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Patients forgoing life-sustaining treatments surpass 500,000 on gov't push to raise self-determination rates

Published: 26 Apr. 2026, 16:00 Updated: 27 Apr. 2026, 12:30

A form to forgo life-sustaining treatment at the end of life [YONHAP/ NATIONAL AGENCY FOR MANAGEMENT OF LIFE-SUSTAINING TREATMENT]

Decision to forgo life-sustaining treatment at the end of life have surpassed 500,000 cumulative cases in Korea, according to the National Agency for Management of Life-Sustaining Treatment on Sunday.

The case number reached 7,882 in March alone, adding to the total 500,622 cases recorded since the Act on Hospice and Palliative Care and Decision on Life-Sustaining Treatment For Patients at the End of Life came into effect in 2018.

By gender, male patients, at 292,381, outnumbered female patients, at 208,241. By region, the greater Seoul area accounted for the majority, with Seoul at 32.7 percent and Gyeonggi at 19.4 percent.

Life-sustaining treatment refers to medical interventions such as cardiopulmonary resuscitation and haemodialysis, a process of filtering the blood, administered to patients in the dying process — procedures that offer no curative benefit and serve only to prolong the dying process itself. Forgoing them means either withdrawing, or to not initiate such treatment, or withdrawing, which is to stop treatment already underway.

There are two ways to decide on life-sustaining treatment. If a patient records their wishes through an advance directive or a physician’s order, it is classified as 'self-determination.' However, if a patient cannot communicate and has no prior documentation, the decision falls to their family or legal guardians. While family-led decisions were once the norm, choices made by the patients themselves now account for more than half of all cases.

Of all cases to date, decisions made based on family testimony account for 159,852 cases, or 31.9 percent and decisions based on physician orders for life-sustaining treatment account for 159,658 cases, also 31.9 percent. Decisions made according to the wishes of a person with parental authority or family members follow at 120,501 cases, or 24.1 percent, with decisions based on advance directives accounting for 60,611 cases, or 12.1 percent. The decisions to withhold or withdraw treatment, therefore, have more often been made through family members than by patients themselves.

The rate of self-determination, however, has exceeded half of all cases in recent years. After surpassing 50 percent for the first time in 2024 at 50.8 percent, it rose to 52.2 percent last year and 52.9 percent last month.

"Since the patient's own wishes are paramount in decisions to withdraw life-sustaining treatment, we are working to raise the rate of self-determination," a Ministry of Health and Welfare official said. The government aims to bring that figure up to 56.2 percent by 2028.

This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
BY CHAE HYE-SEON [[email protected]]