In Asian society, it is inauspicious to talk about illness and death.
However, illness and death is inevitable for everyone; and it would be wise to plan ahead for it.
While modern medical technology can prolong life in the final stages of a terminal illness when there is little or no chance of recovery, not everyone would want to continue treatment.
Terminal illness is defined as an incurable condition caused by injury or disease from which there is no reasonable prospect of a temporary or permanent recovery. For such a condition, death would be imminent regardless of the application of extraordinary life-sustaining measures. The extraordinary life-sustaining measures would only serve to postpone the moment of death of the patient.
In situations where further medical treatment would be futile, a decision has to be made for the withdrawal of such treatment. Some terminally ill patients who are unable to express their wishes at that time (due to being unconscious, or unable to communicate), may want to be spared further suffering and be allowed to die naturally, in peace and with dignity.
The AMD Act was passed in Parliament in May 1996. The law in Singapore allows Singaporeans who wish to make an Advance Medical Directive (AMD) to do so. Anyone who is 21 years old and above, and who is not mentally disordered can make an AMD.
What is an Advance Medical Directive?
An Advance Medical Directive is a legal document that you sign in advance to inform the doctor treating you (in the event you become terminally ill and unconscious) that you do not want any extraordinary life-sustaining treatment to be used to prolong your life.
To make an AMD is a voluntary decision. It is entirely up to you whether you wish to make one. In fact, it is a criminal offence for any person to force you to make one against your will.
To make an AMD, you will have to consult a doctor who, as a witness, is required to explain the AMD to you. You may have to pay the doctor for the services rendered. However, the AMD form itself is free.
Hospital staff, including doctors and nurses, do not know who has made an AMD as it is confidential and they are NOT allowed to ask you if you have made an AMD.
However, if your attending doctor has reasons to believe that you are terminally ill and unable to make your wishes known to him, he can check with the Registrar of Advance Medical Directives on whether you have made an AMD.
When will an AMD be enforced?
The AMD will only come into force once you have been determined to have a terminal illness and a Certificate of Terminal illness has been issued.
Three doctors, including the patient’s hospital doctor, must unanimously certify a patient’s terminal illness. Two of the doctors must be specialists.
If the first panel of three doctors cannot agree unanimously that the patient is terminally ill, the doctor-in-charge will review his diagnosis. If he is still of the opinion that the patient is terminally ill, the matter will be referred to a second panel of three specialists, to be appointed by the Ministry of Health.
If the second panel of doctors also cannot agree unanimously that the patient is terminally ill, the AMD cannot take effect. The patient’s life will continue to be sustained and he will receive medical treatment as normal.
Can I revoke my AMD?
An AMD can be revoked at any time in the presence of at least one witness. You should do so by completing AMD Form 3, which is the standard form for revocation of an AMD. (Those who have made an AMD will receive Form 3 together with Form 2, which confirms that their AMD has been registered by the Registry of AMDs)
Alternatively, you or your witness could write a simple letter to the Registrar of AMDs.
Conclusion
Many people plan for life, but few plan for death because most people assume they can make the decision when their time comes. However this may not always be the case. Therefore, having an AMD is important.
It is also advisable to discuss with your family members and loved ones when registering an AMD. This will help them to understand and respect your wishes should you become terminally ill.
If you want help on insurance, savings and investments, or retirement planning, book an appointment with our financial advisors. Fill in this form, and we will get back to you within a day or two.
