Three million South Koreans have expressed their opposition to life-extending medical care
South Korea is currently engaged in active discussions and legislative movements concerning the expansion of the refusal of life-sustaining treatment for patients in the final stages of terminal illness. This shift aims to provide more autonomy and dignity to patients, improving the quality of their lives.
The current legal framework, established by the End-of-Life Care Decision Act in 2018, allows for the refusal of life-sustaining treatment only for patients in the "end-of-life process," which signifies imminent death with no chance of recovery. However, legislative proposals, such as one by Representative Nam In-soon and other liberal lawmakers, seek to broaden eligibility to "final stages" of disease, encompassing but not limited to the terminal stage, enabling earlier decision-making and withdrawal of care.
This proposed revision has garnered significant public support. Over 3 million South Koreans have registered to refuse life-prolonging treatment, and about 443,874 patients have had treatment withdrawn under the current system. A government survey of 27 heads of medical societies in the country showed that 82 percent agreed that the existing law should be expanded to include patients in the final stages of terminal disease.
One of the most notable cases highlighting the need for change occurred in 2023. A patient with terminal cancer was unable to have life-sustaining treatment withdrawn despite the patient's advance statement and family requests, due to the strict legal criteria for "imminent death." This situation underscores the practical challenges in defining "imminent death" clearly for doctors to confidently act on directives.
Jung Eun-kyeong, the recently appointed minister of health and welfare, recognizes the necessity of expanding eligibility in the current system. She emphasized the need to balance legal clarity and patients' best interests. The government’s Second Comprehensive Plan on Hospice and Life-Sustaining Treatment (2024–28) includes proposals to advance the timing for withdrawal of life-sustaining care to earlier stages.
As of Saturday, the number of people who have signed advance statements accounts for 6.8 percent of the country's adult population. The number of those who had signed forms to refuse life-sustaining treatments in case of untreatable diseases has surpassed 3 million. This statistic reflects the growing awareness and acceptance of the right to a dignified death among South Koreans.
The bill proposed by Rep. Nam In-soon is currently pending deliberation at the National Assembly. The active discussions and legislative movements in 2024-2025 toward broadening the refusal of life-sustaining treatment in South Korea to include the final stages of terminal illness, with strong public and expert support, indicate a promising future for end-of-life care in the country.
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