New end-of-life care law to recognize patients’ treatment refusals from July 31

Hong Kong’s new end-of-life care law will take effect on July 31, allowing mentally capable adults to make legally binding advance medical directives refusing specified life-sustaining treatments.

The Advance Decision on Life-sustaining Treatment Ordinance establishes a statutory framework for advance medical directives and do-not-attempt cardiopulmonary resuscitation (DNACPR) orders, while providing legal protection for healthcare professionals and rescuers who comply with them.

Under the new law, adults aged 18 or above who are mentally capable of deciding on life-sustaining treatment may set out in writing which treatments they wish to refuse if they later lose that capacity and meet specified medical conditions.

These may include being terminally ill, being in a persistent vegetative state or irreversible coma, or having another end-stage, irreversible and life-limiting condition.

Hospital Authority Clinical Ethics Committee chairwoman Doris Tse Man-wah said on Wednesday that an advance medical directive must be signed in the presence of at least two witnesses, one of whom must be a registered medical practitioner.

A directive may be revoked at any time while the person remains mentally capable, including through a written or verbal declaration, making a new directive, or destroying or crossing out the existing document in accordance with statutory requirements.

Tse said healthcare professionals were legally and professionally required to follow a valid and applicable directive, even if the patient’s family disagreed. She encouraged people considering a directive to discuss their wishes with relatives and involve them in medical consultations.

The Hospital Authority has prepared distinctive yellow pouches for patients to store their directives and DNACPR orders, allowing ambulance and emergency personnel to identify the documents quickly. Paper directives may also be stored electronically through eHealth with the patient’s consent.

To streamline emergency procedures under the new framework, related laws such as the Fire Services Ordinance and the Coroners Ordinance have already been amended.

Meanwhile, the authority said it has converted more than 4,800 existing DNACPR forms into the new statutory format and trained over 44,000 staff members. Healthcare personnel and non-emergency ambulance operators will receive refresher training every two years.

Tse warned that healthcare or emergency personnel who knowingly disregard a valid and applicable directive could face legal consequences.

The ordinance would strengthen patients’ autonomy and mark a milestone in Hong Kong’s end-of-life care services, according to the SAR government.

𝗗𝗼𝘄𝗻𝗹𝗼𝗮𝗱 𝗧𝗵𝗲 𝗦𝘁𝗮𝗻𝗱𝗮𝗿𝗱 𝗔𝗽𝗽 ↓