South Korea's top court on Thursday authorised doctors to stop life-sustaining treatment for a comatose woman, approving a request for euthanasia for the first time in the country.
The supreme court, upholding a lower court decision, supported a request by the family of the 76-year-old that she be allowed to die with dignity.
Under current law the removal of a respirator from brain-dead patients is regarded as murder. But the family said that extending life using medical devices would prolong the woman's "painful and meaningless" existence.
The woman was declared brain dead in February last year after she sustained cerebral damage and fell into a coma while undergoing a lung examination at the Severance Hospital in Seoul.
Three months later her children filed a court petition after the hospital rejected their request that she be allowed to die in peace and with dignity.
A court last November approved their request for removal of a life support system, saying she had no chance of recovery and her wish to die could be inferred.
An appeal court upheld that decision in February but the hospital took the case to the top court.
The supreme court said the termination of life-sustaining treatments requires "careful judgement."
However, it said, treatment can be stopped by making a presumption about the wish of the patient. Maintaining a brain-dead state damaged "human dignity" when there was no chance of recovery.
"If it is obvious that the patient will die soon... we can conclude that she or he has already entered a phase of death," the court said.
"In this case, we must respect the patient's will because forced life-sustaining treatment may damage human dignity."
In the current case, it said, the woman had told her family she did not want to be kept alive artificially if any problem arose with her hospital treatment.
Local religious communities have been split on the subject of euthanasia. Activists have warned against abuse of the ruling.
The Korea Medical Association said it would draw up new guidelines for doctors on the subject.
The supreme court "acknowledged the patient's right to make a decision on meaningless life-sustaining treatment," spokesman Choa Hun-Jong told reporters.
But he said such situations should be allowed only when a patient has no chance of recovery.
In 2007 a father was given a four-year suspended jail term for the removal of a respirator from his brain-dead son.