Advance decisions 'can ease end for terminally ill'

Terminally-ill patients are encouraged to discuss care planning for the later stages of their life with loved ones and whether or not they should refuse resuscitation or life-sustaining treatment.

The call from the Hospital Authority came as patients are set to be allowed to make such decisions ahead of time once the Advance Decision on Life-sustaining Treatment Ordinance comes into effect on Friday.

The ordinance opens the way to legal protection for medical professionals and rescuers in respecting patients’ wishes and arrangements.

Alice Mok, cluster coordinator of hospice and palliative care for New Territories East cluster, said allowing patients to set up advance medical directives (AMD) can ensure their quality of life even though they have reached the end stage of life, as well as offer them the best comfort.

“When the illness is irreversible, it is terminal," she said.

"We do have to admit that some of the invasive procedures like resuscitation, it will only prolong the dying phase.

"They may even add on harm to the patients by inducing pain, inducing discomfort in the dying process, and that may not be what the patients wish.”

“Sometimes, patients may wish only for comfort. So if they have the opportunity to express their wishes, AMD will be an opportunity for them to document what they wish not to suffer, receive at the end of life.”

Mok added advance directives can only take effect under three circumstances – the patient is suffering from a terminally-ill condition, in a vegetative stage or an irreversible coma, or is suffering from an advanced progressive illness that is irreversible and the illness is expected to progress with time.

The chief executive of Sha Tin Hospital and Bradbury Hospice in Hong Kong, Ada Yu, said about 80 percent of the roughly 200 patients at Cheshire Home Sha Tin, which she also heads, are suffering from irreversible illnesses.

About 96 percent of them have already decided on their end-of-life care, she added.

Edited by Tony Sabine ...