{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:01:44Z","timestamp":1793091704116,"version":"4.5.0"},"reference-count":98,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T00:00:00Z","timestamp":1602806400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T00:00:00Z","timestamp":1602806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007461","name":"Fondation Brocher","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007461","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Sasakawa Memorial Health Foundation","award":["2018A-002"],"award-info":[{"award-number":["2018A-002"]}]},{"DOI":"10.13039\/100016355","name":"Uehiro Foundation on Ethics and Education","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016355","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Global Research Network program through the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea","award":["NRF-2017S1A2A2040014"],"award-info":[{"award-number":["NRF-2017S1A2A2040014"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Ethics"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Regulations on forgoing life-sustaining treatment (LST) have developed in Asian countries including Japan, Korea and Taiwan. However, other countries are relatively unaware of these due to the language barrier. This article aims to describe and compare the relevant regulatory frameworks, using the (more familiar) situation in England as a point of reference. We undertook literature reviews to ascertain the legal and regulatory positions on forgoing LST in Japan, Korea, Taiwan, and England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main text<\/jats:title><jats:p>Findings from a literature review are first presented to describe the development of the regulatory frameworks surrounding the option of forgoing LST in each country. Based on the findings from the four countries, we suggest five ethically important points, reflection on which should help to inform the further development of regulatory frameworks concerning end-of-life care in these countries and beyond. There should be reflection on: (1) the definition of \u2013 and reasons for defining \u2013 the \u2018terminal stage\u2019 and associated criteria for making such judgements; Korea and Taiwan limit forgoing LST to patients in this stage, but there are risks associated with defining this too narrowly or broadly; (2) foregoing LST for patients who are<jats:italic>not<\/jats:italic>in this stage, as is allowed in Japan and England, because here too there are areas of controversy, including (in England) whether the law in this area does enough to respect the autonomy of (now) incapacitated patients; (3) whether \u2018foregoing\u2019 LST should encompass withholding<jats:italic>and<\/jats:italic>withdrawing treatment; this is also an ethically disputed area, particularly in the Asian countries we examine; (4) the family\u2019s role in end-of-life decision-making, particularly as, compared with England, the three Asian countries traditionally place a greater emphasis on families and communities than on individuals; and (5) decision-making with and for those incapacitated patients who lack families, surrogate decision-makers or ADs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Comparison of, and reflection on, the different legal positions that obtain in Japan, Korea, Taiwan, and England should prove informative and we particularly invite reflection on five areas, in the hope the ensuing discussions will help to establish better end-of-life regulatory frameworks in these countries and elsewhere.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12910-020-00535-w","type":"journal-article","created":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T11:03:09Z","timestamp":1602846189000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Forgoing life-sustaining treatment \u2013 a comparative analysis of regulations in Japan, Korea, Taiwan, and England"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4230-9391","authenticated-orcid":false,"given":"Miho","family":"Tanaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kodama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilhak","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Huxtable","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yicheng","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,16]]},"reference":[{"key":"535_CR1","unstructured":"The National Law Information Center. 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