What is Advanced Medical Directive?
Advanced Medical Directive (AMD) is a legal document that a patient signs to inform the doctor that in the event that he becomes terminally ill or unconscious, he do not want any extraordinary life sustaining treatment to be used to prolong his life.
In short, AMD is a legal document to reinforce the patient right to no treatment.
For example if a patient suffers brain cancer (Glioblastoma), and has gone through rigorous chemotherapy treatment and medication, but at the end, subjected to further end of life due to the cancerous cell spreading throughout the body.
In this situation, before the patient becomes unconscious, the patient may sign a AMD to gives consent to the hospital or doctor to carry out the last wishes of the patient, which to end the life-sustaining treatment.
Scenario 1
Scenario one applies to a case where the patient (mother) sustained liver cancer and had undergone chemotherapy. The son who always accompanied the mother for chemotherapy session agrees with the mother’s decision to stop chemotherapy, and if the mother turns unconscious, would like the hospital or doctor to turn off the mother oxygen supporting system.
The father disagree, and wanted to continue with the oxygen supporting system.
In this situation, if the patient has signed a AMD, the doctor will carry out the patient’s instruction as per the AMD.
The son and father will have to respect the last wishes of the unconscious patient.
This prevents from arguments from both the father and son, where one wants to continue the treatment and the other wants to end the treatment.
With AMD, family follows what the unconscious patient’s decision, and there will be a direction issued under the AMD to resolve the family dispute.
Who should set up AMD?
Everyone above the age of 18 years old should set up a AMD. You will never know when you will become unconscious. Somehow you can get involved with a car accident, and you turn vegetative. In this situation, with the AMD, the doctor can end the life sustaining system for you.
A lot of situation, the hospital or family members have no choice but to continue with the life sustaining system knowing that it brings no benefit to the patient but merely preserving the vegetative state of the patient.
With AMD, the unconscious patient can even choose to donate his organs to the state.
What is the criteria to make an AMD?
* ### 18 years old and above
* ### need to have 2 witnesses
* ### not mentally disordered
* ### the Doctor has to certify that you are of sound mind when sign the AMDDoes an AMD needs to be registered with any Governmental Body?
So far, Malaysia has yet to come out with any regulation or governmental act to govern AMD. However the following code should be referred:
* ### Clause 5 of Section II of the Code of Medical Ethics of the Malaysian Medical Association, which states that "in the case of a dying patient, one should always take into consideration any advance directives and the wishes of the family"
* ### Clause 18 of Consent for Treatment of Patients by Registered Medical Practitioners which issued by Malaysian Medical Council also mentioned about "Advance Care Directives", which states that "**_a medical practitioner should refrain from providing treatment or performing any procedure where there is an unequivocal written directive by the patient_ _ _**The above article is for general information only and does not constitute legal advice. For advice on your specific circumstances, speak to us.
