Medical Innovation Committee holds second citizen panel forum
Deliberations to cover timing of treatment withdrawal, surrogate decision-making and end-of-life care support
The Ministry of Health and Welfare and the Medical Innovation Committee announced Friday they will hold the "Second Medical Innovation Citizen Panel Public Deliberation Forum on Strengthening End-of-Life Medical Care and Support" at Seoul National University's Siheung campus Saturday and Sunday.
About 300 citizen panelists will spend the two-day overnight session discussing when life-sustaining treatment may be withheld or withdrawn, who should make surrogate decisions, and what medical care and support should be available at the end of life.
The Medical Innovation Citizen Panel has been engaged in healthcare reform discussions since July, when it launched its first public deliberation forum on revitalizing regional and essential medical services. Since then, panelists have participated through online in-depth discussions and online policy proposals.
This forum will examine the institutional and social challenges involved in respecting the autonomy and dignity of patients at the end of life while ensuring they receive the care they need.
Discussions will center on three main topics: the appropriate timing for withholding or withdrawing life-sustaining treatment, the decision-making process when a patient cannot express their own wishes, and ways to strengthen medical care and support at the end of life.
Over the two days, panelists will work through each topic in sequence through expert presentations, question-and-answer sessions, small-group discussions and plenary sharing of results.
The first day will focus on the timing of withholding or withdrawing life-sustaining treatment. Panelists will begin by reviewing cases related to life-sustaining treatment decisions and sharing their own experiences.
Expert presentations will then lay out two positions: maintaining the current system, under which life-sustaining treatment may be withheld or withdrawn only after a patient has entered the dying process, and expanding that window to include the terminal stage of illness before the dying process formally begins.
After the presentations and a question-and-answer session, panelists will examine the key issues in small-group discussions, share their views on the timing question and raise concerns about each position, then report their findings to the full panel.
The second day will take up the remaining two topics: who should serve as a surrogate decision-maker for life-sustaining treatment, and end-of-life medical care and support.
Panelists will first hear expert presentations on the current family-centered surrogate decision-making system and the case for reforming it, then exchange views. They will then discuss the procedures and safeguards needed if surrogate decision-making authority were extended beyond immediate family — including how to define the eligible circle of surrogates and who should decide when a patient's wishes cannot be determined and no surrogate is available.
The session will then turn to the medical care and support needed for patients who have decided to forgo life-sustaining treatment, with panelists sharing views on where patients should spend their final days and what care arrangements should be in place to support them.
The second day will close with a plenary sharing of small-group discussion results, bringing the two-day deliberation to a conclusion.
The opening and closing ceremonies, expert presentations and plenary sharing sessions will be livestreamed on the Ministry of Health and Welfare's YouTube channel and open to the public. Small-group discussions, however, will be held in closed session to allow panelists to speak freely and deliberate fully.
The Citizen Panel Steering Committee under the Medical Innovation Committee will compile the results of the forum and report them to the Medical Innovation Committee by the end of November. The findings will inform the committee's broader discussions on strengthening end-of-life medical care and support, as well as deliberations by the Special Committee on Improving the Life-Sustaining Treatment Decision System under the National Bioethics Committee.
Lee Hyung-hoon, second vice minister of health and welfare, said respecting the wishes of patients at the end of life while ensuring they receive adequate medical care and support are important goals that must be pursued together. "Through this public deliberation, we will listen carefully to the diverse views of the public and examine the policy challenges involved in upholding patients' dignity and right to self-determination while ensuring the protection and support they need," Lee said.
Jeong Gi-hyeon, chair of the Medical Innovation Committee, said views on what kind of medical care and support people want at the end of life can differ widely depending on individual values and experiences, making it important to respect one another's perspectives and allow for thorough discussion. "I hope this forum will be a space where citizen panelists can share their diverse experiences and thoughts, and together explore the direction our society should take on end-of-life medical care and support," Jeong said.
thlee@heraldcorp.com
