First there is AMD and then there is LPA and now this thing called ACP come along. I thought that I have all things covered about dying according to my wishes without burdening my loved ones and relatives with decisions in the future when I am not capable of making.
AMD is Advance Medical Directive created in accordance with the Advance Medical Directive Act (Chapter 4A) 1997.
LPA is Lasting Power of Attorney created in accordance with the Mental Capacity Act (Chapter 177A) 2010.
ACP is Advance Care Planning is the Ministry of Health’s initiative to start people discussing about their own palliative care and of end-of-life matters.
Advance Care Planning (ACP) has no weight of law unlike AMD and LPA.
Advance Medical Directive
An AMD is a legal document that one completes stating that one does not wish to receive extraordinary life-sustaining treatment to artificially prolong life in the event of terminal illness where death is inevitable and impending
Lasting Power of Attorney
LPA is a legal document that gives authority to the person you appoint (called your “donee”) to make decisions and act for you when you lack mental capacity.
You may authorise your donee(s) to make decisions about your
- personal welfare (which may include health care) and/or
- property and affairs (including financial matters).
Advance Care Planning
ACP includes the health care preferences when one is at the end-of-life stage and not capable of making preferences known to hospital and health care professionals.
ACP would reduce anguish of personal carers who are his/her loved ones under this circumstance.
Do we need All Three?
To answer this question, let me present a simple decision tree narrative.
1. Does one lack mental capacity to make decisions for himself/herself? If yes, the Lasting Power of Attorney (LPA) kicks in, (if one has LPA executed).
2. Is one at end-stage in the event of terminal illness where death is inevitable? If yes, Advance Medical Directive kicks in, (if one has AMD executed).
3. For All other situations other than 1 and 2 above, Advance Care Planning becomes relevant, (if one has ACP documented). One example is when an old person is bed-ridden and cannot talk or communicate clearly his/her wishes about health care needs such as tube feeding or hooking up to medical equipments or CPR resuscitation during cardiac arrest. With ACP, loved ones and even relatives of the patient can find comfort in caring for him/her without the family squabbling on what to do.
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