Law allowing terminally ill to refuse life-sustaining care planned for July 31 start

The Hong Kong government plans to implement legislation on July 31 allowing terminally ill patients to refuse life-sustaining treatment. In a paper submitted to the Legislative Council, authorities said that the Advance Decision on Life-sustaining Treatment Ordinance, passed in November 2024, would provide legal status to patients’ advance care planning while offering protection to healthcare and rescue personnel. The two instruments covered under advance care planning – advance medical directives and do-not-attempt cardiopulmonary resuscitation (DNACPR) orders – have been in place at public hospitals based on common law since 2010. As the law takes effect, these two instruments will carry formal statutory status. An advance medical directive allows a mentally capable adult to specify which life-sustaining treatments they wish to refuse in the future, such as CPR, artificial ventilation, pacemakers and other measures. It is triggered only when the patient loses mental capacity and reaches a specific clinical state, such as a persistent vegetative state. A directive must be signed in the presence of two witnesses, one of whom must be a doctor. It can be presented in paper form or electronically via the official health record mobile application, eHealth. It remains valid unless the patient revokes it while he or she still possesses the mental capacity to do so. All directives made before the law takes effect remain valid as long as they meet legal requirements and clearly present all instructions. However, patients are advised to review their directives with their doctors regularly. A DNACPR order ensures that rescuers do not perform CPR in out-of-hospital environments when the patient suffers cardiopulmonary arrest. An order must be signed by two doctors, one of whom must be a specialist, using a prescribed paper-based form to allow rescuers to immediately judge its authenticity during an emergency. Each order carries a maximum validity period of one year, but can be extended with a doctor’s signature. DNACPR orders must be made using a prescribed form. Those issued before the law takes effect must be reissued if they were not on the prescribed form. The Hospital Authority began reissuing DNACPR orders using the prescribed forms in December 2025, providing each patient with a folder of a conspicuous design that allows rescuers to quickly identify and access the order. Healthcare staff – specifically doctors, nurses, Chinese medicine practitioners and dentists – as well as rescuers are legally bound to follow a directive or order if they are aware of it. They are granted immunity from civil, criminal or professional misconduct liability if they withhold treatment based on these instruments in good faith. They also face no legal liability if they provide life-sustaining treatment while unaware of the directive. They are not obliged to perform a search of the patient or their belongings to confirm if the patient has an instrument before providing treatment. Pasu Ng Kwai-lun, founder of social enterprise Minimal Funeral and a “life-and-death education” practitioner, said the new law would give both patients and healthcare and emergency personnel more protection, but expected potential conflicts to happen in hospitals, and the handling seemed not yet clear. “One of the major controversies is that family members no longer have the right to oppose an Advance Medical Directive once it has been signed by the patient,” Ng said. “This puts doctors in a very difficult position if family members desperately dispute the decision to withhold treatment at the bedside.” He said there could be a chance the patients might have wanted to be rescued because they wanted to wait for a son’s wedding, the birth of a grandchild or for a relative to fly back from abroad for a final visit, which would also put the doctors in a dilemma between their legal duty and a grieving family. Ng also pointed to limited awareness of the new legislation among the relevant professions and the public: “Many have no idea that it’s not just a choice between CPR and not CPR.” Even if patients had signed those documents, they also needed to present them at the right time and place to effectively implement the decisions, which was not easy and required more guidelines from the government, he said. Authorities said that Hong Kong was largely ready to implement the new law, having provided guidelines and training for healthcare workers and rescuers, updated electronic systems, promoted the ordinance to terminally ill patients and their carers, and continued life-and-death education efforts during the transition period. According to the paper, the number of advance medical directives increased from 325 in 2013 to 2,070 in 2025, while DNACPR orders increased from 325 to 5,084 over the same period.

Law allowing terminally ill to refuse life-sustaining care planned for July 31 start

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}Hong Kong law passed in November 2024 will aid patients’ advance care planning while protecting healthcare and rescue personnel, authorities say

Hong Kong law passed in November 2024 will aid patients’ advance care planning while protecting healthcare and rescue personnel, authorities say