Korea health ministry panel weighs overhaul of life-sustaining treatment rules

South Korea's health ministry said Friday that a special committee examining the country's life-sustaining treatment decision system held its third meeting, focusing on the gap between the rules on paper and how end-of-life care actually unfolds in hospitals.

The committee, chaired by Kim Jang-han, a professor at the University of Ulsan College of Medicine, met at Conference House Dalgaebi. Health Minister Chung Eun-kyung attended.

At the center of the discussion is the difficulty doctors, patients and families report in navigating the system, which allows terminally ill patients to withhold or halt medical procedures that only prolong the dying process.

The committee is examining how decisions are made for patients in acute treatment and those with severe chronic illnesses, and what medical and care support patients need once a decision to stop life-sustaining treatment has been made. Its recommendations are due by the end of the year.

"Efforts have been made to guarantee patients' best interests and respect their self-determination since the system took effect, but difficulties remain in how it operates in medical settings," Chung said. "We will listen fully to the diverse experience and views of field experts and gather public opinion broadly to seek ways to improve the system so that necessary medical care and support can be provided appropriately while respecting patients' wishes."

The panel, which brings together 14 experts from medicine, ethics, patient advocacy, law, religion and the media, will next take up the reality and limits of patients' right to self-determination from the public's perspective.

Separately, the Medical Innovation Committee under the prime minister will hold a second deliberative forum on Nov. 7 and 8, gathering citizen panelists to collect public views on the life-sustaining treatment system for use in the reform discussions.

"In the second half of the year, we will hold a second round of citizen panel deliberations on Nov. 7 and 8," said Chung Ki-hyun, who heads the Medical Innovation Committee. "In this forum we want to hear citizens' thoughts not only on the life-sustaining treatment system but on how they view death and the end of life, and what care and medical treatment they would want if they reached that stage."

The life-sustaining treatment decision system sets out procedures for dying patients to refuse or discontinue medically futile interventions such as CPR, dialysis, chemotherapy and mechanical ventilation.