Implementation of the "Life-Sustaining Treatment Decision-Making Act" in Decisions Regarding Dialysis: A 5-Year Single-Center Experience

Background: The legislation on life-sustaining treatment decisions was enacted in 2016 and has been in effect since February 2018 in South Korea due to social resistance to the implementation of life-sustaining treatment (LST) in patients with end-of-life care. Since then, patients at the end-of-life have been able to decide to receive or discontinue LST. These include cardiopulmonary resuscitation (CPR), mechanical ventilation (MV), hemodialysis (HD), and chemotherapy (CTX). Methods: This was a retrospective chart review of patients who discontinued LST from August 2018 to May 2023 under the law on life-sustaining treatment decisions at single-center. We classified each patient based on underlying diseases, whether to implement existing LST, and whether to self-determine life-sustaining treatment. Results: A total of 105 patients included in the study. Group 1 include patients previously had no dialysis treatment. Group 2 include patient with previous hemodialysis. This table shows the baseline characteristics of those patients (Table 1). The implementation of withdrawing LST was investigated for each group (Figure 1). Conclusion: Our data shows the composition of patients’ implementation of LST termination decisions in a single center in Korea over 5 years. Comparing the dialysis and non-dialysis groups, there is a significant statistical difference in decision not to undergo MV (p=0.024). Patients’ decisions not to undergo CPR, HD, or CTX do not show a statistical difference between those two groups.