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Policy & Legislations

Advance Directives

Life-Sustaining Treatment Plans

Withholding/Withdrawing

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Roles and Functions

The medical institution ethics committee should manage the overall life-sustaining treatment in the institution by conducting necessary tasks such as deliberation, counseling, education, statistical analysis and evaluation in the relevant medical institution.

Deliberation

  • The committee can review the issues requested by the patient or his/her family or medical person regarding decision to withdraw or withhold LST and the implementation thereof. However, it is not mandatory to review the issues related to decision to withdraw or withhold LST and the implementation thereof.
  • If the doctor in charge refuses to implement the decision to withdraw or withhold LST for a certain patient, replacement of the doctor shall be reviewed.
  • It is recommended that the standard procedure for the replacement of the doctor in charge be prepared as its own regulations through the committee review in advance.

Counseling

  • The ethics committee can provide counseling to the patient or the patient's family regarding the decision to withdraw or withhold LST and the implementation thereof. In this case, counseling does not necessarily have to be performed by a member of the committee, but may also be performed by a person who supports the tasks of the ethics committee.
  • If it is deemed necessary to get additional advice from the ethics committee depending on the counseling process and results, it can be considered as part of a review agenda and deliberated.

Education

  • The committee should establish, implement, evaluate, and supplement appropriate education plans regarding medical ethics considering the characteristics of the personnel of the relevant medical institution and members The contents of education include related laws and medical ethics, but it is possible to freely add necessary contents to the relevant institution, and the education timing and methods are determined by the committee.

Statistical Analysis, Evaluation and Preparation of Improvement Plan

  • The committee shall perform statistical analysis on the decision to withdraw or withhold LST and the implementation thereof, which is conducted according to this Act in the relevant medical institution.
  • To this end, the committee shall identify the current status of matters requiring recording and archiving according to the law from time to time, and submit the relevant status and grounds when requested by the Ministry of Health and Welfare.
  • The committee shall evaluate the life-sustaining treatment management system of the relevant medical institution and appropriateness of each case of decision to withdraw or withhold LST and the implementation thereof and prepare improvement plans such as by organization and personnel adjustment, case management plan, etc..

Others

  • In addition, the committee shall carry out matters that the Minister of Health and Welfare deems particularly necessary for the decision to withdraw or withhold LST and the implementation thereof.

Article 14 of the Act(Establishment, Operation, etc., of medical institution ethics Committee)

  • ② A medical institution ethics committee shall perform the following activities.
  • 1. Deliberation on matters requested by a patient at the end stage of life, his/her family or medical person regarding the decision to withdraw or withhold LST and the implementation thereof
  • 2. Deliberation on replacement of doctors in charge under Article 19(3)
  • 3. Counseling for a patient and his/her family with respect to the decision to withdraw or withhold LST
  • 4. Education of medical ethics for medical persons of the relevant medical institutions
  • 5. Other matters as prescribed by the Ordinance of the Ministry of Health and Welfare

Article 9 of Enforcement Decree(Registration and Affairs of medical institution ethics Committee)

  • ③ In Article 14(2) 5, “Other matters as prescribed by the Ordinance of the Ministry of Health and Welfare” refer to the following.
  • 1. Statistical analysis on the decision to withdraw or withhold LST and the implementation thereof
  • 2. Evaluation on the decision to withdraw or withhold LST and the implementation thereof and preparation of improvement plans
  • 3. Other matters that the Minister of Health and Welfare deems particularly necessary for appropriate operation of the decision to withdraw or withhold LST and the implementation thereof