Advance Medical Directive

Advance Medical Directive 2018-01-30T16:37:05+00:00
  • An advance medical directive (AMD) is a legal document instructing doctors that a patient does not want artificial life support should he become terminally ill
  • The AMD Act defines a terminal illness as:
    • An incurable condition caused by injury or disease
    • No reasonable prospect of temporary or permanent recovery
    • Death would be imminent regardless of the use of extraordinary life-sustaining treatment
    • Life support would only serve to postpone the moment of death
  • Certification of terminal illness
    • At least three doctors, one of whom is the patient’s regular hospital doctor
    • At least two of the three doctors must be specialists
    • Decision must be unanimous
    • If decision cannot be made, a panel of three doctors appointed by MOH will make the determination
    • None of the doctors certifying terminal illness may be a beneficiary of the patient’s estate
  • Life-sustaining treatment is defined as any medical procedure or measure which will only prolong the dying process. It does not apply to palliative care.
  • Palliative care is the provision of reasonable medical measures for the aim of relieving suffering, and reasonable provision of food and water
  • Making an AMD
    • Requirements
      • At least 21 years of age
      • Must be of sound mind
      • Two witnesses, at least one of whom must be a medical practitioner
      • Both witnesses must be at least 21 years of age
      • Medical practitioner must ensure that the patient is
        • Not mentally disordered
        • At least 21 years of age
        • Has made the AMD voluntarily and without being coerced
        • Understands the implications of the AMD
    • Obtain an AMD form and submit it to the registry of Advance Medical Directives
  • AMDs may be revoked at any time in the presence of one witness, either orally or in writing
  • Family members are legally not allowed to intervene and overrule an AMD
  • AMD is not euthanasia, which is the deliberate ending of life of a suffering person by unnatural means. The AMD merely prevents a doctor from prolonging life artificially where there is no hope of recovery.

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