Preparation and Practice of the Necessary Documents in Hospital for the Act on Decision of Life-Sustaining Treatment for Patients at the End-of-Life

Purpose Six forms relating to decisions on life-sustaining treatment (LST) for patients at the end-of-life (EOL) in hospital are required by the Act on Decision of LST for Patients at the EOL. We investigated the preparation and creation status of these documents from the database of the National Agency for Management of LST. Materials and Methods We analyzed the contents and details of each document necessary for decisions on LST, and the creation status of forms. We defined patients completing form 1 as self-determined of LST, and those whose family members had completed form 11/12 as family decision of LST. According to the determination subject, we compared the four items of LST on form 13 (the paper of implementation of LST) and the documentation time interval between forms. Results The six forms require information about the patient, doctor, specialized doctor, family members, institution, decision for LST, and intention to use hospice services. Of 44,381 who had completed at least one document, 36,693 patients had form 13. Among them, 11,531, 10,976, and 12,551 people completed forms 1, 11, and 12, respectively. The documentation time interval from forms 1, 11, or 12 to form 13 was 8.6 +/- 13.6 days, 1.0 +/- 9.5 days, and 1.5 +/- 9.7 days, respectively. Conclusion The self-determination rate of LST was 31% and the mean time interval from self-determination to implementation of LST was 8.6 days. The creation of these forms still takes place when the patients are close to death.

Automated summary

This study investigated the preparation and creation status of six forms required for decisions on life-sustaining treatment for patients at the end-of-life in hospitals. The findings showed a self-determination rate of 31% and an average time interval of 8.6 days from self-determination to implementation of life-sustaining treatment. The creation of these forms often occurs when patients are close to death.