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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2021.326    [Accepted]
Preparation and Practice of the Necessary Documents in Hospital for the “Act on Decision of Life-Sustaining Treatment for Patients at the End-of-Life”
Sun Kyung Baek1, Hwa Jung Kim2, Jung Hye Kwon3, Ha Yeon Lee4, Young -Woong Won5, Yu Jung Kim6, Sujin Baik7, Hyewon Ryu8
1Division of Hematology and Oncology, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
2Department of Preventive Medicine, Ulsan University College of Medicine, Seoul, Korea
3Division of Hematology and Oncology, Department of Internal Medicine, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Chungnam, Korea
4Division of Hematology and Oncology, Department of Internal Medicine, National Medical Center, Seoul, Korea
5Division of Hematology and Oncology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
6Division of Hematology and 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, 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: June 1, 2021.  Published online: June 2, 2021.
*Sun Kyung Baek and Hwa Jung Kim contributed equally to this work.
ABSTRACT
Purpose
Six forms relating to decisions on life-sustaining treatment (LST) for patients at the end-of-life (EOL) in hospital are required by the “Act on Decision of LST for Patients at the EOL.” We investigated the preparation and creation status of these documents from the database of the National Agency for Management of LST.
Materials and Methods
We analyzed the contents and details of each document necessary for decisions on LST, and the creation status of forms. We defined patients completing Form 1 as “self-determined” of LST, and those whose family members had completed Form 11/12 as “family decision” of LST. According to the determination subject, we compared the four items of LST on Form 13 (the paper of implementation of LST) and the documentation time interval between forms.
Results
The six forms require information about the patient, doctor, specialized doctor, family members, institution, decision for LST, and intention to use hospice services. Of 44,381 who had completed at least one document, 36,693 patients had Form 13. Among them, 11,531, 10,976, and 12,551 people completed Forms 1, 11, and 12, respectively. The documentation time interval from Form 1, 11, or 12 to Form 13 was 8.6 days (± 13.6 days), 1 day (± 9.5 days), and 1.5 day (± 9.7 days), respectively.
Conclusion
The self-determination rate of LST was 31% and the mean time interval from self-determination to implementation of LST was 8.6 days. The creation of these forms still takes place when the patients are close to death.
Key words: Documents, Life-sustaining treatment, End-of-life, Decisions
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