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Korean J Hosp Palliat Care 2009; 12(1): 20-26
Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward
Der Sheng Sun, M.D., Yeon Joo Chun, M.D., Jeong Hwa Lee, M.D., Sang Hyun Gil, M.D., Byoung Yong Shim, M.D., Ok Kyung Lee, R.N.*, In Soon Jung, M.S.W.† and Hoon Kyo Kim, M.D.
Departments of Internal Medicine, *Hospice and †Team of Social Work, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
Correspondence to: 김훈교
Tel: 031-249-7114, Fax: 031-253-8898
Received: September 1, 2008; Revised: January 19, 2009; Accepted: February 2, 2009; Published online: March 1, 2009.
© Korean Society for Hospice and Palliative Care. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.
Keywords: Advance directives, DNR, Dying with dignity

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