Lifestyle & Belief

To die with dignity in South Korea


SEOUL — Shin Seung-nam, a 44-year-old homemaker, let out a sigh of relief when she heard that doctors had finally removed a comatose woman from life support. South Korea's highest court had just granted the woman the right to die, something Shin had been an adamant supporter of.

Shin was diagnosed with breast cancer in 2004. Although her health is currently good, she lives with the nagging question of “what if.” What if cancer hit her again; what if something happened to her while in treatment; what if she suddenly fell into a coma … how would her husband and teenage twins deal with the situation?

“If I’m not able to recover, it’s a relief to know that I can end my life without having to drag on with things,” she said, sitting in a park after a check-up at the hospital. “When I first heard of the case, I immediately said I supported it.”

The ruling was the first of its kind in the country. It granted the patient, who had been in a vegetative state for more than a year, the right to be removed from a life support system, based on remarks she had made before falling comatose about the treatment she wanted.

For a country deeply rooted in Confucian traditions, the case seems to reflect evolving attitudes toward death. Expected public outrage over the right to "die with dignity" — as the case was dubbed — never materialized.

With a large Christian population and Buddhist influences, alongside the Confucian traditions, the country had traditionally been reluctant to accept the idea of ending one's life at will. Death has widely been considered something inevitable rather than within the realms of human control.

A teaching of Confucius says that all people received their body, hair, and skin as a gift, and therefore, they should be preserved as a way of honoring their parents. Such teachings are thought to have contributed to a conservative view in the culture toward suicide and death.

But there are people like Shin, who has thought differently since long ago, when her mother went into a coma during a medical examination.

“I prayed to God every day that he take her in the morning, just like she died in her sleep,” she said. “I said I would receive all the punishment, but asked that he just let her go.”

Shin described the experience as a time when the family members scattered in all directions. Shin, who was 34 at the time, and her younger siblings found themselves trying to dig up the money to keep their mother in the hospital attached to tubes.

She does not want to see that happen to her family again.

Under current law, doctors are not allowed to release from their care patients who cannot express their own wishes. Doctors are not allowed to release a patient, even if it is the family's wish, if doing so would present a threat to the person's life. Almost a decade ago, a South Korean court convicted a physician of manslaughter for releasing a patient who died after being discharged. The family had cited financial burdens in asking for his release.

There are currently no laws in place to determine under what circumstances a patient can be released from life support. Yonsei University’s Severance Hospital, which took the woman off life support, has outlined three scenarios in which it will consider halting treatment. The  situations are based on the patient's state of health, the wishes of family members and a vote of the hospital's ethics committee.

Although experts say much needs to be done to institutionalize the practice, most acknowledge the significance of the case.

“This case was about patients’ rights. It was to determine whether a patient could decide how to be treated based on their thoughts about medical treatment implied in the past,” said Baek Kyoung-hee, one of the lawyers on the case.

Baek admitted she had doubts for the case in the beginning, but said she saw public perceptions changing as the days went by.

Recent polls conducted by the National Assembly’s Health Committee indicate that roughly 80 percent of the public said they supported the right to “die with dignity,” according to Medical Today, a website dedicated to health news.

Most supporters said they believe the removal of life support would help release both the patient and their families from pain, but not all agree with the idea of “dying with dignity.”

“A patient in a coma who is showing signs of metabolism is a living individual with a spirit inside,” said Lee Seung-goo, a professor at Hapdong Theological Seminary’s department of systematic theology. Roughly 30 percent of the South Korean population is Christian, but religion has not played as large role in the debate as anticipated.

Lee, who is also a member of the Korean Christian Bioethics Association, said it is because people are confused about what practices should be considered biblical. He added that the landmark case should be considered the “unethical practice of euthanasia on an existing life,” and warned that it could undermine the value of life in society.

But Shin thinks it’s for the better. “I would rather go clean instead of living in pain each and every day,” she said.

Questions and uncertainties still surrounding the right to die have prompted Shin to consider leaving a signed document or tape recording of her wishes. “Just in case, you know,” she said.

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