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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2021.327    [Accepted]
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
Ha Yeon Lee1, Hwa Jung Kim2, Jung Hye Kwon3, Sun Kyung Baek4, Young-Woong Won5, Yu Jung Kim6, Su Jin Baik7, Hyewon Ryu8
1Division of Hematology and Oncology, Department of Internal Medicine, National Medical Center, Seoul, Korea
2Department of Preventive Medicine, Ulsan University College of Medicine, Seoul, Korea
3Division of Hematology and Oncology, Department of Internal Medicine, Sejong Chungnam National University Hospital, Sejong, Chungnam National University College of Medicine, Daejeon, Korea
4Division of Hematology and Oncology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
5Division of Hematology and Oncology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
6Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
7Korea National Institute for Bioethics Policy, Seoul, Korea
8Division of Hematology and Oncology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Chungnam National University College of Medicine, Daejeon, Korea
Correspondence  Jung Hye Kwon ,Tel: 82-44-995-4781, Fax: 82-44-995-4782, Email: kwonjhye.onco@gmail.com
Received: March 12, 2021;  Accepted: May 31, 2021.  Published online: June 2, 2021.
*Ha Yeon Lee and Hwa Jung Kim contributed equally to this work.
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 through data analysis of the National Agency for Management of Life-Sustaining Treatment (LST).
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% vs 37.5%, p<0.0001). In comparison to family-determinants, self-determinants were younger (median age, 67 years old vs 75 years old, p<0.0001) and had more cancer diagnosis (87.1% vs 45.9%, p<0.0001). 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.
Key words: Terminal care, Hospices, Advance directives, Withholding treatment
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