Services
Three Instruments of Peace Service - Advance Medical Directive (AMD)
Advance Medical Directive - Mental Capacity Assessment
An Advance Medical Directive (AMD) is an important legal document that allows you, while you still possess the mental capacity, to clearly express your personal wishes in advance regarding end-of-life care and life-sustaining treatment.
In the unfortunate event that you later suffer from a terminal illness, are in a persistent vegetative state, enter an irreversible coma, or suffer from any other end-stage, irreversible, and life-limiting illness, doctors and your family can make medical decisions in accordance with your advance directives. This helps relieve your family from a heavy emotional burden and difficult choices.
Our doctors will explain in detail the practical implications of various life-sustaining treatments, including:
- Cardiopulmonary resuscitation (CPR)
- Mechanical ventilation (artificial respirator)
- Artificial nutrition and hydration
- Other forms of life-sustaining treatment
The doctor will conduct a one-on-one mental capacity assessment to ensure that you, while possessing the mental capacity, clearly understand the nature and consequences of these treatments, and make decisions regarding the administration of various life-sustaining treatments upon signing this directive.
According to the law Advance Decisions on Life-Sustaining Treatment Ordinance, two witnesses are required when making an Advance Medical Directive, one of whom must be a registered medical practitioner. The second witness must be a non-interested party (e.g., not a beneficiary of your will or insurance). If you are unable to arrange a second witness, our Hospital can appoint a qualified healthcare professional from our team to serve as the second witness in accordance with legal requirements. For more details, please consult our doctor.
Fee: HK$4,000
(*Excludes outpatient consultation fees)
Reference Form:
Model Forms of Advance Medical Directive
Assessment Date:
Available upon request. Please make an appointment with our hospital in advance.
Relevant Services of Three Instrument of Peace:
Last Will and Testament - Mental Capacity Assessment
Enduring Power of Attorney - Mental Capacity Assessment
Enqiries & Appointments
Tel: 2711 5222
Frequently Asked Questions
No. An Advance Medical Directive is not euthanasia. Instead, it allows you, while you still possess mental capacity, to state your wishes in advance to refuse certain life-sustaining treatments. It only takes effect under specific conditions, including when you suffer from a terminal illness, are in a persistent vegetative state, enter an irreversible coma, or suffer from any other advanced, irreversible, and life-limiting illness. The purpose is to respect your wishes and avoid receiving excessive or unnecessary life-sustaining treatments.
No. An Advance Medical Directive does not allow you to refuse life-saving treatment in all situations. It only applies to the following three specified serious conditions:
-
Being terminally ill (i.e. the patient suffers from an advanced, progressive and irreversible medical condition with a short life expectancy in terms of days, weeks or months, where any form of LST would only serve to postpone the person’s death);
- Being in a persistent vegetative state and state of irreversible coma; or
- Being in other end-stage, irreversible, life-limiting condition (distinct from the above two categories, specifying the medical condition of the patient is progressive and irreversible and has reached its end-stage and limits the survival of the person), for example, a patient with end-stage renal failure, end-stage motor neuron disease, or end-stage chronic obstructive pulmonary disease. Where these patients may receive dialysis treatment or assisted ventilation to prolong life, such conditions are not categorised as the first category.
[Note: Patients suffering from end-stage dementia will be categorised as the third category.]
Our medical team will carefully assess the patient’s actual condition at the time. Life-sustaining treatment will only be withheld or withdrawn in accordance with your Advance Medical Directive if one of the above three conditions is confirmed. This respects your wishes while ensuring medical decisions are safe and appropriate.
Although both relate to refusing resuscitation, there are important differences:
| Item | Advanced Medical Directive（AMD） | Do Not Resuscitate（DNR） |
| Who Makes it | Made in advance by a mentally competent adult | Issued by two registered doctors (one must be a specialist) as a clinical decision |
| Scope | Can refuse multiple life-sustaining treatments (including CPR, mechanical ventilation, artificial nutrition, etc.) | Mainly refuses cardiopulmonary resuscitation (CPR) only |
| Activation Condition | Only applies in specified terminal or irreversible conditions as defined by law | Can be applied in any current medical situation (decided by doctors, patient, or family) |
| Legal Nature | Legal document that must be signed personally while the individual still possess the mental capacity | Clinical medical instruction that can be decided by doctors, patient, and their family |
| Stage of Application | Mainly for future planning in anticipation of terminal conditions | Mostly used during current hospitalization |
| Validity Period | Remains valid until revoked by the person |
Maximum 12 months, requires renewal |
In short, an Advance Medical Directive is a long-term, comprehensive expression of your wishes made while you have the mental capacity, for potential future end-of-life scenarios. A DNR order is usually a more immediate clinical decision made during current medical treatment.
Our doctors will explain the differences in detail and help you choose the arrangement most suitable for your situation.
According to the legislation, when making an Advance Medical Directive, it must be ensured that you possess the requisite mental capacity and are making the decision with full understanding. A professional assessment and certificate provided by a doctor effectively prove that you had the mental capacity at that specific time, significantly strengthening the legal validity of the document and minimizing the risk of it being challenged in the future.
Yes. As long as you still possess the mental capacity, you can amend or revoke your existing Advance Medical Directive at any time. Our doctors can assist you with the reassessment and updating of the document.
We offer a one-stop service: You only need to make one appointment. Our doctor will explain the various treatments in detail, conduct a mental capacity assessment, and can act as a witness to sign the document on the same day. The entire process is conducted in a private and comfortable environment. Our doctors will assist you with patience and professionalism to complete your Advance Medical Directive.