Shin Sung Joon, Lee Jae Hang
Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
Department of Thoracic Surgery, Dongguk University Ilsan Hospital, Goyang, Korea.
Kidney Res Clin Pract. 2018 Jun;37(2):112-118. doi: 10.23876/j.krcp.2018.37.2.112. Epub 2018 Jun 30.
The Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life came into effect on February 4th, 2018, in South Korea. Based on the Act, all Koreans over the age of 19 years can decide whether to refuse life-sustaining treatments at the end of life via advance directive or physician orders. Hemodialysis is one of the options designated in the Act as a life-sustaining treatment that can be withheld or withdrawn near death. However, hemodialysis has unique features. So, it is not easy to determine the best candidates for withholding/withdrawing hemodialysis at the end of life. Thus, it is necessary to investigate the meaning and implications of hemodialysis at the end of life with ethical consideration of futility and withholding or withdrawal of intervention.
《临终关怀或生命末期患者维持生命治疗的决定法》于2018年2月4日在韩国生效。根据该法，所有19岁以上的韩国人可以通过预先指示或医生医嘱决定是否在生命末期拒绝维持生命的治疗。血液透析是该法指定的可在濒死时停止或撤除的维持生命治疗选项之一。然而，血液透析有其独特之处。因此，确定生命末期停止/撤除血液透析的最佳人选并不容易。因此，有必要在考虑无效性以及干预措施的停止或撤除的伦理问题的基础上，探讨生命末期血液透析的意义和影响。
