SEOUL NATIONAL UNIVERSITY HOSPITAL

The Center for Palliative Care and Clinical Ethics is playing a role in relieving the pain of patients with severe diseases, helping them and their families living with dignity. We are also involved in difficult decisions and ethical conflict mediation related to treatment and patient care.

Introduction to the Center for Palliative Care and Clinical Ethics
The Center for Palliative Care and Clinical Ethics at Seoul National University Hospital was first opened as a Hospice department in 1996, changed its name to Hospice Center in 2014, and started the Clinical Ethics Consultation Team in 2015. After changing its name and becoming the Palliative Care and Clinical Ethics Center in 2018, our center has been providing wholistic care via the multidisciplinary team (physician, nurse, and social worker) in the field of palliative care and clinical ethics and supporting solving ethical issues in medical situations.

Palliative care Service

1) What is palliative care? 

Palliative care is an integrated medical service aiming to improve the quality of life by reducing complex issues such as symptoms, discomfort, and stress that patients and their families experience during the treatment process.

ㆍPhysical symptom management	ㆍLiaison with care organizations	ㆍLiaison with  socioeconomic support
ㆍLiaison with treatments/programs	ㆍAdvance care planning	ㆍPsychological and emotional support
ㆍspiritual care support	ㆍCaring for bereaved families	ㆍLiason with volunteers

Q. Which patients can use the service? 

A. Patients with serious illness can use the service anytime when they need symptom management or help with psycho-emotional and socioeconomic support and face difficult decision making in the treatment process.

Q. Can I use the service while getting disease treatment?

A. You can use the service during active anti-disease treatment. It is often mistaken that palliative care is only available for patients in the terminal stage when no treatment options are left. However, palliative care can be used anytime you need the service.
Your treatment is also not discontinued when you use palliative care. You can receive the service concurrently with disease treatment.

2) Palliative Care Consultation Team service

Seoul National University Hospital is providing an advisory hospice palliative care service, a program of the Ministry of Health and Welfare in Korea. 

It is a specialized palliative care provided by the palliative care consultation team (doctors, nurses, and social workers) for terminal patients with cancer or chronic obstructive pulmonary disease in inpatient or outpatient setting.

Clinical Ethics Support Service

1) Advance Directives

This can be written by anyone over the age of 19 and is used to document the use of life-sustaining treatment and hospice care in case of facing the End stage of life in the future.
*life-sustaining treatment : Medical treatment by cardiopulmonary resuscitation, hemodialysis, administering anticancer drugs, mechanical ventilation and other medical treatments to a patient at the end stage of life, which merely extends the duration of the end stage of life without curative effects

Q. When can I write Advance Directives?

A. You can write the document anytime if you are capable of reasonable decision-making, regardless of whether you have a disease or not.

Q. When does the Advance Directives get used?

A. The document is used to express the patient’s opinion when they are unconscious, unable to speak, or suffers a decline in cognitive function after being confirmed as the patient at the “End stage of life”.

Q. What is the “End stage of life”?

A. This is defined as a patient who has received a medical assessment from two doctors to be in a state of imminent death, in which there is no possibility of revitalization or recovery despite treatment, and where symptoms worsen rapidly

Q. Do all treatments get discontinued when the patient writes the Advance Directives?

In case of patients not on the End stage of life	In case of patients on the End stage of life
All possible active treatments can be performed.	Medical care that relieves the patient’s discomfort other than life-sustaining treatment can be performed.