[Reporter’s Notebook] What Is the Essence of Dignified Death?

"Before we get into the main story, we need to clarify the terminology first." This was the statement made by Professor Yoon Seok Ko of the Department of Pulmonology at Seoul Asan Medical Center, whom this newspaper met during the investigation of the dignified death series 'A Certain Death.' He argued that the currently used term 'dignified death' is a euphemism that hinders proper social discussion. He insisted that it would be better to use the action-centered term 'physician-assisted voluntary dying.'

Regarding the act where a doctor provides medication or other means to a terminally ill patient in severe pain to allow the patient to end their own life, proponents use the term 'dignified death,' while opponents use 'euthanasia' or 'physician-assisted suicide.' The connotations and weight of these terms differ. It is obvious that public opinion polls would show different approval rates depending on which term is used.

There is a psychological term called the 'primacy effect.' It means that the information presented first has a stronger influence than information learned later, even if the information is the same. If one first encounters the term 'dignified death,' they may develop a positive bias. Conversely, if the word 'suicide' is heard first, there is a higher chance of a negative perception. It is not precisely known when the term 'dignified death' began to be used in Korea. There is only speculation that the term 尊嚴死 (dignified death), directly translated from English in Japan, was adopted as is. When inquiring at the National Institute of the Korean Language, they said there is no concrete information about the origin of the term 'dignified death.'

Korea will enter a super-aged society starting next year. The discussion on dignified death is a reality that will soon be faced. However, the arguments for and against remain evenly balanced, including respect for human dignity and patient autonomy on the pro side, and social-economic pressures and lack of infrastructure preparation on the con side.

To minimize social confusion surrounding dignified death, it is necessary to start by establishing value-neutral terminology. Currently, the term 'assisted dignified death' is the most commonly used. The term 'dignified death' directly translated from Japanese corresponds to 'death with dignity.' It originated from a three-year legal battle in 1975 in New Jersey, USA, where the parents of Karen Ann Quinlan, a woman in her twenties who became a vegetative state, won the right to remove the ventilator so she could have a death with dignity. The background of the term's origin is far from value-neutral. Some opposing groups reject the term 'assisted dignified death' itself, saying, "To be honest, it is physician-assisted murder and aiding suicide." In such circumstances, any policy decision is bound to face backlash.

There is a need for terminology that both proponents and opponents can accept. All words implying positive or negative connotations such as dignity, pain, and suicide should be excluded from the outset. The term 'physician-assisted voluntary dying' proposed by Professor Ko could be an alternative. The social discussion should begin not with whether patients in severe pain who end their own lives are dignified or not, but whether they should be able to voluntarily end their lives with the help of a physician.