What if you were stuck with an incurable disease and had to undergo treatment or surgery? What if it fails? And you are left brain dead? Most countries have what is called a Living Will to handle the situations mentioned earlier. Singapore, on the other hand, has the Advance Medical Directive. We will be discussing what an Advance Medical Directive is about. Who is the Advance Medical Directive for? Why do people make an Advance Medical Directive? And how can you make an Advance Medical Directive?
What is the Advance Medical Directive About?
An advance medical directive is a legal document. This legal document gives your doctor your wish or instruction in case you become terminally ill, bedridden and unable to make decisions for yourself. Despite Singapore’s healthcare scenarios like the ones mentioned above cannot be avoided. And when faced with a situation like the one mentioned having an Advance Medical Directive can help voice out your will. Take a look at the example below to get the idea of what an Advance Medical Directive is about.
Patient A suffers from stage four breast cancer. She undergoes a treatment, but her body is not responding to the medications. A year before her illness made a turn for the worst. She decided on her own to make an Advance Medical Directive. An Advance Medical Directive is a document containing her wishes if ever her body becomes unresponsive to treatment. It states there that she does not want to be subjected to any extraordinary life-prolonging treatment or device. Back to the first scene, Patient A’s body is unresponsive to chemotherapy, and her doctor tells her family that she only has 6 months left. Though there may be a treatment that can prolong her life a little, turn 6 months into a year, Patient A’s doctor follows her wishes in the Advance Medical Directive and discharges her. Patient A dies peacefully in her home surrounded by her family.
Singapore’s healthcare care is ever evolving, and doctors around the world are testing many treatments. Terminal diseases like cancer, leukemia, AIDS (Acquired Immune Deficiency Syndrome), and many others are currently being researched. Scientists and physicians are constantly looking for possible cures and treatments to help people around the world who are suffering.
Why do People Make An Advance Medical Directive?
There are two reasons why people chose to make an Advance Medical Directive:
- for Financial Reasons
- To end suffering and die a natural death
For Financial Reasons
Health insurance in Singapore provides quality care to citizens, and medical insurance helps most people pay for medical expenses. But, there are cases where even the best medical insurance offered by Singapore, cannot save you from the heavy load of hospital bills you have to pay. Medical bills are expensive, especially if you have a terminal illness. For people with incurable diseases, they prefer to end the treatment and save their families the burden of paying for expensive treatments that won’t save their lives.
It’s simple if you place yourself in the patient’s shoes, you are dying and have no hope of getting better. Do you want to die leaving your family in deep debt, just because of a so-called new treatment that “could” prolong your life? So, you make an Advance Medical Directive while you are still able to prevent this, scenario of large debt, from happening.
To End Suffering and Die a Natural Death
People with cancer, leukaemia and other terminal illness experience tremendous pain. And when their conditions become worse and hopeless, they will prefer to just stop treatment altogether. A person in a coma or a person who is bedridden due to cancer or leukaemia would prefer short suffering. Prolonging their lives even though you know that they won’t be cured, is basically the same as extending their torture. You, as the person feeling and going through this pain, may want to end it early but you can’t speak or voice out your wishes. Making an Advance Medical Directive before you lose the ability to communicate is your medium of getting your wishes across to your loved ones. This way you will not submit them to making the decision of opting for “mercy killing” just to end your suffering.
With your Advance Medical Directive, you can spend your last days at home, surrounded by your family and friends, dying a natural death with dignity.
Requirements for Filing an AMD:
- You Must be at least 21 years old
- Do not have Mental Disorders
- Must have (2) Two Witnesses (For more information, see ‘Your Witnesses’ below)
How to Apply for AMD?
Step #1: Have an AMD FORM
Getting an AMD Form is easy, you can get one from Hospitals, Polyclinics and Medical Clinics. You can also get one directly from your Doctor, or you can get your AMD Form Online.
In printing the AMD Form, make sure you print the form in a single sheet—both sides of a single sheet should be printed.
Step #2: Ask for a Doctor’s Advice and Have Witnesses
Asking for Your Doctor’s Advice
You cannot file for an AMD without asking your doctor’s advice or any doctor’s advice. Your doctor can be your first witness, and it’s the doctor’s responsibility to make sure that:
You’re not forced into filing for the AMD
Your state of mind is stable upon making the AMD
You fully understand that nature of making the AMD
It is required to have at least (1) One Doctor as your witness. It is more prefered if you have your family doctor as your witness. If your doctor refuses to become a witness, you can opt to ask for other doctor’s sign.
The other witness must be at least 21 years old. It can be your doctor’s nurse or any other person. But if one of your witnesses is your relative, you should make sure that he/she has no interests with your death.
In pre-filling your details in Form, your (2) two witnesses must be present.
Step #3: Submission of the AMD Form to the Registrar
After you completely fill the form out, the AMD Form should be submitted to the Registrar of Advance Medical Directives either by mail or by hand at:
Note: Faxed Copies are not accepted.
The AMD is not registered until it is submitted to the Registry of Advance Medical Directives. The Registrar will then inform you, the AMD Maker, that your file is already registered.
The AMD Form is free. However, the consultation with the doctor as well as being a witness depends on your doctor.
For Filing Overseas
If you plan on filing the AMD Overseas, you must make sure your doctor must be registered on the (SMC) Singapore Medical Council. You will also have your AMD filed in the Registry in Singapore, in order for your file to be valid.
Singapore’s Advance Medical Directive allows you to voice out your wishes in the face of an incurable disease. It provides a way for you to make a decision for yourself for your family’s welfare as well as your own. This simple document is a way for you to tell your family what you have to say and what you wish for yourself and for them.