3.2M South Koreans Opt Out of Life-Sustaining Treatment – ‘Dignified Death’ Trend

More than 3.2 million South Koreans have formally registered their intent to forgo life-sustaining treatment in the event of an incurable illness, according to data released by the National Agency for Management of Life-sustaining Treatment. This represents a significant and growing trend within the country’s evolving approach to end-of-life care.

A Growing Movement Towards End-of-Life Choice

As of December, 3.2 million South Koreans—2.13 million women and 1.07 million men—have opted to participate in the nation’s end-of-life decision system. This system is often described as facilitating a “dignified death.” The numbers demonstrate a steady increase in participation since the system’s inception.

Demographic Trends in Advance Care Planning

The majority of those registered, 2.37 million people, are aged 65 or older, representing over two-thirds of all registrants. This suggests that older adults are particularly engaged with advance care planning and expressing their wishes regarding future medical interventions.

Did You Know? The system allowing for these decisions was first introduced in February 2018, stemming from the Act on Decisions on Life-sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life.

The Evolution of the System

The system began with approximately 86,000 registrations in its first year. It surpassed 1 million registrants in August 2021, 2 million in October 2023, and reached 3 million in August 2025. This rapid growth indicates increasing public awareness and acceptance of advance care planning.

As of December, 185,952 people had Physician Orders for Life-Sustaining Treatment—documents outlining a patient’s wishes—registered with the agency. Since the law’s enactment, life-sustaining treatment has been withdrawn in 478,378 cases, following consent from patients or their families.

Expert Insight: The increasing number of South Koreans formally documenting their end-of-life wishes reflects a broader global conversation about patient autonomy and the right to make informed decisions about one’s own healthcare, even when facing incurable illness.

Ongoing Debate and Potential Changes

Discussions surrounding the scope of “dignified death” continue in South Korea, mirroring similar debates in other countries. These conversations often centre on ethical considerations and defining eligibility criteria. Currently, the law restricts these decisions to patients in the “end-of-life process,” defined as those with an incurable condition and an expected death within months, with no possibility of recovery.

Last year, Representative Nam In-soon proposed an amendment that could broaden eligibility to include patients assessed as likely to die, even if not yet in a terminal state. If approved, this amendment would allow individuals to decline life-sustaining treatment earlier in the course of an irreversible illness, expanding the system’s reach beyond its current limitations.

Frequently Asked Questions

What percentage of registrants are women?

As of December, 2.13 million of the 3.2 million registrants are women.

When was the current system for end-of-life decisions introduced?

The system was introduced in February 2018.

How many cases have involved the withdrawal of life-sustaining treatment since the law took effect?

Life-sustaining treatment has been withdrawn in 478,378 cases since the law took effect, with the consent of patients or their families.

As South Korea continues to grapple with these complex issues, how might evolving societal values and medical advancements shape the future of end-of-life care?