Key Components of Advance Medical Directive (AMD): When Does It Comes Into Effect

Advance Medical Directive (AMD) is an essential legal document that outlines your preferences for medical treatment in situations where you may be unable to communicate your wishes. So, what are the key components of the Advance Medical Directive, and when do they come into effect? An AMD comes into effect only when you are incapacitated and unable to make decisions for yourself, ensuring that your healthcare preferences are respected even if you cannot express them. Three doctors must agree unanimously to your terminal condition.

Curious about creating an AMD and ensuring its effectiveness? Read on for a comprehensive guide to the key components of the Advance Medical Directive, including detailed information on how and when they come into effect, to help you make informed decisions about your future healthcare.

What Does AMD Do?

doctor holding the hand of patient with AMD

Advance Medical Directive (AMD) is a legal document that upholds the principle of patient autonomy in end-of-life care. It empowers individuals to make informed decisions about their medical treatment in advance, particularly when they are no longer able to do so themselves due to terminal illness.

Key Features of the AMD:

Patient Choice: The AMD allows competent adults to express their wishes regarding the acceptance or refusal of extraordinary life-sustaining treatment (ELST) in the event of a terminal illness.
Terminal Illness Definition: A terminal illness is defined as an incurable condition with no prospect of recovery, where death is imminent regardless of ELST, and such treatment would only prolong the dying process.
Extraordinary Life-Sustaining Treatment Defined: ELST refers to medical procedures or interventions that merely prolong the dying process for a terminally ill patient when death is imminent. This excludes palliative care, which focuses on comfort and symptom management.
Informed Decision-Making: The AMD process emphasises informed consent. Individuals should discuss their healthcare wishes with their doctors and loved ones to ensure their AMD reflects their values and beliefs.

Benefits of the AMD:

Empowers Patients: The AMD allows individuals to have control over their end-of-life care decisions.
Reduces Family Burden: By clearly outlining preferences, the AMD can guide loved ones in making difficult decisions and alleviate potential family conflict.
Respect Patient Autonomy: The AMD upholds the right of competent adults to make autonomous choices about their medical treatment.
Promotes Open Communication: The AMD encourages open communication between patients, doctors, and families about end-of-life care preferences.

Individuals who wish to create an AMD are encouraged to consult with a legacy planning expert, like The Life Legacy, to understand the process and ensure their wishes are clearly documented.

When Does An Advance Medical Directive (AMD) Come Into Effect?

As mentioned above, three doctors must agree unanimously to your terminal condition. These doctors must consist of 1 doctor treating and 2 specialists. If the 2 doctors don’t agree, the AMD cannot come into effect.

An AMD in Singapore becomes operational when the following three conditions are met:

Terminal Illness: The patient must be diagnosed with a terminal illness as defined by the AMD Act. This refers to an incurable condition with no prospect of recovery, where death is imminent regardless of extraordinary life-sustaining treatment (ELST).
Need for ELST Decision: The patient's condition necessitates the use of ELST, which are medical interventions that solely prolong the dying process when death is unavoidable.
Incapacity for Decision-Making: The patient is unconscious or unable to make informed decisions due to their condition.

When the doctors unanimously agree that the patient meets all three criteria listed above, they will initiate the AMD activation process by certifying the patient’s terminal illness and forwarding the form to the Registrar.

AMD Register Search:

The Registrar conducts a search within the AMD Register using the information provided in Form 5. This search determines if the patient has a registered AMD under the AMD Act (1996) that is currently valid.

Communication with Doctor:

The Registrar informs the doctor of the search results via Form 6, typically sent by fax. This form indicates whether an active AMD exists for the patient.

The AMD activation process ensures a patient's wishes regarding ELST are respected, even when they are unable to express them directly. Timely communication between healthcare professionals and the AMD Register is crucial for making informed decisions about a patient's end-of-life care.

Who Can Help Me With My AMD?

Having an Advance Medical Directive (AMD) is an empowering step towards ensuring your end-of-life wishes are respected. But navigating the legalities and paperwork can feel overwhelming. Here at The Life Legacy, we're here to guide you through the process.

How The Life Legacy Helps:

Understanding the AMD: We'll provide a clear explanation of the AMD and its implications, ensuring you make an informed decision.
Completing the AMD Form: We'll walk you through filling out the AMD form accurately and comprehensively.
Doctor Certification: We'll assist you in scheduling an appointment with your doctor to have the AMD certified.
Registration: We'll handle mailing the completed and certified AMD form to the Registrar on your behalf, ensuring it's properly registered in the national system.

Don't wait until it's too late. Let's work together to create an AMD that reflects your wishes and provides peace of mind for you and your loved ones.