The physician’s primary duty to preserve life

The physician’s primary duty to preserve life is the principle the doctor explicitly invokes when Yeong-hye’s refusal to eat makes her survival uncertain. In the hospital, that obligation drives decisions to intensify treatment, even as Yeong-hye resists feeding and asks to leave. The principle is presented not as a simple resolution but as a source of ethical tension: preserving life requires intervention, while intervention may override the patient’s expressed wishes.

Medical Judgment and the Limits of Treatment

When In-hye asks about her sister’s condition, the doctor says the hospital has done its best without improvement. He proposes intravenous feeding and warns that, if Yeong-hye does not improve, she will need transfer to a critical ward at a general hospital. He also gives In-hye limited time to try speaking with her sister, while making clear that the medical team is preparing for further intervention. The doctor explains that Yeong-hye’s case does not fit the pattern of a patient who fears food is poisoned and might be reassured by seeing a doctor eat it. The staff do not know why she refuses food, and the medicines have not helped. He states the governing priority directly: “Our first duty as doctors is to preserve life.” Because the hospital cannot be sure it can keep Yeong-hye alive, he says, transfer is necessary. His account makes the duty both a professional commitment and a limit: the staff act to preserve life, yet acknowledge uncertainty about the illness and the effectiveness of their measures.

The Patient’s Wishes and Institutional Care

The principle operates within a tightly managed hospital environment. When Yeong-hye is admitted to a six-person ward, staff check her belongings and remove a thick woolen belt, then lead her through a locked door. The procedures establish the hospital’s attention to safety, but they also define the space in which her care takes place: access and movement are controlled, and her sister experiences the barred window as a source of guilt. Before she stops speaking, Yeong-hye tells In-hye that people insist she eat, that she dislikes eating, and that she is forced; she also objects to injections and asks to be released. In-hye answers that her sister can barely walk and is being kept going by an IV, then offers discharge if Yeong-hye promises to eat. Yeong-hye turns away and says that In-hye is just the same. The exchange exposes a conflict within care itself: In-hye is trying to protect her sister, but the condition she sets reproduces the demand that Yeong-hye submit to eating.

Compulsory Feeding and Its Consequences

As Yeong-hye’s condition worsens, the doctor and hospital staff attempt to feed her through a tube. The procedure requires several staff members to restrain her; Yeong-hye resists, and the initial attempt fails. When the tube is eventually inserted and feeding begins, she suffers gastric bleeding. In-hye breaks away from the staff and demands that they remove it. The attempt to sustain Yeong-hye thus becomes a crisis in which medical action intended to preserve life also precipitates an immediate medical emergency. The doctor then says Yeong-hye must be transferred to a main hospital in Seoul for treatment to stop the bleeding, warning that the effect will not last long but that it is the only option if they want to keep her alive. The duty to preserve life continues to direct the response, now through urgent transfer after the feeding procedure has gone badly. In-hye leaves with the admission letter and collapses in a bathroom, where she vomits. The episode leaves the principle unresolved: it explains why the doctors intervene, but does not erase the conflict between survival, coercive treatment, and Yeong-hye’s stated refusal.