South Koreans to register advance end-of-life directives online

South Koreans will soon be able to register advance directives for life-sustaining treatment online, free from the time and location constraints of the current in-person-only system. Discussions will also begin on expanding the window during which life-sustaining treatment may be withheld or withdrawn — currently limited to the terminal dying phase — to cover the broader terminal illness stage, subject to social consensus. Hospice reimbursement rates will be improved to ensure stable service delivery, and an upgrade of the integrated hospice information system is set to be completed by year's end.

The Ministry of Health and Welfare said Monday it convened the National Hospice and Life-Sustaining Treatment Committee and reviewed and confirmed the 2026 implementation plan under the Second Comprehensive Hospice and Life-Sustaining Treatment Plan (2024–2028).

Among the plan's key provisions, advance directives — which currently require an in-person visit to a registered institution — will be made available for online registration.

The ministry also plans to continue expanding the network of in-person registration sites, focusing on regional public health institutions and medical facilities with ethics committees.

Alongside this, formal discussions will begin through the National Bioethics Committee and other bodies on extending the permissible window for withholding or withdrawing life-sustaining treatment beyond the current dying phase to encompass the terminal stage of illness.

The ministry will also build a document management system to convert statutory forms — including advance directives — into electronic records for storage, and will continue to expand education programs for staff at medical institutions and advance directive registration agencies.

On the hospice side, home hospice reimbursement rates will be improved to ensure stable service delivery, and the ministry will analyze barriers to hospice expansion and develop plans to strengthen infrastructure. Particular focus will be placed on developing a hospice service model tailored to long-term care hospitals and rolling it out in clinical settings.

The integrated hospice information system will be upgraded by the second half of this year to support patient referrals between specialized hospice institutions through shared waitlist data, and to enable detailed statistical analysis including outcomes for patients who leave the waitlist.

The ministry will develop hospice education materials for patients with chronic respiratory failure and expand practical training programs to support specialized hospice care. It also plans to improve the bereavement family hospice satisfaction survey by incorporating input from experts and frontline workers, with findings to inform future policy improvements.

"End-of-life issues are something that can come to any of us — to me, to my family, to everyone," Deputy Minister Lee Hyeong-hun said. "We will continue to reflect the voices from the field and keep developing the system so that people can prepare for a dignified end to their lives."

Meanwhile, the number of institutions where people can register advance directives grew from 760 in 2024 to 819 last year, with new sites added at public health centers and senior welfare centers. Medical institutions implementing the life-sustaining treatment decision system expanded from 468 to 513 over the same period, while specialized hospice institutions — including those participating in the long-term care hospital hospice reimbursement pilot — more than doubled, from 88 to 194.