Advance Medical Directive

An Advance Medical Directive (AMD) is a legal document signed by a person, in advance, to indicate that he/she does not wish to have any extraordinary life-sustaining treatment to prolong his/her life in the event he/she becomes terminally ill and unconscious, and where death is imminent.1

The Singapore parliament passed the Advance Medical Directive Act in May 1996 to allow Singaporeans who wish to make an AMD to do so.2 The law came into effect in July 1997.3 As medical technology advances, some of these new possibilities can raise ethical and legal issues. For example, while medical technology can technically prolong life in the final stages of a terminal illness, it cannot stop the dying process. Further medical intervention would be medically ineffective and some terminally ill persons, who are unable to express their wishes at that time, may wish to be spared further suffering and would like to die naturally.4

Under the act, an AMD can only be executed when a patient is certified with a terminal illness; needs extraordinary life-sustaining treatment; and is not capable of making rational judgment. After the AMD has taken effect, a patient with terminal illness will still receive palliative care and medication.5

Anyone who is aged 21 years and above, and of a sound mind, can make an AMD. Any person who wishes to make an AMD can do so by completing a prescribed AMD form, signed in the presence of two witnesses, and return it to the Registrar of AMD. The AMD form is available at private clinics or polyclinics. It is a voluntary decision and no one can make an AMD on behalf of another person.6

An AMD can be revoked at any time in the presence of at least one witness. This can be done by either completing a standard form for revocation of an AMD or by writing to the Registrar of AMD.7


Joycelyn Hwang

1. Ministry of Health Singapore. (2010). Advance Medical Directive Act. Retrieved 2016, May 30 from
2. House passes Advance Medical Directive Bill. (1996, May 3). The Straits Times, p. 1. Retrieved from NewspaperSG.
3. Advance Medical Directive (AMD) comes into force today. (1997, July 1). The Straits Times, p. 26. Retrieved from NewspaperSG.
4. Ministry of Health Singapore. (2010). Advance Medical Directive Act. Retrieved 2016, May 30 from
5. Ministry of Health Singapore. (2010). Advance Medical Directive Act. Retrieved 2016, May 30 from
6. Singapore. The Statutes of the Republic of Singapore. (1997, Rev. ed.). Advanced Medical Directive Act (Cap.4A). Retrieved 2016, June 7 from Singapore Statutes Online website:;page=0;query=CompId%3Ad9f981d5-633a-4a48-8fbb-c4f858a3ea27%20ValidTime%3A20170324000000%20TransactionTime%3A20170324000000;rec=0;
7. Advance medical directive: The facts. (2001, April 8). Home, The Straits Times, p. 26. Retrieved from NewspaperSG.

The information this article is valid as at 2016 and correct as far as we can ascertain from our sources. It is not intended to be an exhaustive or complete history of the subject. Please contact the Library for further reading materials on the topic.


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Advance directives (Medical care)--Singapore
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Advance directives (Medical care)--Law and legislation--Singapore