Health ministry opens citizen forum on end-of-life care

South Korea's health ministry said Friday it will convene a two-day public deliberation on end-of-life medical care, bringing about 300 citizen panelists together to debate when life-sustaining treatment may be withheld or withdrawn and who should decide for a patient who cannot speak.

The forum, organized with the Medical Innovation Committee, runs from Saturday to Sunday at Seoul National University's Siheung campus. Panelists will spend the night and take up three agendas in turn: the timing of withholding or stopping life-sustaining treatment, who acts as surrogate decision-maker, and how medical and care support should be provided at the end of life.

On the first day, the panel will hear cases and share personal experiences before experts present opposing positions. One would keep the current rule that treatment may be withheld only once a patient has entered the dying process; the other would move that point back to the terminal stage of illness. Small-group discussions are to follow, with the findings reported to the full panel.

The second day turns to surrogate decisions. Experts will explain the current family-centered approach and the case for changing it, after which panelists will discuss how far decision-making authority should extend beyond family members and what procedures and safeguards should apply when a patient's wishes cannot be established and no surrogate is available. The panel will then take up the care and support needed by patients who have opted against life-sustaining treatment, including where they spend their final days.

Opening and closing sessions, expert presentations and the sharing of group results will be streamed live on the ministry's YouTube channel. The small-group discussions themselves will be closed to allow panelists to speak freely.

The citizen panel operating committee, chaired by Kim Hak-rin, will compile the results and report them to the Medical Innovation Committee late this month. They are also to feed into the committee's work on strengthening end-of-life care and into deliberations of a special committee on improving the life-sustaining treatment system under the National Bioethics Committee.

The panel is a roughly 300-member group recruited with gender, age and region balanced to bring public views into the government's medical reform drive, which is overseen by the Medical Innovation Committee under the prime minister. It began in July with a first deliberation on reviving local and essential medical services and has since taken part in online discussions and policy proposals.

"Respecting the wishes of patients at the end of life and providing the medical care and support they need are important tasks that must be considered together," Second Vice Health Minister Lee Hyung-hoon said. "Through this public deliberation we will listen to the diverse views of the public and examine policy tasks so that necessary protection and support is provided while respecting patient dignity and the right to self-determination."

Medical Innovation Committee Chairman Chung Ki-hyun said views on what care people want at the end of life can differ according to individual values and experience. "It is important to discuss them sufficiently while respecting each other's opinions," he said, adding that he hoped the forum would allow panelists to share their experiences and help chart a direction for end-of-life care and support the society needs.