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SINGAPORE \u2013 Over the past three decades, more than 84,500 individuals have signed an advance medical directive (AMD). <\/p>\n
This is a legal document allowing individuals to refuse extraordinary life-sustaining treatment if terminally ill and unconscious. <\/p>\n
Nominated MP Kuah Boon Theng, a medical law and ethics lawyer, asked in Parliament on April 7 if the Ministry of Health (MOH) can remove the requirement for a doctor to be present at the signing of AMDs.<\/p>\n
Currently, when one signs an AMD, two witnesses are required to be present and also sign the directive. One of the witnesses has to be a doctor, and the other has to be at least 21 years old, among other criteria. <\/p>\n
Minister of State for Health Rahayu Mahzam said in response that the decision to sign an AMD has to be taken seriously as it states that the individual does not want to use any treatments to prolong their life if they become terminally ill, unconscious or require life-sustaining treatment.<\/p>\n
\u201cHence, safeguards are in place to protect the interests of individuals. For example, a witnessing doctor ensures that the individual understands the medical implications of making an AMD, is not being coerced, and is of sound mind,\u201d added Ms Rahayu.<\/p>\n
In response, Ms Kuah said lawyers can also make the same assessment of the individual and provide the same advice on implications of the AMD.<\/p>\n
She added that an advantage of doing away with the requirement is that individuals can benefit from a \u201cone-stop shop\u201d \u2013 being able to sign both an AMD and the lasting power of attorney (LPA) at the same time with a lawyer present.<\/p>\n
Ms Kuah noted that the take-up rate for AMDs has been \u201cquite slow\u201d compared with that of LPAs, which appoint one or more trusted persons to make decisions on an individual\u2019s personal matters including welfare, property and finances, if that individual loses mental capacity. <\/p>\n