Individuals who are 18 years of age or older, mentally competent, and informed may make an 'Advance Medical Directive'. This document clearly specifies which life-sustaining treatments they wish to refuse under specific circumstances when they reach the end of life and are no longer able to make their own decisions. A valid and applicable 'Advance Medical Directive' is legally binding. It is absolutely not euthanasia.
Medical professionals shall implement the directive based on the patient's health status if any of the following three specific clinical conditions are met:
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Terminal illness with a life expectancy of only a few months or less;
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Persistent vegetative state or irreversible coma;
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Other advanced, irreversible, and life-limiting diseases.
- Advance Care Planning (ACP) During the initial meeting, doctor will explain and discuss an Advance Care Planning (ACP) that aligns with the individual's preferences with both the declarant and their family, addressing any concerns. This session typically lasts 30–45 minutes. After the meeting, the declarant should discuss the options with other family members and carefully consider their decision before deciding whether to proceed with a second meeting for formal signing.
- Signing the Advance Medical Directive (AMD) During the second meeting, the doctor will assess the declarant's mental capacity to ensure they are fit to sign the Advance Medical Directive (AMD) and fully understand the content and their choices. The doctor serves as the First Witness. Once the Second Witness has also signed, the procedure is complete.
- The original Advance Medical Directive (AMD) should be kept safely by the declarant and their family. When ambulance personnel arrive, the declarant or family members must present the original document to the healthcare team to ensure the instructions are implemented where applicable. It is recommended to store the signed AMD alongside other emergency documents (such as medical records and follow-up slips) in a prominent and easily accessible location at home.
- The declarant may change or cancel their Advance Medical Directive (AMD) at any time based on their personal decision. The principle is: "CAUTIOUS IN, EASY OUT."
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| Cardiopulmonary Resuscitation(CPR) | Artificial Ventilation |
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| Blood Products | Pacemakers |
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Vasopressors (i.e.：Cardiac stimulants) |
Antibiotics |
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| Specialised treatments for particular conditions |
Artificial nutrition and hydration (i.e. the feeding of food and water to a person through a tube) |
Protecting the Declarant's Autonomy
- Decisions are rooted in the declarant's best interests, allowing them to refuse invasive treatments and choose specific Life-Sustaining Treatments (LST).Ensures that the individual maintains their dignity and quality of life during their final stages.
Relieving the Family's Decision-Making Burden
- Family members no longer need to argue over whether to "save or not save" the patient.By simply following the declarant's signed instructions, families can avoid the guilt and emotional conflict often associated with end-of-life decisions.
Providing Legal Basis for Treatment providers
- The medical team implements the instructions according to the law, which significantly reduces the risk of disputes.It provides clear professional guidelines and protects healthcare workers from legal liability when honoring a valid directive.