Choosing how to spend life’s final moments is a topic that can weigh heavily on the heart. However, we all have the right to contemplate a dignified end and to decide our wishes in advance. This is precisely what ‘Advance Directives for Life-Sustaining Treatment’ allows us to do. In the past, the process was cumbersome, requiring a direct visit to a registration agency. However, with online creation becoming available from 2026, accessibility will significantly improve.
Preparing in advance for situations where expressing your will might be difficult due to a sudden accident or illness, by stating your wishes regarding the discontinuation of life-sustaining treatment or the use of hospice care, is a wise choice that reduces not only your own burden but also the psychological burden on your family. If you wish to conclude your life with dignity according to your own will, it’s time to properly understand Advance Directives for Life-Sustaining Treatment.
What exactly are Advance Directives for Life-Sustaining Treatment?
Advance Directives for Life-Sustaining Treatment are documents in which adults aged 19 or older express their wish not to receive life-sustaining treatment or to utilize hospice care if they become a patient in the dying process in the future. ‘Life-sustaining treatment’ refers to medical procedures aimed solely at prolonging life without therapeutic effect, such as cardiopulmonary resuscitation, artificial respiration, blood dialysis, and anticancer drug administration. These directives maintain legal effect even if the individual becomes unable to express their will, ensuring the patient’s right to self-determination and dignity.
This differs from a ‘Life-Sustaining Treatment Plan,’ which is prepared by a patient who has entered the terminal or dying phase in a medical institution with their attending physician. Advance Directives for Life-Sustaining Treatment are distinct in that they can be prepared in advance while one is still healthy.
Changes to Creation and Registration Methods in 2026
From the second half of 2026, Advance Directives for Life-Sustaining Treatment will be available for online creation and registration. Previously, it was only possible to create them by visiting a registration agency designated by the Ministry of Health and Welfare and undergoing face-to-face counseling.
The introduction of an online creation system is expected to significantly improve accessibility to the system, allowing individuals to record their wishes without time and location constraints. However, procedures such as enhanced identity verification, video education for sufficient counseling and training, and learning content evaluation will also be introduced for online registration. The Ministry of Health and Welfare plans to continue expanding existing face-to-face registration agencies.
How do the Directives’ Validity, Changes, and Withdrawal work?
Advance Directives for Life-Sustaining Treatment can be changed or withdrawn at any time after their creation. You can visit any Advance Directives for Life-Sustaining Treatment registration agency designated by the Ministry of Health and Welfare, even if it’s not the agency where you initially created the document, to make changes or withdraw it. With the introduction of the online system, it is expected that withdrawal and modification will also be possible online.
The directives’ validity only takes effect when medical professionals medically determine that the patient is in the ‘dying process.’ In emergency situations where recovery is possible, necessary treatment will be provided normally. Furthermore, according to the 2026 implementation plan, measures are being pursued to advance the timing for withholding or withdrawing life-sustaining treatment from the ‘dying phase’ to the ‘terminal phase,’ and social consensus on this is currently underway.
Ultimately, preparing for a dignified end to life is an important matter for yourself and your family. Why not start preparing for a regret-free conclusion by clearly stating your wishes through the creation of Advance Directives for Life-Sustaining Treatment? You can find more detailed information on the National Agency for Management of Life-Sustaining Treatment website.