Who decides when you can’t? A guide on planning for end-of-life care
A free digital tool for Singaporeans to complete their advance care plans (ACP) online was rolled out on July 19. But what exactly is ACP, and how does it differ from an advance medical directive or lasting power of attorney? Here’s what to know about planning for end-of-life care.
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Advance care planning is a national programme that allows people to document their medical treatment preferences in advance.
PHOTO: LIANHE ZAOBAO
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Advance care plan
Advance care planning is a national programme that allows people to document their medical treatment preferences in advance, in line with their goals and values.
It also allows them to designate up to two people to decide on medical care for them in the event that they become mentally incapacitated.
While not legally binding, the ACP serves as a guide for loved ones and healthcare teams to act according to their best interests. It includes healthcare preferences such as the extent of treatment and pain control options.
Anyone above 21 years old can do an ACP.
Those who are generally healthy can complete their ACP online through the new digital tool called myACP
It can be found on the My Legacy@LifeSG platform at mylegacy.life.gov.sg
They can also approach public hospitals, polyclinics, or certain social care providers to make such a plan.
Those with existing illnesses, such as cancer or heart failure, will need to complete their ACP with the help of their healthcare team or a certified facilitator.
The Agency for Integrated Care website advises the public to complete an ACP, even if they already have an advance medical directive or lasting power of attorney.
Advance medical directive
An advance medical directive (AMD)
To make an AMD, an individual needs to fill in a form available in clinics, polyclinics and hospitals, or download it from the Ministry of Health website.
The AMD must be made through a doctor. Two witnesses have to be present when the person signs the AMD – one must be the doctor, and the other one must be at least 21 years old. Both witnesses will sign the form during the session.
The completed form is submitted to the Registrar of Advance Medical Directives in a sealed envelope.
Lasting power of attorney
A lasting power of attorney (LPA) allows you to appoint one or more trusted persons to make decisions on your personal welfare, property, finances and other matters if you lose mental capacity. Those who make LPAs are known as donors, while the people they appoint are called donees.
There are two LPA forms: Form 1 grants general powers to donees, while Form 2 is for donors who want to grant specific or customised powers to donees and has to be drafted by a lawyer.
Both forms can be made digitally through the Office of the Public Guardian Online portal.
Donees will be notified via SMS or e-mail when a donor submits the LPA form. They can then accept the appointment through the portal.
Thereafter, the donor will visit the certificate issuer – who is a medical practitioner accredited by the public guardian, a practising lawyer, or a registered psychiatrist – to digitally sign the LPA using Singpass.
The issuer then certifies and submits the LPA on the donor’s behalf through the portal.
Hard-copy LPA forms are still accepted in exceptional situations, such as when the donor or donee does not have a Singpass account required to access the portal.
