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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