Comprehensive Korean Medicine Treatment as Palliative Care and Limitations of DNR Implementation in a Patient with Terminal Hepatocellular Carcinoma: A Case Report

Objectives: This study reports the effects of comprehensive Korean medicine treatment as palliative care in a patient with terminal hepatocellular carcinoma (HCC) and discusses the practical challenges of implementing do-not-resuscitate (DNR) orders in a Korean medicine hospital.Methods: A 61-year-old man with stage IV HCC who discontinued immunotherapy received comprehensive Korean medicine treatment, comprising <i>Saenggangeonbi-tang-gami, Gunchil-dan</i>, and acupuncture, for palliative symptom management from July 14 to August 22, 2025.Results: Korean medicine treatment was associated with symptom control during the terminal phase. Acute hepatotoxicity was not observed, suggesting an acceptable safety profile. However, the independent contribution of Korean medicine treatment could not be determined because of the concurrent use of conventional medications and the difficulty in distinguishing treatment effects from the natural course of terminal malignancy.Conclusion: Comprehensive Korean medicine treatment may be considered a component of palliative care in patients with terminal HCC. However, further institutional development and systematic end-of-life care guidelines are required to ensure appropriate DNR implementation in Korean medicine hospitals.