Advanced Medical Directive
What is an AMD
An Advance Medical Directive (AMD) is a legal document that lets you make your wishes known in advance specifically, that you do not want extraordinary life-sustaining treatment if you become terminally ill and unconscious. Recognised under Singapore law and regulated by the Ministry of Health, the AMD ensures your healthcare decisions are respected even when you're unable to communicate them.
Why Care
Advance Care Planning is about taking control of your future healthcare decisions. While thinking about serious illness or end-of-life care can be daunting, planning ahead ensures that your values and preferences are known and respected in unexpected situations.
By documenting and discussing your wishes, you provide clarity for your loved ones and healthcare providers, reducing uncertainty and anxiety during critical moments. It’s a meaningful step in securing dignity and peace of mind for the future.
Why have an AMD
Frequently Asked Questions
Discussing end-of-life care may feel uncomfortable, but planning ahead ensures that your wishes are respected and relieves your loved ones from making difficult decisions on your behalf. Advance care planning is not about giving up—it is about expressing your choices regarding medical treatment. It helps guide your family and healthcare team to act in alignment with your values, whether you wish to accept all treatments, limit some, or decline life-prolonging interventions.
Euthanasia refers to intentionally ending the life of a terminally ill or severely injured person in a painless manner, typically for reasons of mercy. Physician-assisted suicide involves a doctor providing the means or information for a patient to end their own life.
An AMD, however, does not involve ending life. Instead, it is a legal document that allows you to state your wish not to receive extraordinary life-sustaining treatment if you become terminally ill and unconscious. The aim is not to hasten death, but to allow the natural process to take its course while still receiving appropriate medical care.
Patients with an AMD will continue to be cared for—this includes palliative care, pain relief, and emotional support. It simply means that treatments which serve only to prolong the dying process, without curing the condition, will be withheld. As of now, euthanasia and physician-assisted suicide remain illegal in Singapore.
Any Singaporean resident aged 21 years or older, who is mentally sound, is eligible to make an Advance Medical Directive (AMD). You don’t need to be ill to sign an AMD—it can be completed at any time, even when you are in good health. The key requirement is that you have a clear intention not to prolong your life through extraordinary life-sustaining treatments should you become terminally ill and unconscious in the future.
Yes, you may revoke your Advance Medical Directive (AMD) at any time, as long as you are mentally sound. The revocation must be done in the presence of at least one witness and can be carried out in either of the following ways.
Option 1: Write and submit a formal letter of revocation to the Registry of AMD.
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Option 2: Complete and submit Form 3 to the Registry of AMD.
If the person who wishes to revoke the AMD is physically unable to complete the revocation themselves, the witness may do so on their behalf. In such cases, a clear explanation must be provided, stating why the individual is unable to carry out the process personally.
No legal representation is required to complete an Advance Medical Directive (AMD). You simply need a registered medical practitioner and a second witness aged 21 or above, both of whom must be present when you sign the form.
Once your Advance Medical Directive (AMD) has been successfully processed, the Registry of AMD will send you an official acknowledgement confirming its registration.
According to the Ministry of Health Singapore, for an Advance Medical Directive (AMD) to take effect, a panel of three doctors, including the patient's hospital doctor and two specialists, must unanimously certify that the patient is terminally ill.
If this first panel cannot reach unanimous agreement, the attending doctor will reassess the diagnosis. Should the doctor still believe the patient is terminally ill, the case will be referred to a second independent panel of three specialists, appointed by the Ministry of Health.
If this second panel also fails to reach unanimous agreement, the AMD will not take effect. In such cases, the patient will continue to receive all necessary medical treatments, including life-sustaining care.