Terminology use and self-determination in end-of-life coverage by Korean national daily newspapers: a quantitative content analysis
This quantitative content analysis of 106 articles from seven Korean national daily newspapers (2023–2025) reveals that end-of-life coverage frequently conflates distinct terminologies and prioritizes legal-institutional frames over the autonomy frame, thereby obscuring the specific scope of self-determination and highlighting the need for conceptual clarity to safeguard patient choice.
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In South Korea, as the population ages, the question of how people choose to end their lives has moved from private family conversations into the center of public debate. The country has already established a legal framework that allows doctors to stop life-sustaining treatments, such as ventilators or feeding tubes, for patients who are dying. This process is distinct from other concepts that often get mixed up in the public mind, such as physician-assisted suicide, where a doctor provides a drug for a patient to take themselves, or active euthanasia, where a doctor directly administers a lethal dose. While the law in Korea currently covers only the stopping of treatment, the public and the media frequently use terms like "death with dignity" or "euthanasia" to describe all these different scenarios interchangeably. This confusion matters because each scenario involves different actions, different people, and different legal rights. If the words used to describe them are blurry, the public cannot clearly understand what choices are actually available or what protections apply to each one.
A team of researchers from the Korean Medical Association set out to see how the country's major newspapers were handling this complex topic. They looked at 106 articles published between 2023 and 2025 in seven national daily newspapers, ranging from conservative to progressive outlets. Their goal was to count how often these different terms were used correctly and to see what kind of stories the newspapers were telling. They examined whether the articles focused on the legal rules and procedures, the personal right of a patient to choose, or the role of family and suffering. They also checked if the writers clearly distinguished between stopping treatment, helping a patient end their own life, or a doctor ending a life directly.
The researchers found that the newspapers were often muddying the waters. In more than half of the articles, the writers mixed up the core terms or used them incorrectly. The most common confusion involved the phrase "death with dignity," which appeared in articles describing physician-assisted suicide, active euthanasia, and the stopping of life-sustaining treatment as if they were all the same thing. Similarly, the term "euthanasia" was frequently used to describe physician-assisted suicide, even though the two involve different actors: in one, the patient takes the final action, and in the other, the doctor does. This lack of precision meant that readers were rarely given a clear picture of which specific act was being discussed or what the specific legal boundaries were for that act.
When the researchers looked at the main themes of the stories, a clear pattern emerged. Almost every article mentioned the legal and institutional side of the issue, such as the laws, the procedures, and the requirements for a decision to be valid. This legal frame was the main focus of the story in about 60 percent of the articles. In contrast, while the idea of personal autonomy—the right of a person to make their own choice—appeared in more than 90 percent of the articles, it was only the central focus in about 11 percent of them. In other words, the newspapers talked about the right to choose, but they almost always framed that right within the context of legal rules and procedures rather than treating the personal choice itself as the primary story.
The study also looked at why people might support or oppose these end-of-life choices. When articles presented reasons to support physician-assisted suicide, the most common argument was the right to self-determination. However, when articles presented reasons to oppose it, the focus was rarely on the idea that life is sacred. Instead, the most frequent concerns were about the potential for abuse of the system and the fear that patients might feel pressured by their families or society to choose death. The researchers noted that in Korean culture, families play a very large role in medical decisions, and the articles reflected a worry that this family involvement could sometimes become a burden or a source of pressure rather than support.
The findings suggest that while the newspapers are covering the topic of end-of-life decisions extensively, the way they use language and structure their stories may be hindering a clear public understanding. By blending distinct medical and legal concepts under the same labels, the coverage makes it difficult for citizens to grasp the specific differences between stopping treatment and assisted dying. The researchers concluded that for the public to truly understand their rights and the limits of those rights, the media needs to use precise language that separates these different acts. They argue that safeguarding a person's right to decide how they die requires not just legal protections, but also a public conversation that is clear about what each option actually involves and who is involved in making it happen.
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