When a patient with a terminal illness says, “I’d rather die,” it is rarely an empty complaint. Often, it is a cry for relief from excruciating pain they are experiencing for the first time. For those with bone metastases from breast cancer, the sensation is described as a constant, stabbing knife. For those with pulmonary fibrosis, the thickening of lung tissue leads to a relentless struggle for breath. When this agony continues without letup, the desire for death can become an involuntary plea for peace.
Spending a Fortune to Die Far from Home
On the 9th of last month, a man in his 60s suffering from severe pulmonary fibrosis was intercepted by police while attempting to board a flight to Switzerland. He had left a suicide note at home, prompting his children to report his disappearance. Officers removed him from the plane and, after lengthy persuasion, he returned home.
However, the question remains: did his return end his torment? The man had spent substantial time and money arranging for assisted suicide in a country where it is legal. He was not looking for a way out of life, but a way out of a world defined by unceasing pain.
The Reality of Life-Sustaining Treatment: The Nasal Tube Dilemma
The rising interest in a "dignified death" reflects a growing desire to die with humanity intact, rather than hooked to machines in a hospital bed. Many patients fear their final image in the minds of their grandchildren will be one of suffering.
The process of "nasal tube feeding" is particularly controversial. The insertion is painful, and the constant sensation of a foreign object often leads conscious patients to instinctively pull the tube out. In some long-term care facilities, "measures" taken to prevent this are criticized as inhumane.
Under the current Life-Sustaining Treatment Decision Act, even those who refuse life-sustaining treatment often still receive tube feeding. The law excludes CPR, hemodialysis, chemotherapy, and mechanical ventilation, but it maintains that providing water and basic nutrition is an essential mark of respect for life. Consequently, even if a patient has signed an advance directive, nutritional support through a nasal tube cannot be discontinued until the very end.
Over 3.2 Million Registered Advance Directives
As of March 10, over 3,266,401 people have registered an Advance Directive for Life-Sustaining Treatment. According to the National Agency for Management of Life-Sustaining Treatment, 494,945 people have already implemented these decisions.
Since its inception in 2018, this system has allowed patients to withhold or withdraw medically meaningless treatments when a physician determines they are in the dying process. Any adult aged 19 or older can document these preferences in preparation for their final days.
Is a Dignified Death Possible in Korea?
While the withdrawal of life-sustaining treatment is legal, assisted suicide—ending one's life with medical assistance—remains illegal in South Korea. Despite this, a survey by the Korea Institute for Health and Social Affairs found that 82% of respondents support the idea.
Experts argue that full legalization of assisted suicide is premature due to significant ethical concerns. However, there is an urgent call to expand the eligibility of the current Act and to develop more effective analgesics. Currently, many painkillers that act on the central nervous system offer limited relief for extreme terminal pain.
Everyone eventually leaves this world after a period of illness. The challenge for society is to reduce that duration of suffering as much as possible. While many hope to "die peacefully in their sleep," the reality for most is a complex medical and legal journey. The search for a "dignified death" continues to be a profound question for the aging population of South Korea.
