Policy & Legislations

Life-Sustaining Treatment Plans

Site Information

Withdrawing/Withholding Life-sustaining Treatment

Requirements for Withdrawing / Withholding Life-sustaining Treatment
(Implementation of Decision to withdraw or withhold LST)

If the person is assessed as a ‘patient at the end stage of life’ by two doctors according to the Life-sustaining Treatment Decisions Act and if the Decision to withdraw or withhold LST for the patient is verified, the doctor in charge can implement the decision.

STEP 1
Assessment of
Patient at
the End Stage of Life
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STEP 2
Verification of
Decision to Withdraw
or Withhold LST
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STEP 3
Implementation of
Decision to Withdraw
or Withhold LST

Implementation

  • If the decision to withdraw or withhold LST is verified for the patient at the end stage of life, the doctor in charge should implement the decision immediately.
  • The life-sustaining treatment that can be implemented is given within the scope of decision to withdraw or withhold LST e.g.) If it is indicated that the person wants to withhold or withdraw mechanical ventilation or cardiopulmonary resuscitation in the Life-sustaining Treatment Plan, the decisions should be implemented only for the two procedures, mechanical ventilation and cardiopulmonary resuscitation when the person became a patient at the end stage of life.
  • However, upon implementing life-sustaining treatment decisions, medical practice to relieve pain and nutrition supply, water supply, and simple supply of oxygen should be kept uninterrupted.

Replacement of Doctor in Charge

  • If the doctor refuses to implement the decision to withdraw or withhold LST, the head of the relevant medical institution should replace the doctor by going through the review of the ethics committee.
  • In this case, the head of the medical institution should not dismiss the doctor or treat him or her unfavorably because of the doctor’s refusal to implement the decision to withdraw or withhold LST.
  • The medical institution ethics committee that is requested to review the replacement of doctor should immediately review and replace the doctor by a majority vote of registered members.
  • After review on the replacement, the ethics committee should immediately notify the doctor who will be replaced and implement the decision of review results and information necessary for implementation.