Consensus guidelines for the definition of the end stage of disease and last days of life and criteria for medical judgment

Sang Min Lee, Su Jung Kim, Youn Seon Choi, Dae Seog Heo, Sujin Baik, Bo Moon Choi, Daekyun Kim, Jae Young Moon, So Young Park, Yoon Jung Chang, In Cheol Hwang, Jung Hye Kwon, Sun Hyun Kim, Yu Jung Kim, Jeanno Park, Ho Jung Ahn, Hyun Woo Lee, Ivo Kwon, Do Kyong Kim, Ock Joo KimSang Ho Yoo, Yoo Seock Cheong, Younsuck Koh

    Research output: Contribution to journalReview articlepeer-review

    14 Citations (Scopus)


    In Korea, the Hospice, Palliative Care, and Life-sustaining Treatment Decision-making Act was enacted in February 2016 in order to ensure that the patient's self-determination in end-of-life care processes is respected. To enhance physicians' understanding of this act and to provide proper criteria for medical judgment in variety of clinical settings, consensus guidelines were published in November 2016. In this article, the characteristics of these guidelines and related issues regarding the definitions of 'the end stage of disease' and 'last days of life' and the criteria for medical judgment are presented and summarized. According to the guidelines, the term 'end stage of disease' refers to a state in which there is no possibility of a fundamental recovery and the symptoms are expected to worsen within months. The terms 'the last days of life' and 'the final days of life' refer to a state in which, despite treatment, the patient's condition is worsening and death is impending, with no possibility of recovery. The attending physician and another relevant specialist should both judge a patient's medical condition as either 'end stage of disease' for hospice/palliative care or 'the last days of life' for dying patient care according to the law. Caregivers should provide appropriate medical information to eligible patients for palliative or 'end stage of disease' care through advance care planning. Therefore, it is critically necessary that caregivers understand the legitimate process of hospice/palliative and dying patient care based on the patient's wishes and best interests. Physicians should apply these consensus guidelines to eligible patients considering their clinical course and the patients' wishes.

    Original languageEnglish
    Pages (from-to)509-521
    Number of pages13
    JournalJournal of the Korean Medical Association
    Issue number8
    Publication statusPublished - 2018 Aug

    Bibliographical note

    Funding Information:
    This study was supported by a grant from the Korea National Institute for Bioethics Policy. The authors cordially thank Ms. Joo Hyun Kim to prepare many times of meetings during the preparation of this guideline.

    Publisher Copyright:
    © Korean Medical Association.


    • Advance care planning
    • Consensus guideline
    • End-of-life care
    • Hospice
    • Palliative care

    ASJC Scopus subject areas

    • General Medicine


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