Hong Kong legislation on advance medical directives will provide clarity and reassurance
- A comprehensive publicity drive is needed to ensure greater community awareness by the time the new legislation comes into effect
A lack of public awareness was, for almost 20 years, cited as a reason for delaying the passing of a law giving legal status to advance medical directives.
These documents allow terminally ill patients to reject certain treatments as the end of their life nears. Now, such legislation is being scrutinised by lawmakers and is expected to be passed this year.
It is welcome and long overdue. The law is needed to provide clarity and reassurance for patients, their families and medical health professionals.
Even when passed, it will not come into operation for 18 months to allow the healthcare sector time to prepare for the changes. That period also is intended to be used for public education and promotion of the new laws.
Three-fourths of Hongkongers willing to set up advance medical directives: survey
Publicity, despite years of discussion since an initial Law Reform Commission report in 2006, is still required.
Awareness of advance directives, prohibiting treatments such as cardiopulmonary resuscitation (CPR) or artificial ventilation, has grown over the years.
The Hospital Authority issued guidelines on their use in 2010. The number of directives issued by its patients rejecting CPR, for example, rose from 325 in 2013 to 1,742 in 2021. But more needs to be done.
A new survey has revealed that more than 75 per cent of respondents had not previously heard of advance medical directives. This is better than a similar survey in 2016 which found nine out of 10 people were unaware of them, but shows there is room for improvement.
Once people understand the concept, the majority supports it. The latest survey, organised by the Jockey Club End-of-Life Community Care Project, found 74.4 per cent to be in favour of setting up such directives for themselves.
A comprehensive publicity drive is needed to ensure greater community awareness by the time the new law comes into effect.
Hong Kong’s terminally ill may have more say in medical treatments and deaths
The aim of the legislation is to empower patients to make decisions about the treatment they receive – or do not receive – in the final stage of their life. Their wishes are expressed while they still have mental capacity.
Currently, the directives are governed by the common law. But there is a need for the legal position to be clearer. Medical professionals can be unwilling to refrain from administering life-saving treatment and disputes can arise with family members.
The new law, which applies not only to hospital staff but those providing emergency treatment elsewhere, must provide sufficient safeguards for both patients and healthcare workers.
The relationship between the legislation and other laws will need to be clearly established. Ultimately, the aim is to ensure that the final days of a patient’s life are lived with comfort, compassion and dignity.
The new law is a step forward. Now, greater awareness is needed.
