2) and non-self-determining patients (G3, G4). Cancer was the most common diagnosis for each group. The period from life-sustaining treatment decision to implementation was 10.76, 1.01, 0.86, and 1.19 days for G1, G2, G3, and G4, respectively. In the logistic regression analysis, the self-determination ratio was higher for 40-49 years old and lower for cardiovascular disease and gastrointestinal disease. Age was has a major impact on life-sustaining treatment decisions (LSTD), and with increase in age, the family, and not the patient, made the LSTD. The LSTD method also differed depending on the disease. The self-determination rates of patients with circulatory or digestive diseases were somewhat lower than that of those with neoplastic diseases. The period from decision-making to implementation is short for end-of-life care.

Keywords: Advance directives; Autonomy; Decision making; End-of-life care; Terminal care.

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