THE ADVANCE DECISION ON LIFE-SUSTAINING TREATMENT ORDINANCE

April 2025

The long-awaited Advance Decision on Life-Sustaining Treatment Ordinance (“the Ordinance”) was passed and gazetted on 24 November 2024. Under the Ordinance, the Advance Medical Directive (“AMD”) is now formally governed by statue, so the patients’ decisions are respected to direct whether life-sustaining treatments are to be withheld in case of emergency within the legal framework.

The AMD is a document to allow individuals to direct that life-sustaining treatments be withheld under certain specified conditions if they become mentally incapable of making the decisions in future. Any adult can sign the AMD in the presence of two witnesses, one of whom must be a registered medical practitioner. As a safeguard to the AMD maker, the witnesses must have no interest in the maker’s estate to avoid any conflict of interest. The medical practitioner has to certify that the maker of the AMD is mentally sound in signing the instrument. The AMD may be conveniently revoked by the maker even by verbal revocation in the presence of one or more witnesses or by written revocation or by destruction of the AMD.

Apart from the AMD, the Ordinance also provides the “Do Not Attempt Cardiopulmonary Resuscitation Order” (“DNACPR”). This order provides direction that no cardiopulmonary resuscitation can be performed to a person suffering cardiac arrest. The DNACPR must be made in writing by a statutory form and issued by two registered medical practitioners with one being a specialist and it is also revocable at will.

The Ordinance is a good way forward to the terminal autonomy of an individual and the AMD and DNACPR may become part of estate planning in addition to the will, trust arrangement and enduring power of attorney.