Advance directives in Hong Kong : moving forward to legislation

Abstract

Background: An advance directive (AD) is a legal statement indicating the form of healthcare the patient would like to receive at a future time when he/she is no longer mentally competent to make decisions. As there are increased concerns to respect the preferences of medical treatment of patients suffering from terminal illnesses, AD receives more attention and recognition in healthcare settings. However, Hong Kong has neither statue nor direst case law on the legal status of AD. A public consultation was therefore launched by the government in 2019. The present study aimed to examine the views towards ADs in response to the proposed legislation. Methods: Fifty-nine responses were received from questionnaires and the findings formed a protocol and guideline for the focus groups. Twenty-three participants participated in two focus group discussions. A thematic analysis revealed three themes of views towards ADs legislations: public awareness, completion of ADs, and dying in place. Results: Older and young participants held slightly different views on the acceptance of verbal and written format, and the presence of witnesses of ADs. Overall, participants considered the general public did not have adequate knowledge of AD. Conclusions: Findings suggested that public education should be enhanced, and guidance and protocols for healthcare professionals were needed after legislation of ADs. In addition, dying in place should also be facilitated while legislative barriers on Coroners Ordinance should be amended.