Korea opens end-of-life rules to 300 citizens as hospice use climbs

South Korea's Ministry of Health and Welfare is putting the hardest questions in end-of-life care to ordinary citizens, a sign that dignified dying has moved from a private choice to a matter of how the system is designed.

About 300 members of the Medical Innovation Citizens' Panel will meet for two days from Nov. 7 at Seoul National University's Siheung campus to debate when life-sustaining treatment may be withheld or withdrawn, who may decide on a patient's behalf, and how end-of-life medical care and support should be provided. The sessions run under the Medical Innovation Committee, chaired by Chung Ki-hyun, which sits under the prime minister.

The panel was recruited with balance across gender, age and region, and has already deliberated this year on regional and essential medical care. The weekend format is built around expert presentations, questions and answers, and small-group discussions, with the opening and closing ceremonies and the presentations streamed live on the ministry's YouTube channel. The small-group discussions themselves will be closed.

The timing follows steady growth in the uptake of existing tools. Ministry figures released on Nov. 5 show 26,020 patients newly entered hospice care in 2025, up 1,702, or 6.9 percent, from 24,318 a year earlier and a third straight annual increase from 22,394 in 2023. Facilities offering hospice care rose by six to 194 at the end of 2025, including 104 inpatient units, 40 home-based, 44 consultative and six nursing-hospital units.

Registrations of the advance statement of intent to forgo life-sustaining treatment reached 499,961 in 2025, taking the cumulative total to 3,201,958 since the system began in February 2018. Registrations of life-sustaining treatment plans stood at 29,557 for the year, or 185,952 cumulatively.

Where decisions to withdraw treatment were carried out — 81,220 cases in 2025 — the patient's own wishes had been confirmed through a plan or an advance statement in 52.2 percent, up 19.7 percentage points from the first year of the system. The number of institutions registered to take advance statements rose by 59 to 819, and hospitals with registered ethics committees by 40 to 513.

Public awareness appears to be keeping pace. In the ministry's survey, 83.2 percent of respondents said they had heard of hospice care, up 2.8 percentage points from 80.4 percent a year earlier; 89.9 percent said it was necessary and 93.1 percent said they would use it. Satisfaction among users of specialist hospice institutions was 94.7 percent.

The citizen panel's conclusions will be reported to the Medical Innovation Committee at the end of November and feed discussions at a special committee on reforming the life-sustaining treatment decision system under the National Bioethics Committee.

Koh Soon-hoon, the ministry's director-general for health policy, linked the interest to Korea's entry into a super-aged society, saying the government will keep working so that anyone can express and have respected their wishes for the end of life. Second Vice Minister Lee Hyung-hoon told the panel that honouring a patient's wishes and providing adequate care are tasks that must be considered together, and Chung of the innovation committee said views differ with personal values and experience, making respectful deliberation the point.