Monday, September 3, 2007

Making your Advanced Medical Directive

I wanted to make an Advanced Medical Directive. It will have to do since it is the closest I can get to euthanasia which is not allowed in Singapore.

In the unfortunate event that I become incapable of making my express wishes known, I would not want my life to be prolonged needlessly. The contrary would only waste money and sap energy from my loved ones. It also takes up valuable hospital resources that might better serve those who have more hope. When it is time to go, I rather do so with dignity and be cool about the whole affair.

From http://www.moh.gov.sg/mohcorp/legislations.aspx?id=7120 , "an Advanced Medical Directive (AMD) is a legal document that you sign in advance to inform the doctor treating you (in the event you become terminally ill and unconscious) that you do not want any extraordinary life-sustaining treatment to be used to prolong your life." Extraordinary life-sustaining treatment is any medical treatment which serves only to prolong the process of dying for terminally ill patients but does not cure the illness. An example is the respirator that is connected to a patient to assist him/her to breathe. It serves only to artificially prolong the life of a terminally ill patient.

The AMD Act was passed in the Singapore Parliament in May 1996.

I hopped over to the forms section and downloaded the AMD form (link opens to pdf file). I had thought that once I find two witnesses, I am done with this instruction of my mortal body. It was a good thing that I read through the form before arranging for the witnesses. From the form and the FAQs (go to http://www.pqms.moh.gov.sg/apps/fcd_faqmain.aspx and type in "AMD"), it seems that one of the two witnesses must be a doctor. I understand the rationale behind this but it seems an inconvenience nevertheless. How many people have friends who are doctors? In fact, even if you have a friend who is a doctor, I suspect that the witnessing is only valid if he does so in his professional capacity.

Then I began to wonder.

Why do people even want to make an AMD? I would count the AMD as one of the more important "medical decisions" of one's life. People make AMDs because they have certain motivations, certainly not for fun. For dignity like I mentioned? To prevent loved ones from wasting time and resources? Embarrassingly, I can't think of other possible motivations.

Yet if it is because of saving money that one makes an AMD, isn't it ironic that he first has to spend money to visit a doctor? Like I said, I can appreciate the need of having a doctor as a witness. He can explain to you the AMD and make sure that you really understand what you thought you understood. But if money was the crux in the first place, would paying to see a doctor for the signing put one off? After all, the AMD form itself is free.

With our current health minister giving his portfolio a vibrant shake, I feel that more can be done here. The AMD act has been in existence for more than a decade but how many people had exercised their rights? I would suggest that the government steps in to make the making of an AMD completely free.

I want to say that all doctors should have the goodness in their hearts to volunteer (= do free) as witnesses for the AMD signing. But you know, I know, we know; so we won't say more. Instead of this suggestion, perhaps the government can compensate those doctors who help with the witnessing. Say, every time someone approaches a doctor to be witness for AMD making, that doctor will be given a token $20.

Even if the entire nation becomes "AMD-certified", the cost is still hardly crippling. Would the nice government think about it? Cheers. :D


The Hunger Site The Child Health Site The Breast Cancer Site The Animal Rescue Site

0 comments: