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진솔 ( Jin Sol ) - Kosin University Gospel Hospital Department of Internal Medicine
김제훈 ( Kim Je-Hun ) - Kosin University Gospel Hospital Department of Pulmonary and Critical Care Medicine
이진영 ( Lee Jin-Young ) - Kosin University Gospel Hospital Department of Internal Medicine
고택용 ( Ko Taek-Yong ) - Kosin University Gospel Hospital Department of Thoracic and Cardiovascular Surgery
오규만 ( Oh Gyu-Man ) - Kosin University Gospel Hospital Department of Internal Medicine
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Abstract
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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 came into force in February 2018 in Korea. This study reviews the practices of end-of-life care for patients who withdrew or withheld lifesustaining treatment at a tertiary care hospital, addresses the limitations of the law, and discusses necessary steps to promote patient-centered self-determination.
Methods: We retrospectively analyzed the medical records of patients who died after agreeing to withhold lifesustaining treatment in 2018 at our university hospital. The cause of death, the intensity of end-of-life care, and other characteristics were reviewed and statistically analyzed.
Results: Of a total of 334 patients, 231 (69%) died from cancer. The decision to stop life-sustaining treatment was made by family members for 178 patients overall (53.3%) and for 101 (43.7%) cancer patients, regardless of the patient’s wishes. When the patient decided to stop lifesustaining treatment, the time from the authorization to withhold life-sustaining treatment to death was longer than when the decision was made by family members (28.7±41.3 vs 10.5±23.2 days, P<0.001).
Conclusion: In many cases, the decision to discontinue lifesustaining treatment was made by the family, not by the patient. In order to protect human dignity based on the patients’ self-determination, it is necessary for patients to understand their disease based on careful explanations from physicians. Ongoing survey-based research will be necessary in the future.
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KeyWords
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Advance care planning, Terminal care, Korea
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원문 및 링크아웃 정보
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등재저널 정보
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