If the patient is assessed as a ‘patient at the end stage of life’ by two doctors pursuant to the Life-sustaining Treatment Decisions Act and if the decision to withdraw or withhold LST for the patient is verified, the doctor in charge can implement the decision.
Assessment of Patient at the End Stage of Life (Appendix Form 9)
Verification of Decision to Withdraw or Withhold LST of the Patient
Implementation of Decision to Withdraw or Withhold LST
The implementation of decision to Withdraw or Withhold LST can be made only for the ‘patient at the end stage of life.’ Here, the “the end stage of life” means a state of imminent death, in which there is no possibility of revitalization or recovery despite treatment, and symptoms worsen rapidly.
Whether a certain patient is at the end stage of life should be assessed identically by the doctor who directly treated the patient and one medical specialist in the relevant field.
It is very difficult to accurately predict the time of death. To be able to make a assessment persuasively about whether a patient is at the end stage of life, it is appropriate that the doctor who treated the patient directly at the end stage of life makes a assessment based on medical expertise by considering characteristics of the clinical situation.
The ‘medical specialist in the relevant field’ is not limited to a specific field, and the head of the medical institution can appoint a specialist from within the institution or invite from other institutions.
However, since it should be a specialist who can assess the end stage of life, it is necessary to prepare related standards and procedures within the medical institution by comprehensively reviewing various clinical situations such as causative disease, characteristics of the individual, and the care provided, so that an appropriate specialist can be assigned.
The doctor in charge and the medical specialist in the relevant field who made an assessment on the end stage of life should prepare the Assessment of the Patient at the End Stage of Life(Appendix Form 9). The medical institution should retain it for 10 years after implementing the decision to withdraw or withhold LST.