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논문분류	춘계학술대회 초록집
제목	Ethical reflection in the field of nephrology: Hemodialysis as a life-sustaining therapy
저자	Yu Ah Hong
출판정보	2019; 2019(1):
키워드	well-dying law \| hemodialysis \| withhold \| withdrawal \| questionnaire survey
초록	The Ministry of Health and Welfare announced the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life, known as the “well-dying” law from February 2018. The law expanded expert hospice care services to terminally-ill patients suffering from non-cancerous, incurable diseases, such as AIDS, chronic obstructive pulmonary disease and chronic liver disease. Hemodialysis is one of the options designated in the Act as a life-sustaining treatment that can be withheld or withdrawn near death. However, hemodialysis has unique features. Because hemodialysis is periodically provided on an ongoing basis, skipping an upcoming turn may be justifiable as an omission rather than an active act of withdrawal. It is complicated and difficult to determine the best candidates for withholding/withdrawal hemodialysis at the end of life. Thus, it is necessary to investigate nephrologists’ opinions of well-dying law on hemodialysis to find the meaning and implications of withholding/withdrawal hemodialysis at the end of life according to legal and ethical consideration. We performed a questionnaire survey to determine the nephrologists’ perceptions and opinions of well-dying law on hemodialysis from January 22, 2019 to April 30, 2019. We sent and received e-mails to and from the regular members registered with the Korean Society of Nephrology (KSN). The questionnaire was designed as follows: 1) demographics, including age, sex, and medical school graduation year, affiliated hospitals and specialties 2) perceptions on the well-dying law; 3) opinions on hemodialysis as life-sustaining treatment based on well-dying law; 4) factors affecting the decision of withholding/withdrawal hemodialysis as life-sustaining treatment; 5) hospice/palliative care for end-stage renal disease patients. This presentation is the results of questionnaire survey from the nephrologists on the meaning and implications of withholding or withdrawal hemodialysis as a life-sustaining treatment.
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