Life-sustaining Treatment Plan is prepared by the doctor in charge in accordance with the patient’s intention, and whether the patient is a terminal patient or a patient at the end stage of life should be assessed identically by the doctor who directly treated the patient and one medical specialist in the relevant field.

What is a Life-sustaining Treatment Plan?

Life-sustaining Treatment Plan means a written plan where a patient whose death is medically predicted such as a terminal patient or a patient at the end stage of life documents matters on his or her life-sustaining treatment decisions and hospice care with the doctor in charge. In other words, the patient receives sufficient explanation on his or her medical condition and life-sustaining treatment and leaves his or her life-sustaining treatment plan in writing.

What is the target population?

The target population is patients who have been diagnosed as terminal patients or patients at the end stage of life by the doctor in charge and one medical specialist in the relevant field. Therefore, the patient should first consult a doctor to see if he or she is eligible for preparing the Life-sustaining Treatment Plan. For detailed information, you can contact your doctor or Ethics Committee established at the relevant medical institution. If you are eligible, you can request to prepare the life-sustaining treatment plan after receiving sufficient explanation on life-sustaining treatment and hospice care from the doctor in charge. If the patient is a minor, the patient and his or her legal representative can receive the explanation together and prepare the plan.

Terminal Patient, Patient at the End Stage of Life - Target Disease, Condition, Confirmation

	Terminal Patient	Patient at the End Stage of Life
Target Disease	Cancer, Acquired Immunodeficiency Syndrome(AIDS), Chronic obstructive respiratory disease, Chronic liver cirrhosis (Disease restriction removed on March 28, 2019)	No disease restrictions
Condition	The patient is expected to die within a few months because there is no possibility of a fundamental recovery, and the symptoms gradually worsen despite proactive treatment	The patient is in a state of imminent death, in which there is no possibility of revitalization or recovery despite treatment, and symptoms worsen rapidly
Confirmation	▲ Clinical symptoms ▲ Existence of other diseases or illnesses ▲ Degree of improvement by drug administration or procedure ▲ Progression of previous medical treatment ▲ Diagnosed by the doctor in charge and one medical specialist in the relevant field comprehensively in consideration of the possibility of other treatments	Assessed by the doctor in charge and one medical specialist in the relevant field

How is it prepared?

It is prepared by the doctor in charge. The doctor in charge provides sufficient explanation on the following matters to the patient before preparing the Life-sustaining Treatment Plan and prepares it by using the legal form. The plan is completed with the patient’s signature or by sealing the form after he or she received and sufficiently understood the information and confirmed and agreed upon the content of the Life-sustaining Treatment Plan.

How is it utilized?

If the patient who prepared the Life-sustaining Treatment Plan enters the end stage of life, the doctor in charge may withhold the procedure or discontinue the procedure that the patient is already receiving according to the Life-sustaining Treatment Plan.

What do you do for a patient without mental capacity?

If there is a Life-sustaining Treatment Plan or Advance directive on Life-sustaining Treatment that can verify the intention of the patient at the end stage of life, it can be respected and implemented. However, if the patient is in a state of no mental capacity without having prepared the Life-sustaining Treatment Plan or Advance directive on Life-sustaining Treatment, identical statements of two or more family members can be considered as the patient’s life-sustaining treatment decision and be implemented.At this time, the patient’s family members who can state the patient’s intention include the spouse, lineal descendants and lineal ancestors, who are 19 years or older. However, if there is no one falling under the category, siblings may be included. If there is only one family member, the statement of the one family member can be regarded as representing the patient’s intention. If the patient's intention cannot be verified through the statement, life-sustaining treatment decisions can be made for the patient through consensus of the patient's entire family. If a patient's family member is missing, or has no mental capacity due to unconsciousness, he or she is excluded from the scope of family. If the patient is a minor, the decision must be made by the person with parental rights. In case the patient is conscious, the family members should not make a decision on life-sustaining treatment on behalf of the patient without informing the patient himself or herself. Therefore, it is appropriate to provide the opportunity for the patient to make his or her own decisions on life-sustaining treatment at a point in time when the patient is aware of his or her condition, and the end stage of life is predicted.