IPS' key recommendations about end-of-life decisions

If a mentally incapacitated patient has not stated his wishes in advance through Advance Care Planning, for instance, the decision to preserve his life or take him off life support lies with the doctor.
If a mentally incapacitated patient has not stated his wishes in advance through Advance Care Planning, for instance, the decision to preserve his life or take him off life support lies with the doctor.PHOTO: ST FILE

The restrictions under Section 13(8) of the Mental Capacity Act must be emphasised to families

The law forbids family members from making decisions about the life-sustaining treatment of a mentally incapacitated loved one.

If the patient has not stated his wishes in advance through Advance Care Planning (ACP), for instance, the decision to preserve his life or take him off life support lies with the doctor.

ACP facilitators should discuss the Act's restrictions with family members and ask the elderly about their preferences on this matter.

Palliative care providers should involve religious leaders in end-of-life conversations

To a certain extent, culture and religion influence each patient's perceptions of death and his final days. Religious institutions could help to design relevant spiritual care programmes for patients in hospices.

Start having the difficult conversations on death and dying

The IPS researchers said it is time to normalise end-of-life topics and refrain from shying away from them. They suggested that these topics can be raised during milestone events such as attaining adulthood, marriage, childbirth, retirement or while getting life insurance.

 
 

Develop the palliative care sector further in terms of providing financial incentives and manpower

The researchers said government medical subsidies are skewed towards treating medical conditions and covering healthcare services while long-term care services are financed by a small group of voluntary or charitable organisations.

Hence, patients choose to die in hospitals than at home since subsidies push people to seek hospitalisation for their long-term care needs.

They also said more doctors, allied health professionals and medical specialists should be trained to raise manpower in the palliative care field.

Simplify paperwork for family members when they make end-of-life plans

For instance, the Agency for Integrated Care and the Office of the Public Guardian could work more closely by merging the documentation processes for ACP and appointing a Lasting Power of Attorney.