Advance Medical Directive (AMD)

What is an AMD – An AMD is a legal document that allows a person to state and register his wish in advance that he does not wish to be subjected to extraordinary life-sustaining treatment in the event when he is suffering from a terminal illness and is unconscious or incapable of expressing rational judgment.

Who can make an AMD – Anyone who is 21 years of age and above and is of sound mind.

Why make an AMD – Every patient has the right to decide whether to accept or reject the treatment that is offered to him by a medical practitioner. Thus, before a person becomes a patient, or even while he is a patient and is still of sound mind, the person may make a voluntary decision for himself to execute an AMD.

How to make an AMD – There is a Form to fill up, which may be obtained in most health care institutions and clinics. The Form shall be signed in the presence of 2 witnesses who should not have any vested interests in the patient’s death. The Form must be registered with the Registrar of AMD for it to be valid. The Registrar will inform the person when the AMD has been registered.

Witnesses – One must be a medical practitioner. The other must be 21 years of age or older.

Revocation – The person may revoke the AMD anytime while he still of sound mind by communicating it orally or in writing, in the presence of at least 1 witness. If it is in writing, the Registrar of AMD ought to be notified so that the Registrar can record the revocation in the Register.

Conditions that must be present for the AMD to come into effect – All 3 conditions must be satisfied:

  1. That the patient is suffering from a terminal illness;
  2. He requires extraordinary life-sustaining treatment; and
  3. He is unconscious or incapable of expressing rational judgement.

The Doctor will then check with the AMD Register as to whether the patient has registered an AMD before taking any final action.

Since this concerns life and death, many formalities are in place to check and balance the entire process before the plug is pulled. The duty of the Doctor is onerous and he has checklists to comply with.

The above is a general write-up. I will be happy to discuss with you to address your specific needs.

Ganesh S Ramanathan (Advocate & Solicitor)

(M/s Karuppan Chettiar & Partners)


May 2020