Core Points - The implementation of the "Life-Sustaining Treatment Decision Act" in South Korea since February 2018 has led to over 3 million adults, approximately 6.8% of the adult population, signing documents to refuse life-sustaining treatment [1][11] - The law allows adults aged 19 and above to voluntarily fill out advance directives to refuse or discontinue life-sustaining treatment, with a significant increase in registrations observed over the years [10][11] - The concept of "dignified death" is gaining acceptance in South Korea, particularly among the elderly, as societal attitudes towards death and dying evolve [5][9] Group 1 - Over 440,000 individuals have terminated life-sustaining treatment based on the law [3] - The number of people signing advance directives surged from about 86,000 in 2018 to over 300,000 by August 2025 [11] - The law outlines specific medical interventions that can be refused, including CPR, dialysis, cancer treatment, and mechanical ventilation [10][11] Group 2 - The aging population in South Korea is a significant factor driving the acceptance of "dignified death," with over 20% of the population aged 65 and above by the end of 2024 [9] - The cultural shift towards accepting death as a natural part of life is reflected in personal stories of individuals choosing to refuse life-sustaining treatments [5][6] - The law has led to a reduction in the number of patients dying in pain due to unnecessary medical interventions [29] Group 3 - There is a notable difference in the acceptance of "dignified death" among elderly women, with 24.9% of women aged 65 and above signing advance directives compared to 17.1% of men [38] - Economic factors play a role in the decision-making process, with lower-income individuals more likely to support "dignified death" due to the financial burden of prolonged medical care [33][34] - Despite the progress, many patients still face challenges in accessing adequate palliative care, particularly those with non-cancerous terminal illnesses [34][35]

Core Insights - The discussion revolves around the impending elder care and end-of-life crisis facing the post-90s and post-00s generations in China, emphasizing the need for proactive preparation [8][14][39] Group 1: Research and Observations - The research conducted by the professor and his team over the past 15 years includes visits to hospitals, hospice care facilities, and nursing homes, focusing on how Chinese people approach aging and death [1][3] - A significant finding is that the elderly population in China aged 65 and above has doubled from 7% in 2001 to 14% in 2021, indicating a rapid shift towards an aging society [14] - The professor collected 364 narratives from families and medical staff to understand how death is discussed in Chinese culture [3][12] Group 2: Death and Dying in Chinese Society - The traditional model of end-of-life care in China is primarily family-based, while newer models include hospital-based palliative care, which is often misunderstood [17][19] - There is a stark contrast between the number of people receiving palliative care (less than 300,000 annually) and the millions suffering from terminal illnesses, highlighting a gap in care quality [19][21] - The professor emphasizes the importance of diverse end-of-life care models, including community-based approaches and traditional practices, rather than focusing solely on hospital care [21][23] Group 3: Cultural Perspectives on Death - The societal approach to death in China has shifted, with a growing tendency to avoid discussions about death, leading to a "barbaric" form of dying that lacks dignity [33][34] - The professor argues that the strong filial piety in Chinese culture often leads to decisions about end-of-life care being made by family members rather than respecting the wishes of the dying individual [28][30] - There is a call for a more nuanced understanding of death that incorporates traditional beliefs and practices, moving away from a singular, materialistic view of death [36][38]

Group 1 - The implementation of the "Life-Sustaining Medical Treatment Decision Act" in South Korea since February 2018 has led to over 3 million adults signing documents to refuse life-sustaining treatment, representing approximately 6.8% of the adult population [1] - As of October 9, 2023, more than 440,000 individuals have terminated life-sustaining treatment based on this law, with a significant increase in registrations from about 86,000 in 2018 to over 1 million in 2021, and surpassing 3 million in 2023 [1] - The law allows adults aged 19 and above to fill out advance directives at designated registration institutions, specifying their wishes regarding life-sustaining treatment during the "end-of-life process" [1] Group 2 - The current legal framework restricts the application of the law to patients in the "end-of-life process," which has led to controversies, such as a case in 2023 where a terminal cancer patient was unable to have their treatment terminated due to being in a comatose state [2] - In response to the narrow scope of the law, members of the Democratic Party of Korea have proposed amendments to expand the law's applicability to include patients in terminal and potentially fatal stages, aiming to enhance patient autonomy and quality of life [2] - The proposed amendments are currently under review by the National Assembly [2]