Market coverage note: This article covers information from both Korea and the United States. Each piece of information is labeled 🇰🇷 Korea or 🇺🇸 U.S. in the text to indicate which country it applies to.
After a parent receives a serious diagnosis, the question families ask most often is, "What do we do now?" It is easy to feel that continuing treatment is the only way to express love — but when medical recovery is unlikely, choosing to conclude life without suffering, with dignity, is also a form of care. The procedures that allow your parents to record that choice in advance, in their own words, are the hospice and palliative care system and the life-sustaining treatment decision-making system.
🇰🇷 Korea Hospice and palliative care in Korea provides comprehensive care aimed not at cure but at quality of life for patients with terminal illness and their families. A decision to withhold or withdraw life-sustaining treatment refers to the decision not to initiate, or to discontinue, interventions that only prolong the dying process without therapeutic benefit. Both systems are enshrined in the Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life (the Life-Sustaining Treatment Decisions Act), enacted in 2016 and in effect since 2018.
🇰🇷 Korea Since the Life-Sustaining Treatment Decisions Act took effect, the number of cases in which life-sustaining treatment was withheld or withdrawn has grown steadily — from approximately 31,000 in 2018 (10.6% of deaths) to approximately 70,000 in 2024 (19.6%). According to the 국립연명의료관리기관 (National Agency for Management of Life-Sustaining Treatment), as of 2026, approximately 3,580,000 people have registered a 사전연명의료의향서 (advance directive regarding life-sustaining treatment), approximately 210,000 have registered a 연명의료계획서 (life-sustaining treatment plan), and the cumulative number of life-sustaining treatment withdrawal cases stands at approximately 550,000. Anyone may prepare these documents in advance, and the content may be changed or revoked at any time.
🇰🇷 Korea A 사전연명의료의향서 (advance directive) may be completed by anyone aged 19 or older and is a document in which a person states in advance that they do not wish to receive life-sustaining treatment should they enter the dying process. As of December 2025, registered institutions have expanded to 819 locations (including public health centers and senior welfare centers), and medical institutions authorized to carry out the life-sustaining treatment decision system have grown to 513. In June 2026, an online completion and registration process was officially established, meaning that in the future, directives may be completed without visiting an institution in person. In addition, mobile registration certificates began to be issued in June 2025.
🇰🇷 Korea The number of designated hospice specialist institutions is also growing rapidly. Through the 2nd Comprehensive Plan for Hospice and Life-Sustaining Treatment (2024–2028), the 보건복지부 (Ministry of Health and Welfare) plans to expand hospice specialist institutions from 188 in 2023 to 360 by 2028, and to increase 의료기관윤리위원회 (hospital ethics committees — the bodies authorized to approve withdrawal of life-sustaining treatment) from 430 to 650 over the same period. However, as of 2025, there are only 39 home-based hospice institutions nationwide, meaning that the options for patients who wish to spend their final days at home remain limited.
🇺🇸 U.S. In the United States, end-of-life care is supported through the Medicare hospice benefit. Eligibility is established when two attending physicians certify that the patient has a life expectancy of six months or less if the illness follows its normal course. Under this benefit, patients elect palliative care in place of curative treatment for their terminal condition, thereby forgoing Medicare coverage for aggressive treatment of that condition. As of 2024, approximately 1,910,000 Medicare beneficiaries used hospice, and for the first time, 53.1% of Medicare decedents died while enrolled in hospice — the first time in history that a majority of Medicare decedents have used hospice.
🇺🇸 U.S. The Medicare hospice benefit is structured as two initial periods of 90 days each, followed by unlimited subsequent periods of 60 days. Covered services include nurse visits, social worker visits, chaplain services, physician visits, prescription medications, medical supplies, short-term inpatient care, and bereavement support for the family. There is generally no cost-sharing, though there may be a copayment of up to $5 per prescription for symptom-management medications. In the United States as well, completing an Advance Directive or a POLST (Physician Orders for Life-Sustaining Treatment) ahead of time helps ensure that a person's wishes are respected in a crisis.
In both countries, the key is to have these conversations with family while everyone is still in good health. If your parents have already shared what kind of ending they want — and what interventions they do not want — then when the difficult moment comes, the family will not have to bear those decisions alone. A registered directive can be changed or cancelled at any time, so there is no need to worry that writing one now means it can never be undone.
Sources: 보건복지부 (Ministry of Health and Welfare) and 국가호스피스연명의료위원회 (National Committee for Hospice and Life-Sustaining Treatment) 2026 Hospice and Life-Sustaining Treatment Implementation Plan announcement (June 2, 2026); 국립연명의료관리기관 (lst.go.kr) registration statistics; 메디칼타임즈 reporting on the status of the Life-Sustaining Treatment Decisions Act (2026); 건강보험연구원 (Health Insurance Research Institute) analysis of end-of-life medical costs (2023); National Alliance for Care at Home, Facts and Figures 2025 Edition; MedPAC, March 2025 Report to Congress, Chapter 9: Hospice; CMS Medicare Hospice Benefit guidance (June 2025).
Note: This article was compiled by AI from the sources cited above. We strive for accuracy, but for decisions about your specific situation, please confirm the latest guidance from a professional or the relevant agency.