Advance Medical Directives in Singapore
An Advance Medical Directive (AMD), also known as a “living will”, is a legal document you sign in advance to inform your doctor that you do not want the doctor to use any extraordinary life-sustaining treatment to prolong your life, in the event that you are terminally ill and become unconscious or incapable of exercising rational judgment.
The Advance Medical Directive Act (the AMDA) is a law in Singapore passed in 1996 authorising the use of AMDs in Singapore.
What is Extraordinary Life-Sustaining Treatment?
“Extraordinary life-sustaining treatment” means any medical procedure or measure which, when administered to a terminally ill patient, will only prolong the process of dying when death is imminent, but excludes palliative care.
What is a Terminal Illness?
“Terminal illness” is defined in the AMDA as an incurable condition caused by injury or disease from which there is no reasonable prospect of a temporary or permanent recovery. For such a condition, death is imminent even if extraordinary life-sustaining measures were used. These measures would only serve to postpone the moment of death for the patient.
When Will the AMD Not Have Any Effect?
A medical practitioner has a duty to inform a patient who is conscious and capable of exercising a rational judgment of all the various forms of treatment that may be available in his particular case so that the patient may make an informed judgment as to whether a particular form of treatment should, or should not, be undertaken.
Who Can Make an AMD?
A person who is not mentally disordered and is at least 21 years old may make an AMD.
Do You Need a Lawyer to Make an AMD?
Lawyers and legal advice are not necessary in the making of an AMD. However, in the event of death or sickness, it is generally advisable to ensure that one’s affairs are in order, through estate planning or other legal means. Legal advice may be sought to draw up a will, or to implement a lasting power of attorney.
How Can You Make an AMD?
To make an AMD, you will have to complete an AMD form (which is available from any clinics, polyclinics, or hospitals, or online from here), sign it in the presence of two witnesses, and return it to the Registrar of AMDs at the Ministry of Health. More detailed instructions may be found on the AMD form itself.
Witnesses for the AMD
Two witnesses are needed in the signing. The signer’s doctor must be one of the two witnesses. The doctor will ensure that the signer is not forced into making the AMD, is of sound mind, and understands the nature and implications of an AMD.
The other witness must be at least 21 years old.
Additionally, both witnesses must not have any vested interests in the signer’s death. Specifically, the witness must not:
- Be a beneficiary under the signer’s will or any policy of insurance;
- Have any interest under any instrument under which the signer is the donor, settlor or grantor;
- Be entitled to an interest in the estate of the signer on the signer’s death without a will;
- Be entitled to an interest in the moneys of the signer held in the CPF or other provident fund on the death of that signer; and
- Have registered an objection to the AMD (a doctor who for any reason objects to the AMD and registers his objection can refuse to witness the signing of an AMD).
Even if the witness is a relative of the signer, he would be allowed to act as witness so long as he has no vested interests in the signer’s death.
Making an AMD is a voluntary and optional decision. It is a criminal offence for any person to force you to make one against your will. Forcing or misleading another person into signing an AMD is an offence punishable under the law. If convicted, such a person can be fined and imprisoned and disqualified as a beneficiary.
If you have made an AMD regardless of objections from members of your family, the doctors will have to respect your AMD.
The AMD is a confidential document. Hospital staff, including doctors and nurses, do not know who has made an AMD as it is confidential and they are not allowed to ask you if you have made an AMD.
However, if your attending doctor has reasons to believe that you are terminally ill and unable to make your wishes known to him, he can check with the Registrar of Advance Medical Directives on whether you have made an AMD.
How Much Does it Cost to Make an AMD?
To make an AMD, you will have to consult a doctor who, as a witness, is required to explain the AMD to you. You may have to pay the doctor for the services rendered. However, the AMD form itself is free.
Is it Possible to Make an AMD While You are Overseas?
As long as the first witness is a doctor currently registered with the Singapore Medical Council, and the AMD is filed with the AMD Registry in Singapore, the AMD is considered valid.
Can an AMD be Revoked?
An AMD can be revoked at any time in the presence of at least one witness, by completing the AMD revocation form. Alternatively, the person or his witness could write a letter to the Registrar of AMDs.
Where a person is unable to write, the AMD may be revoked orally or in any other way in which he can communicate. It is then the responsibility of the witness to the revocation to submit the notice of revocation using the revocation form or the letter. The witness should also state the reason why the person revoking the AMD could not do so himself.
For more information on revoking an AMD, refer to the FAQ section of the Ministry of Health website.
- Fiduciaries and Fiduciary Law in Singapore
- Muslim Inheritance Law in Singapore
- What Happens to Your Debts When You Die?
- How to Donate your Assets to Charity
- Organ Donation in Singapore (under HOTA, or For Science)
- Can I Use My Will to Distribute Insurance Proceeds?
- 8 Tools You Must Know for Estate Planning in Singapore
- Who Pays for the Mortgage Debts and Medical Bills After Death?
- Complete Guide to CPF Nominations and How to Make One in Singapore
- Is Inheritance Tax/Estate Duty Payable When You Die in Singapore?
- Missing Persons in Singapore: A Family’s Next Step If Never Found
- How Do I Make a Will?
- Choosing an Executor for Your Will in Singapore
- Get An Affordable Will Made By Experienced Lawyers
- Where Should You Store Your Will?
- Why Should You Make a Will?
- What is a Mutual Will, Mirror Will and Joint Will?
- How Can I Change My Will?
- Checklist for Drafting a Comprehensive Will in Singapore
- Appointing a Guardian for Your Children in Your Will in Singapore
- How to Plan for Mental Incapacitation
- What is a Lasting Power of Attorney and How to Make One in Singapore
- Advance Medical Directives in Singapore
- Appointment of Deputies under the Mental Capacity Act
- Revocation of a Lasting Power of Attorney
- How to Appoint a Deputy for a Loved One Lacking Mental Capacity in Singapore
- Mental Capacity Assessment for LPAs and Wills
- An Executor’s Checklist to Executing a Will in Singapore
- What Happens If You Die Without a Will in Singapore?
- How Do I Contest a Will?
- Wills, Probate, and Executors: What to Do When a Loved One Passes Away in Singapore
- Letters of Administration - Intestacy law in Singapore
- Unfair Maintenance: What Can Singapore's Law Do for You?
- Applying for a Grant of Probate in Singapore
- Can a half-brother be considered a next of kin? (when distributing the assets of the deceased)
- What happens to property when a deceased’s next-of-kin or named personal representative is uncontactable?
- Obtaining a Fresh Grant of Probate and Resealing a Foreign Grant of Probate
- What happens to residuary property not accounted for?
- What happens to a Singapore expatriate's assets when he passes on?
- How to Access the Bank Account of a Deceased Spouse
- What happens to my assets overseas when I pass on?
- What Happens to the HDB Flat When One Owner Passes Away?
- Simultaneous Death: How are Assets Distributed When Family Members Die at the Same Time?
- What to Do If the Will Cannot be Found
- What to Do If There are Disputes With or Between the Executors of a Will in Singapore
- What If a Beneficiary Dies Before Receiving His Inheritance?
- What Happens to the Car When the Owner Passes Away?