• Child Health Nursing Research
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• v.23 no.3
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• pp.292-299
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• 2017

Purpose: This study was done to analyze nursing students' attitudes to life-sustaining treatment by measuring their awareness of biomedical ethics and resulting attitude toward withdrawal of life-sustaining treatment. Methods: This study was a descriptive research to assess the level of nursing students' awareness of biomedical ethics, attitude toward withdrawal of life-sustaining treatment, and correlations between these variables. After the nursing students signed a consent form they were assessed. Data collection was done from September 1 to October 25, 2016, and analyzed using SPSS 23.0 WIM Program. Results: There was a negative correlation and significant difference between nursing students' awareness of biomedical ethics and attitude toward withdrawal of life-sustaining treatment. There was a significant correlation among attitude toward withdrawal of life-sustaining treatment and medical ethics, mortality ethics. Conclusion: The findings in the study indicate that it is necessary to provide nursing students with easy access to continuous education to help them establish an acceptable view of withdrawal of life-sustaining treatment.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.85-98
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• 2010

Purpose: This study was aimed to investigate the awareness and attitudes towards withdrawal of the life-sustaining treatment among nurses, physicians, and the families of intensive care unit (ICU) patients in general hospitals. Methods: The data were collected using a questionnaire from 80 ICU nurses, 80 physicians, and 80 families of ICU patients in general hospitals. Data were collected from February 22nd to May 31st, 2010. Rusults: ICU nurses, physicians, and families of ICU patients felt that objective and ethical guidelines were needed in making a decision to withdraw the life-sustaining treatment. The main reason for withdrawal of the life-sustaining treatment was found that the patients could not recovered despite many efforts. The role of nurses in decision making process on withdrawal of the life-sustaining treatment was considered very positive from the view of physicians and family members. The most important role of nurses for those patients in ICU was found to try their best to care for the patients. Conclusion: ICU nurses should play a major coordinating role in communication among patients, their families, and medical teams. Also, an appropriate roles of nurses in the process of the withdrawal of the life-sustaining treatment should be established.

• Journal of Hospice and Palliative Care
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• v.24 no.1
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• pp.36-45
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• 2021

Purpose: This study examined the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment among nursing college students, and attempted to identify the mediating effect of Role Perception on Life-sustaining Treatment in that relationship. It is hoped that the findings will ultimately contribute to the development of active nursing strategies. Methods: The participants were 142 nursing college students in the third and fourth years of study who had experienced clinical practice at two universities in cities Y and C. Data were collected from November 1 to 30, 2019. For data analysis, SPSS for Windows version 22.0 was used to calculate descriptive statistics, the t-test, Pearson's correlation coefficients, and multiple regression. To analyze the mediating effect, the Baron and Kenny bootstrapping method was used. Results: Attitudes toward Withdrawal of Life-sustaining Treatment of nursing college students had a significant positive correlation with Knowledge of Life-sustaining Treatment Plans (r=0.34, P<0.001) and Role Perception on Life-sustaining Treatment (r=0.44, P<0.001). Role Perception on Life-sustaining Treatment partially mediated the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment (95% CI, 0.446~1.055). Conclusion: Based on the results of this study, improving nursing college students' Role Perception on Life-sustaining Treatment could be used as a coping strategy to establish positive Attitudes toward Withdrawal of Life-sustaining Treatment.

• The Korean Society of Law and Medicine
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• v.10 no.1
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• pp.263-305
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• 2009

Is it lawful to withhold or withdraw life-sustaining treatment applied to a patient in a terminal condition or permanent unconscious condition? In Korea, there are no such laws or regulations which control affairs related to the withholding or withdrawal life-support treatment and active euthanasia as the Natural Death Act or the Death with Dignity Act in the U. S. A. And in addition there has had no precedent of Supreme Court. Recently Supreme Court has pronounced a historical judgment on a terminal care case. The court allowed the withdrawal of life-sustaining treatment from a patient in a permanent unconscious state. Fundamentally the court judged that the continuation of that medical treatment would infringe dignity and value of a patient as a human being. And the court required some legal grounds to consider such withdrawal or withholding of medical care lawful. The legal grounds are as follow. First, the patient is in a incurable and irreversible condition and already entered a stage of death. Second, the patient executed a directive, in advance, directing the withholding or withdrawal of life-support treatment in a incurable and irreversible condition or in a terminal condition. Otherwise, at least, the patient's will would be presumed through his/her character, view of value, philosophy, religious faith and career etc. I regard if a patient is in a incurable and irreversible condition or in a terminal condition, the medical contract between a patient and a doctor would be terminated because of the actual impossibility of achievement of it's purpose. So I think the discontinuation of life-sustaining care would be legally allowed without depending on the patient's own will.

• The Korean Society of Law and Medicine
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• v.10 no.2
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• pp.309-341
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• 2009

According to a case of Supreme Court's Sentence No. 2009DA17417 (May 21, 2009), the Supreme Court judges that 'the right to life is the ultimate one of basic human rights stipulated in the Constitution, so it is required to very limitedly and conservatively determine whether to discontinue any medical practice on which patient's life depends directly.' In addition, the Supreme Court admits that 'only if a patient who comes to a fatal phase before death due to attack of any irreversible disease may execute his or her right of self-determination based on human respect and values and human right to pursue happiness, it is permissible to discontinue life-sustaining treatment for him or her, unless there is any special circumstance.' Furthermore, the Supreme Court finds that 'if a patient who is attacked by any irreversible disease informs medical personnel of his or her intention to agree on the refusal or discontinuance of life-sustaining treatment in advance of his or her potential irreversible loss of consciousness, it is justifiable that he or she already executes the right of self-determination according to prior medical instructions, unless there is any special circumstance where it is reasonably concluded that his or her physician is changed after prior medical instructions for him or her.' The Supreme Court also finds that 'if a patient remains at irreversible loss of consciousness without any prior medical instruction, he or she cannot express his or her intentions at all, so it is rational and complying with social norms to admit possibility of estimating his or her own intentions on withdrawal of life-sustaining treatment, provided that such a withdrawal of life-sustaining treatment meets his or her interests in view of his or her usual sense of values or beliefs and it is reasonably concluded that he or she could likely choose to discontinue life-sustaining treatment, even if he or she were given any chance to execute his or her right of self-determination.' This judgment is very significant in a sense that it suggests the reasonable orientation of solutions for issues posed concerning withdrawal of meaningless life-sustaining medical efforts. The issues concerning removal of medical instruments for meaningless life-sustaining treatment and discontinuance of such treatment in regard to medical treatment for terminal cases don't seem to be so much big deal when a patient has clear consciousness enough to express his or her intentions, but it counts that there is any issue regarding a patient who comes to irreversible loss of consciousness and cannot express his or her intentions. Therefore, it is required to develop an institutional instrument that allows relevant authority to estimate the scope of physician's medical duties for terminal patients as well as a patient's intentions to withdraw any meaningless treatment during his or her terminal phase involving loss of consciousness. However, Korean judicial authority has yet to clarify detailed cases where it is permissible to discontinue any life-sustaining treatment for a patient in accordance with his or her right of self-determination. In this context, it is inevitable and challenging to make better legislation to improve relevant systems concerning withdrawal of life-sustaining treatment. The State must assure the human basic rights for its citizens and needs to prepare a system to assure such basic rights through legislative efforts. In this sense, simply entrusting physician, patient or his or her family with any critical issue like the withdrawal of meaningless life-sustaining treatment, even without any reasonable standard established for such entrustment, means the neglect of official duties by the State. Nevertheless, this issue is not a matter that can be resolved simply by legislative efforts. In order for our society to accept judicial system for withdrawal of life-sustaining treatment, it is important to form a social consensus about this issue and also make proactive discussions on it from a variety of standpoints.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.139-161
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• 2017

In this paper, The Supreme Court of Korea 2016. 1. 28. 2015Da9769 was reviewed. In the previous case, Korean Supreme Court 2009Da17417 for the element to requirement for permission of the withdrawal of life-sustaining treatments, the patient's consent for withdrawal of life-sustaining treatments was assumed a declaration of intention to terminate the contract. But the consent for withdrawal of life-sustaining treatments corresponds not to those. The consent for medical treatments is not the juristic acts but the real acts. If the presumptive intention about these withdrawal regards as the termination of medical contract, the contract must be up to the starting the civil proceedings. According to this case, although the partial cancellation of medical contract is admitted, on the other hand medical expenses obligation ist exempted only after the final decision. At the withdrawal of life-sustaining treatments the medical obligation ist exempted because of the inability to providing the medical payment, which confirmed by the final decision about the withdrawal of life-sustaining treatments. Therefore the judgement of this case ist appropriate in that sense, the medical obligation ist waived only after the final decision. However that legal basis lies not at the partial cancel but at the partial inability.

• Journal of East-West Nursing Research
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• v.23 no.2
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• pp.171-179
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• 2017

Purpose: The purpose of current study was to investigate nurses and physicians' attitudes towards withdrawal of life-sustaining treatment (LST) and knowledge about withdrawal of LST guideline by Korean Medical Association. Methods: Data were collected from 345 nurses and 88 physicians using a self-report questionnaire and analyzed using descriptive statistics, independent t-test or ${\chi}2$ test. Results: Participants' attitudes towards withdrawal of LST were positive and there was no significant difference between nurses and physicians. Nurses' knowledge of the guideline for withdrawal of LST was significantly higher than that of physicians, whereas physicians' knowledge of the purpose of the guideline was significantly higher than that of nurses. Conclusions: Nurses and physicians' knowledge of and attitudes toward withdrawal of LST may affect the quality of life of patients and their families. The result of this study may be helpful to design a program for improving the perception on LST of healthcare providers.

• Journal of the Korea Society of Computer and Information
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• v.25 no.2
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• pp.181-188
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• 2020

This study was conducted to identify the effects of the degree of death orientation, attitudes toward withdrawing life-sustaining treatment, and awareness of biomedical ethics on paramedic students' own biomedical ethics. The participants of this study were 228 paramedic students from a college located in D city. Data were collected from April to June 2019 through a self-report questionnaire. There was a positive correlation between awareness of biomedical ethics and attitude toward withdrawing life-sustaining treatment (r=.63, p<.001). Multiple linear regression analysis showed that the factors affecting students' awareness of biomedical ethics were religion (β=.12, p=.018) and their attitude toward withdrawal of life-sustaining treatment (β=.61, p<.001), with an explanatory power of 41.0%. Educational programs must focus on attitudes toward withdrawing life-sustaining treatment to improve paramedic students' awareness of biomedical ethics.

• Journal of Hospice and Palliative Care
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• v.15 no.4
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• pp.193-204
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• 2012

Purpose: This correlation study was performed to examine Korean adults' perceptions and attitudes towards death with dignity and the withdrawal of life sustaining treatment and to identify factors that predict their attitude towards death with dignity. Methods: The study was conducted using convenience sampling of 291 adults from three towns of a metropolitan city in Korea. Data were collected using structured questionnaires which surveyed people's perception about and attitudes towards withdrawal of life sustaining treatment and scaled their attitude towards death with dignity. Data were analyzed by using descriptive statistics, Pearson correlation coefficients and multiple regression. Results: The attitude towards the withdrawal of life sustaining treatment and death with dignity showed a significant positive correlation (r=0.49, P<0.001). For attitudes towards death with dignity, significant predictors were attitudes towards the withdrawal of life sustaining treatment, age, religion, a proper withdrawal process and advanced medical directives, which explained 49.3% of total variance. Conclusion: The results of this study may contribute to development of a new medical decision-making system including nurses' appropriate roles in the process of withdrawing life sustaining treatment and advanced medical directives.

• Journal of the Korea Convergence Society
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• v.10 no.8
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• pp.335-344
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• 2019

This study is a descriptive research to measure the awareness and attitude toward withdrawal of life-sustaining medical treatment (WLSMT) among medical and nursing students. The data collection was conducted between 8 October and 15 November 2018, and the responses of 240 students were analyzed. The analysis results are as follows. More than 95 percent of medical and nursing students said the WLSMT was necessary. The medical students answered that 'patient's will' is important and nursing student answered that 'patient and family's will' is important. The nursing student showed that "family will and decision" was more important than the medical student in deciding to discontinue life care. Based on the results of the study, continuous discussion on the development and application of education programs to form attitudes and awareness of the discontinuation of life-saving treatments based on correct values is needed for prospective medical students and nursing students.