The government plans to implement a law allowing terminally ill patients to refuse life-sustaining treatment from July 31, more than 20 months after the Legislative Council finally passed it. This has, wisely, allowed the healthcare sector time to prepare for important changes and for public education and awareness.

The Advance Decision on Life-sustaining Treatment Ordinance provides legal status to patients’ advance-care planning while offering protection to healthcare and rescue personnel. Advance medical directives and do-not-attempt-cardiopulmonary-resuscitation (DNACPR) orders have been in place at public hospitals based on common law since 2010. As the new law takes effect, these two instruments will acquire formal statutory status.

A lack of public awareness was cited as reason for the delay for almost 20 years. The law is therefore welcome and long overdue. It is needed to provide clarity and reassurance for patients, their families and medical and health professionals.

Awareness of advance directives has grown over the years. The Hospital Authority issued guidelines on their use in 2010, but more needed to be done.

Although directives are covered by common law, the legal position needed to be clearer. Medical professionals could be unwilling to refrain from administering life-saving treatment and disputes could arise with family members.

A survey ahead of the passing of the legislation in November 2024 revealed that more than 75 per cent of respondents had not previously heard of advance medical directives. Once people understand the concept, however, evidence shows a majority tends to support it. The survey, organised by the Jockey Club End-of-Life Community Care Project, found 74.4 per cent in favour of setting up such directives for themselves.