Korea needs an electronic system to immediately execute patients’ life-sustaining treatment plans to fully utilize patients’ right to choose death with dignity upon a terminal diagnosis, a report said.
The report suggested hospitals match patients' information with that of subscribers of the national health insurance.
The National Health Insurance Service (NHIS) released the research report on development plans to operate the life-sustaining treatment system on Friday. NHIS’ research fellow Kim So-yoon, a professor at Yonsei University’s College of Medicine, authored the report.
According to the report, 85 institutions accepted the registration of life-sustaining treatment plans as of Sept. 3, 2018, excluding 179 branches and offices of NHIS.
Within one month after the “well-dying” law took effect, there was zero case where a hospital stopped a life-sustaining treatment based on a patient’s refusal statement. Within six months, only 0.7 percent of patients discontinued the medication.
The report said medical institutions that register the patient’s plan on life-sustaining treatments lacked skilled workforce for consultation, needed to standardize consultation service, had limited roles, and lacked resources for registration.
Moreover, some institutions failed to reflect the patients’ refusals of life-sustaining treatments because the information was not electronically synchronized among hospitals, the report said.
“If patients do not remember making the life-sustaining treatment plan when they were healthy or fail to toss the information to the hospital in an emergency, hospitals need an electronic system to check on the patient’s plan at the time of the patient’s visit,” the report emphasized.
Instead, the nation could link the information of national health insurance subscribers with the hospital information system, the report said. Then, hospitals will be able to check the data of patients who are the insurance subscribers, it added.
Hospital ethics committees, which decide whether to suspend the life-sustaining treatment and implement the decision, also face difficulties to function properly due to the lack of electronic linkage between hospitals and the NHIS subscriber information.
There are 159 medical institution ethics committees in Korea, but more than half of them are concentrated in the Seoul metropolitan area. Except for tertiary hospitals, general hospitals and nursing homes do not usually have an ethics committee.
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