Advance care directives | Hong Kong SAR Advance care directives | Hong Kong SAR

19 Aug 2022

There is no dementia-specific or universal legislation pertaining to advance care directives in Hong Kong. At present, advance directives have been implemented through administrative measures by Hospital Authority (HA) since 2010 under the common law. Based on self-determination by patients, a standard form along with a detailed guideline from clinicians is used for advance directives, including refusal of life-sustaining treatments, signatures of two witnesses involving a doctor, effective at times of losing mental capacity, and applicability witnessed by non-HA doctors. Since 2012, the Clinical Management System (CMS) has marked advance directives witnessed by HA doctors as a reminder to assist clinical communication. Currently, advance directives cover patients (a) terminally ill; (b) in a persistent vegetative state or a state of irreversible coma; or (c) in other specified end-stage irreversible life limiting condition, which includes patients with irreversible loss of major cerebral function and extremely poor functional status, end-stage renal failure, end-stage motor neuron diseases, and end-stage chronic obstructive pulmonary diseases. However, the public response to advance directives is lukewarm due to low public awareness, reluctance of doctors to certify ADs and other implementation issues. There were only 5,561 advance directives made during 2012-2018. In the 2018 Policy Address, the Government was pledged to consult the public again in 2019 on the future arrangements of advance directives and relevant end-of-life care (Legislative Council Secretariat, 2019, June 6; The Government of the Hong Kong SAR, 2019, May 22).


Legislative Council Secretariat. (2019, June 6). Advance healthcare directives of patients. Retrieved from https://www.legco.gov.hk/research-publications/english/essentials-1819ise07-advance-healthcare-directives-of-patients.htm

The Government of the Hong Kong SAR. (2019, May 22). LCQ15: Advance directives in relation to medical treatment [Press release]. Retrieved from https://www.info.gov.hk/gia/general/201905/22/P2019052200261.htm