Tuesday, October 31, 2006

Advance Medical Directive (AMD)

The Advance Medical Directive (called a living will in the US) was passed a decade ago, but there are only 4000 Singaporeans who have signed an AMD. A third of them did so only after the high-profile case of Teri Schiavo, the American whose feeding tube was removed after being in a vegetative state for 15 years.

The Act allows adults to refuse extraordinary life-sustaining treatment for a terminal illness.

The low sign up rate worries Health Minister Khaw Boon Wan. "You know something is not quite right. You should be having hundreds of thousands of people signing on." Although he acknowledged that it may be a sensitive, emotive and personal issue, he intends to start a national conversation on end-of-life care and how people choose to be treated in their final stages.

Due to Asian cultural attitudes, Singapore society is not ready for it. There is not enough public awareness, and even if there is, people would not want to sign up either. Some people are worried that they might not be given a chance to live. Technology is so advanced that it can postpone death for many days and many weeks.

Athough personally I feel there isn't going to be any quality of life to the patient then. And there is the physical pain. The high medical costs. The biggest cost of medical care is in the last days.

The document to apply for an AMD can be downloaded from the MOH website, but it is not so easy to get it signed. You need to find two doctors as witnesses.

Chris & I had in our early twenties signed directives to donate all our organs after our deaths. We will sign the AMD, when the process is made simpler & easier. The decision to stop life-saving procedures should not be left to the family members, I should decide when I'm still in control of my faculties.


  1. Hi, I thank you for your comment on my pumpkin art posting. I have had some family business to take care of these past several days that is why my posting has been late I try to write a post at least once each week. I must say your blog site is looking good and I enjoy reading your posts. Keep up the great writing and have a Happy Halloween and take care. Bill

  2. hey thanks for sharing about the AMD, my hb and I had this chat since before we got married about not pro-longing our lives should we be in a state of coma due to terminal illness and can't be conscious to make our own decision... signing an AMD is sure a good way to cut short the pain...