The number of citizens choosing to select "a dignified death" instead of unnecessary life-sustaining treatment in their final moments has surpassed 3 million. Alongside this, there is a growing social demand to expand the timing of ceasing life-sustaining treatment from "end-of-life" to "terminal patients," prompting the political sphere to actively pursue legal amendments to guarantee patients' right to self-determination and improve quality of life.
According to the National Life-Sustaining Treatment Management Agency on the 10th, the number of registered individuals indicating their intention not to receive life-sustaining treatment has been counted at 3,003,177 as of the 9th. This surpassed 3 million for the first time in 7 years and 6 months since the implementation of the Life-Sustaining Treatment Decisions Act (Dignified Death Act) in February 2018, corresponding to approximately 6.8% of the country's adult population.
The advance directive for life-sustaining treatment is a document that outlines the implementation of life-sustaining treatments and the desire for hospice care in preparation for end-of-life. Individuals aged 19 years and older can sign a statement of consent at one of the 556 designated registration agencies after receiving sufficient explanation, indicating agreement to not implement or cease life-sustaining treatment in the event of a medical determination that they are in the process of dying.
In its inaugural year in 2018, only about 80,000 people registered, but participation steadily increased, surpassing 1 million in August 2021. After 2 years and 2 months, the number reached over 2 million in October 2023, and it took less than 2 years to reach 3 million.
Among the registrants, women numbered 1,990,000, which is double that of men. The registration rate increases with age, with 1 in 5 (21.0%) individuals aged 65 and older and especially 1 in 4 (24.9%) women aged 65 and older expressing their intention to cease life-sustaining treatment. Up to now, a total of 443,874 cases of actual termination of life-sustaining treatment have been implemented.
For those who have not yet registered their intention, the trend of refusing life-sustaining treatment is on the rise. A survey conducted last year by the Korea Institute for Health and Social Affairs (KIHASA), which targeted 1,021 adults, found that 91.9% indicated they would be willing to cease life-sustaining treatment if they became terminally ill. The percentage of those supporting the legalization of assisted dignified death also reached 82.0%.
There are also growing calls to expand the timing for ceasing life-sustaining treatment, currently allowed only for "end-of-life" patients, to include "terminal" patients. The distinction between terminal and end-of-life is unclear, and the argument is made that the scope should be broadened in accordance with the system's intention to enhance the quality of life for terminal patients and their families.
In fact, a study conducted by Yonsei University's Industry-Academic Cooperation Foundation at the request of the Ministry of Health and Welfare last year found that 22 out of 27 relevant medical associations (81.5%) agreed to advance the timing of ceasing life-sustaining treatment. A related bill proposed by Democratic Party of Korea lawmaker Nam In-soon was also submitted to the National Assembly last year.
Minister Jeong Eun-kyeong noted in a written response during her confirmation hearing before her appointment that "there are concerns that limiting the implementation of decisions to withhold or cease life-sustaining treatment to end-of-life periods restricts patients' self-determination and protection of their best interests, and I agree on the need to expand the scope from end-of-life to terminal patients." A Ministry official stated, "This is an area that needs social consensus, and we are currently listening to various opinions and discussing it."