Is an Advance Medical Directive (AMD) Right for You?

Imagine this: you’re in a situation where you can’t speak for yourself due to a serious illness or injury. Who would make your medical decisions? How can you ensure your healthcare treatments align with your wishes? This is where an Advance Medical Directive (AMD) provides clarity.

What is an AMD?

An AMD is a legal document that allows you to outline your preferences for medical treatment should you become terminally ill and unconscious, specifying that you do not want any extraordinary life-sustaining treatment to prolong your life. This can include decisions about life-sustaining treatments, resuscitation efforts, and other healthcare interventions.

In modern healthcare, planning for future medical situations is crucial to comprehensive care. This helps prevent unwanted medical interventions and aligns your treatment with your values and wishes.

The benefits of having an AMD

Let’s explore how an AMD can benefit you and your loved ones.

Guaranteeing your medical preferences are respected

One of the primary benefits of an AMD is that it guarantees that your medical preferences are known and respected.

This document states your wishes regarding treatments like ventilators or feeding tubes. By documenting these preferences, you remove any guesswork for healthcare providers, who will then follow your instructions with confidence.

For you, this means having control over your healthcare decisions. For your loved ones, it means they won’t have to make difficult decisions on your behalf. Instead, they can find comfort in knowing they are supporting your clearly stated wishes.

The impact on your family’s emotional well-being

Having an AMD reduces the emotional pressure on your family during difficult times. When your medical preferences are clearly stated, your loved ones don’t have to guess what you might want, or make tough decisions during a crisis. This clear guidance can prevent disagreements and bring stress levels down, allowing your family to focus on being there for you emotionally instead of being weighed down by the decision-making process.

Helping medical staff make informed decisions

Without an AMD, doctors and nurses might have to make critical treatment choices without knowing your preferences, which could lead to actions that don’t reflect your values. With an AMD, healthcare providers have a clear roadmap of your treatment preferences, ensuring that the care you receive matches your intentions. This supports a patient-centred approach in healthcare and enhances the efficiency and effectiveness of medical care, as providers can act quickly and confidently, knowing they are following your directives.

Should you sign an AMD?

Putting an AMD in place is a voluntary decision that is entirely up to you. More importantly, it is a criminal offence for anyone to force you to create an AMD against your will.

Before signing an AMD, here are several factors for you to consider:

  • Personal values and beliefs: Reflect on your values and beliefs about medical care and end-of-life treatment.
  • Medical history: Consider your current health status and any chronic conditions you may have.
  • Family dynamics: Think about how your family might respond to your wishes and involve them in the discussion if appropriate.
  • Legal advice: Consult with a legal professional to ensure your AMD is correctly drafted and legally binding.

How do I make an AMD?

To make an AMD, you need to meet a few requirements: you must be at least 21 years old and have the mental capacity to make informed healthcare decisions. Simply follow these steps:

Step 1: Obtain an AMD Form

You can get the AMD form from medical clinics, polyclinics, and hospitals. Ask your doctor for the form if you’ve decided to put an AMD in place. Alternatively, you can download the AMD form online (ensure to print both sides on a single sheet of paper, front and back).

Step 2: Consult a doctor with a witness present

You must create the AMD through a doctor (no lawyer or legal advice is needed). The doctor will ensure that:

  • You are making the AMD voluntarily
  • You are mentally competent
  • You fully understand the nature and implications of creating an AMD

You will need two people to witness your signing of the AMD, and they must sign the form in your presence. One witness must be the doctor, and the other must be at least 21 years old. The second witness can be the doctor’s nurse or another suitable person. Relatives can act as witnesses as long as they have no vested interest in your demise.

If a doctor objects to the AMD and registers their objection with the Registrar, they have the right to refuse to witness the signing. In this case, you can approach another doctor.

Step 3: Return the form to the registrar of AMDs

Send the completed form in a sealed envelope by mail or by hand to the Registrar of Advance Medical Directives at:

Ministry of Health, Singapore

College of Medicine Building

16 College Road

Singapore 169854

Your AMD becomes valid only after it is registered with the Registrar of Advance Medical Directives. You will receive an acknowledgment once the directive has been registered.

Is it free?

You must consult a doctor who will act as a witness and is required to explain the AMD to you thoroughly. While the AMD form itself is free, you may need to pay the doctor for their time and the services they provide during this consultation.

Read more: Making a Will: What Is It, Why Is It Important, and What Happens When You Die

FAQs on AMDs

How does the hospital know I have an AMD?

Hospital staff, including doctors and nurses, do not automatically know who has made an AMD, as this information is confidential. They are also not allowed to ask you directly. However, if your attending doctor believes that you are terminally ill and unable to communicate your wishes, they can check with the Registrar of Advance Medical Directives to see if you have an AMD on file.

Can I revoke my AMD once it’s made?

You can revoke an AMD at any time in the presence of at least one witness. To do this, complete AMD Form 3, which is the standard form for revocation. If you have made an AMD, you will receive Form 3 along with Form 2, which confirms that your AMD has been registered by the Registry of AMDs.

What if I’m unable to write?

You can revoke the AMD orally or through any other method of communication. The responsibility then falls to the witness of the revocation to submit the notice using Form 3 or a letter. The witness must also explain why you could not submit the revocation notice yourself.

Creating an AMD is a proactive measure to ensure your healthcare preferences are respected and followed during critical times when you cannot communicate your wishes. By understanding the benefits, considering the necessary steps, and addressing common questions, you can make an informed decision about whether an AMD is right for you.

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