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An Advanced Medical Directive (AMD) is a legal document in Singapore that lets you state in advance that you do not wish to receive extraordinary life-sustaining treatment if you are:
It provides clear instructions to your doctors and relieves your loved ones from having to make difficult choices on your behalf. An AMD ensures that your wishes are respected and that medical care remains aligned with what you have decided in advance.
Your doctor’s role is to help you understand the implications, witness your decision, and ensure the directive is completed and submitted correctly.
Several legal and medical documents deal with future decision-making, but they serve different purposes. This includes:
| DOCUMENT | WHAT IT COVERS | WHEN IT TAKES EFFECT | WHO MAKES THE DECISIONS |
| Advanced Medical Directive (AMD) | Refusal of extraordinary life-sustaining treatment in terminal illness | Only when you are terminally ill, unconscious, and death is inevitable | Your wishes, recorded in advance |
| Lasting Power of Attorney (LPA) | Allow someone to act on your behalf for personal welfare, property, and financial matters | When you lose mental capacity | Your appointed Donee(s) |
| Will | Distribution of assets after death | After death | Executor carries out instructions |
| Do-Not-Resuscitate (DNR) Order | Instruction not to perform CPR if heart or breathing stops | During a medical emergency | Given by you (or authorised decision-maker) beforehand |
The AMD is meant to protect your right to make your own healthcare choices and to avoid unnecessary medical interventions at the end of life.
Its purpose is to:
Making an AMD is a forward-looking decision that brings peace of mind. Some of the benefits include:
In Singapore, you can make an AMD if you meet these criteria:
| ELIGIBILITY | ELABORATION |
| Age | You need to be at least 21 years old to be eligible to make an AMD. |
| Mental capacity | This means you can fully understand what the AMD involves before you sign it. You should be clear about: The medical circumstances under which the AMD would applyWhat “extraordinary life-sustaining treatment” means (e.g. machines or interventions that prolong life without changing the outcome)The consequences of refusing such treatment In other words, you must be of sound mind and able to weigh the information, ask questions, and make an informed decision. Doctors are required to explain the AMD to you to ensure you understand it before witnessing your signature. |
| Voluntary choice | An AMD must be made out of your own free will. You should not be pressured by family members, caregivers, or anyone else into signing it. The decision must reflect your personal values, beliefs, and wishes about medical care at the end of life. To safeguard this, the form is signed in the presence of a doctor and a witness, who will both confirm that you: Were not under coercion, duress, or undue influenceChose to make the AMD freely and independently This ensures the AMD truly represents your voice and not the wishes of others. |
Creating an AMD is a straightforward but important process. It ensures your wishes are properly recorded and legally recognised. The process entails:
| STEPS | PROCESSES |
| Get the AMD form | You can obtain the official AMD form from the Ministry of Health (MOH) website, public hospitals, polyclinics, or participating medical clinics. |
| Consult a doctor | A registered doctor must explain the document to you in detail.The doctor’s role is to make sure you fully understand the meaning, purpose, and consequences of the AMD before you sign. |
| Sign the form | You must sign the AMD in the presence of the doctor and a witness (someone not related to you or benefiting from your death).This safeguard ensures that your decision is voluntary and informed. |
| Submit the form | Once signed, the form should be mailed or delivered to the Registrar of AMDs at the MoH.It will then be reviewed, recorded, and stored securely. |
| Receive confirmation | You will receive an official letter of acknowledgement once your AMD has been registered.The AMD itself remains confidential and can only be accessed by authorised doctors if needed. |
An AMD does not affect your normal medical care and does not apply in routine health situations. It only takes effect under very specific and extreme circumstances.
Some of them are, but not limited to:
These strict safeguards are in place to ensure that the AMD is applied only when the situation is absolutely clear, preventing any misuse or premature decisions.
An AMD is not permanent and can be revoked at any time, as long as you still have mental capacity. The revocation can be done in several ways, such as:
This flexibility ensures that your AMD always reflects your current wishes and values.
At Phoenix Medical Group, we provide professional guidance for making your AMD in Singapore. Our experienced family doctors take the time to explain every step clearly, ensuring your wishes are understood, respected, and properly documented with care.
Book an appointment with us today and let our trusted team support you in making this important choice with clarity and peace of mind.
Some of the common misconceptions are:
No. A lawyer is not required. You only need a doctor and an independent witness to sign the form with you.
There is no fee for submitting or registering an AMD with the Ministry of Health. You may, however, be charged a consultation fee by the doctor who explains and witnesses the form.
Yes. An AMD and an LPA serve different purposes and do not conflict. An AMD covers end-of-life medical care, while an LPA allows someone you appoint to make broader decisions, such as financial or personal welfare matters, if you lose mental capacity.
Doctors do not automatically know. Your AMD is kept confidential in a central registry managed by the MoH. It is only disclosed to your treating doctors if you are certified as terminally ill and unconscious.
Yes. Both Singapore Citizens and Permanent Residents can make an AMD. Foreigners on long-term passes generally cannot, unless they become a PR.
You can revoke your AMD at any time, as long as you still have mental capacity. This can be done in writing, verbally in front of a doctor and witness, or by submitting a revocation form to the Registrar of AMDs.
No. Making an AMD is entirely voluntary. It is your personal choice whether to create one.
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