Policy & Legislations

Life-Sustaining Treatment Plans

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How to decide and withhold/withdraw LST

How to decide and withhold/withdraw LST image

  • Assessment for the Patient at the End of Life
  • Expression of patient’s intention for life-sustaining treatment decision(Life-sustaining Treatment Plan or Advance Statement on Life-sustaining Treatment)
  • Verification of life-sustaining treatment plan
  • Verification of advance directive on life-sustaining treatment
  • Mental capacity of the patient
  • Verification from the patient by the doctor in charge
  • Verification by two doctors
  • Mental capacity of the patient
  • Preparation of life-sustaining treatment plan
  • Assumption of the intention of patient
  • Verification of consistent statements of two or more family members
  • Verification of unanimous consensus of the patient’s family members

In case of implementing according to the life-sustaining treatment plan

STEP 1
Assessment of the
Patient at the End Stage of Life
(Appendix Form 9)
icon - plus
STEP 2
Verification of
Life-sustaining
Treatment Plan
(Appendix Form 1)
icon - equal symbol
STEP 3
Preparation and
Notification of
the Implementation of
Decision to Forgo LST
(Appendix Form 13)

If the patient has prepared the life-sustaining treatment plan, the doctor in charge shall confirm and implement the Assessment of the Patient at the End Stage of Life and Life-sustaining Treatment Plan and shall prepare and notify the Implementation of Decision to Withdraw or Withhold LST.

In case of implementing according to the advance directive on life-sustaining treatment

STEP 1
Assessment of Patient
at the End Stage of Life
(Appendix Form 9)
icon - plus
STEP 2
Search, Verification,
and Recording of
Advance Directive on
Life-sustaining Treatment
(Appendix Form 10)
icon - equal symbol
STEP 3
Preparation and
Notification of the
Implementation of
Decision to Forgo LST
(Appendix Form 13)

If there is a searched advance directive on life-sustaining treatment, the doctor in charge(if the patient has mental capacity) or the doctor in charge and the medical specialist in the relevant field(if the patient does not have mental capacity) shall check the Assessment of the Patient at the End Stage of Life, then record whether or not Advance Directive on Life-sustaining Treatment has been checked, implement, and prepare and notify the Implementation of Decision to Withdraw or Withhold LST.

In case of implementing according to statements of two or more family members

STEP 1
Assessment of Patient
at the End Stage of Life
(Appendix Form 9)
icon - plus
STEP 2
Verification and
Recording of Statements
of Patient's Family
(Appendix Form 11)
equal symbol
STEP 3
Preparation and
Notification of the
Implementation of
Decision to Forgo LST
(Appendix Form 13)

If two or more patient family members state the patient’s intention for the decision to withdraw or withhold LST, the doctor in charge and the medical specialist in the relevant field shall confirm the Assessment of the Patient at the End Stage of Life, then record and implement the statement of the patient family, and prepare and notify the Implementation of Decision to withedraw or withhold LST.

Patient Family :The spouse of the patient, lineal descendants, and lineal ancestors are included who are 19 years or above. If no one falls under the category, siblings are included.

In case of implementing according to unanimous consensus of patient family members

STEP 1
Assessment of Patient
at the End Stage of Life
(Appendix Form 9)
icon - plus
STEP 2
Verification and
Record of the Intention of
the Person with the Parental
Rights and Patient's Family
(Appendix Form 11)
equal symbol
STEP 3
Preparation and
Notification of the
Implementation of
Decision to forgo LST
(Appendix Form 13)

If the decision to withdraw or withhold LST for the patient is made based on unanimous consensus of patient family members, the doctor in charge and the medical specialist in the relevant field shall confirm the Assessment of the Patient at the End Stage of Life and the Intention of the Patient Family and Persons with Parental Rights, record and implement the decision, and prepare and notify the Implementation of Decision to withdraw or withhold LST.

Scope of Family
① Spouse, parents/children
② If there is no one falling under ①, grandparents/grandchildren
③ If there is no one falling under ① and ②, siblings are included(enforced on March 28, 2019)