Advanced Medical Directive (AMD): Singapore Guide [2025]

Advanced Medical Directive (AMD): Singapore Guide

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Advanced Medical Directive (AMD) Singapore Guide

Let’s face it – thinking about end-of-life care isn’t something we like to dwell on.

But imagine this: you’re in a hospital, unable to speak or make decisions, and your family is left guessing what you would have wanted.

That’s where an Advance Medical Directive (AMD) comes in – a legal tool that ensures your voice is heard when it matters most.

In this post, you’ll discover:

  • What an Advance Medical Directive (AMD) is and how it works
  • The key benefits, from ensuring natural death to easing family stress
  • Practical steps to create, amend, or revoke one
  • Why AMDs are crucial for healthcare planning in Singapore

 

Let’s dive in!

What is an Advance Medical Directive (AMD)?

An Advance Medical Directive (AMD) is a legal document that empowers you to express your medical treatment preferences in advance.

It comes into play specifically if you’re terminally ill, unconscious, or otherwise unable to make your wishes known.

By signing an AMD, you’re taking control of how you are cared for in such situations, mainly to prevent extraordinary life-sustaining measures that prolong life without addressing the underlying condition.

In Singapore, the AMD is governed by the Advance Medical Directive Act, and the Ministry of Health (MOH) serves as the regulatory body.

It is not a blanket directive but is strictly applicable under specific legal conditions: you must be certified by a panel of doctors as terminally ill, unconscious, or incapacitated, with no reasonable prospect of recovery.

This ensures clarity and protects both your intentions and the healthcare providers involved.

Benefits of an Advance Medical Directive

Respect for personal autonomy

Autonomy is about having the power to make decisions for yourself, and the AMD ensures that your voice is heard – even when you can’t speak for yourself.

By signing an AMD, you’re actively participating in your healthcare planning.

This proactive approach prevents others – your family, friends, or even doctors – from making assumptions about what they think is best for you.

Emotional relief for loved ones

An Advance Medical Directive (AMD) provides emotional relief for families by offering clear guidance on medical preferences, reducing confusion and stress during critical decisions.

By documenting your wishes, it prevents conflicts and ensures that your family won’t need to debate decisions about life-sustaining treatments.

This clarity promotes harmony, as it eliminates guesswork and minimises disagreements among family members, especially during emotionally challenging times.

Dignity in end-of-life care

With an AMD, you can opt for a natural death – one that is free from invasive or extraordinary interventions.

Instead of relying on mechanical ventilation or artificial nutrition, which may only prolong the process of dying without improving quality of life, an AMD enables you to decline such measures.

This decision honours the natural progression of life and aligns with the values of many who prefer not to have their final days dominated by medical procedures.

Financial benefits

By clearly stating your preference to decline extraordinary life-sustaining treatments like mechanical ventilation or prolonged ICU stays, an AMD can lead to significant cost savings.

Support for healthcare providers

The clarity an AMD provides helps medical teams make decisions confidently, especially in critical situations where rapid action is necessary.

It also reduces ethical dilemmas when deciding on life-sustaining treatments, particularly when family members disagree.

By providing legally binding guidance, the AMD ensures that healthcare professionals can focus on delivering care that aligns with your preferences, reducing confusion and moral conflict.

Promotes discussions about end-of-life care

An Advance Medical Directive (AMD) is more than a legal document – it’s a starting point for meaningful conversations about end-of-life care.

By creating an AMD, you open the door for discussions with loved ones and caregivers about your healthcare preferences, which fosters a better understanding of your values and choices.

These conversations help ensure that everyone involved understands your wishes, such as declining extraordinary measures or preferring to pass away peacefully at home.

Open communication reduces misunderstandings and allows your family to support you in a way that aligns with your choices, creating a sense of unity and trust.

What isn’t covered by an AMD?

Non-terminal conditions

An AMD applies only when you are certified as terminally ill, unconscious, or incapacitated with no chance of recovery.

It does not come into effect for non-terminal conditions, such as chronic illnesses or disabilities, even if they significantly affect your quality of life.

Routine or emergency medical treatment

The AMD does not guide routine medical treatments, such as surgeries, medications, or other healthcare interventions unrelated to a terminal condition.

Similarly, it does not cover emergency medical decisions, such as resuscitation without a terminal diagnosis.

Appointing a decision-maker

Unlike a Lasting Power of Attorney (LPA), an AMD does not appoint a person to decide on your behalf.

If you want someone to oversee broader aspects of your care, such as managing your finances or making welfare decisions, you’ll need to create an LPA.

Financial or legal decisions

An AMD is strictly about medical treatments and does not extend to financial planning, legal matters, or personal welfare decisions.

For these, additional legacy planning tools like wills or trusts are necessary.

How do I make an AMD?

To create an Advance Medical Directive (AMD), you must be at least 21 years old, of sound mind, and make the decision voluntarily.

The process includes downloading the official AMD form from the Ministry of Health (MOH), filling it out with your personal details and healthcare preferences, and signing it in the presence of 2 witnesses.

One witness must be your attending doctor, and the other must be an impartial individual.

After signing, submit the sealed form to the Registrar of Advance Medical Directives at the Ministry of Health.

Once processed, you’ll receive an acknowledgement confirming the registration of your AMD, ensuring that your healthcare preferences are legally recognised and that you can guide decisions when necessary.

Where can you make an AMD?

In Singapore, you can create an Advance Medical Directive (AMD) in several healthcare settings.

The process involves consulting with a certified doctor who will act as a witness and ensure you understand the implications of your decision.

Here are the most common places where you can make an AMD:

  1. Public healthcare institutions
  2. Private clinics
  3. Specialist clinics
  4. Polyclinics
  5. Community healthcare providers

 

How much does it cost to make an AMD?

The cost of making an Advance Medical Directive (AMD) in Singapore primarily depends on consultation fees charged by doctors and any administrative fees.

The most significant cost is the consultation fee for the doctor who witnesses and certifies your AMD form.

Fees can vary depending on the type of healthcare facility: public healthcare institutions and polyclinics tend to offer lower costs.

At the same time, private clinics and specialist clinics charge higher fees for more personalised services.

There may be minimal administrative fees for processing the AMD, though these are often negligible or covered by the healthcare provider.

If multiple doctors are involved, particularly in complex medical cases, the overall cost may increase.

What happens after you make an AMD?

Once you’ve completed and submitted your Advance Medical Directive (AMD), the process doesn’t end there.

Several key steps are undertaken to ensure your directive is properly registered, securely stored, and accessible when required.

1. Registration of your AMD

After submitting your completed AMD form to the Registrar of Advance Medical Directives at the Ministry of Health (MOH), your directive will be officially registered.

The Registrar is responsible for maintaining all AMD records in Singapore.

2. Confirmation of registration

Once your AMD is successfully registered, you will receive a written acknowledgement from the Registrar.

This confirmation serves as proof that your directive is valid and on file.

Keep this acknowledgement safe, and consider informing your loved ones that you’ve completed the process.

3. Secure storage

Your AMD is stored securely in the national registry managed by the MOH.

This ensures that the document is protected against loss or unauthorised access.

Only authorised personnel, such as healthcare professionals involved in your care, can access your AMD when necessary.

4. Access by healthcare providers

When the situation arises (e.g., you are terminally ill and unable to communicate), healthcare providers will check the AMD registry to verify if you have a directive in place.

If you do, they will follow the instructions outlined in your AMD to guide their treatment decisions.

5. Implementation of AMD

If your healthcare providers determine that the conditions specified in the AMD Act are met – such as terminal illness and incapacity – they will implement your directive.

This means withholding extraordinary life-sustaining treatments following your wishes.

6. Revocation or amendment (optional)

You have the right to revoke or amend your AMD at any time.

To do so, you must submit a formal notice of revocation or amendment to the Registrar.

This ensures that the most current version of your directive is on file and enforceable.

Can my family override my AMD?

The short answer is no – your family cannot override a valid Advance Medical Directive (AMD).

Once your AMD is registered and legally valid, it becomes a binding document that healthcare providers must follow, ensuring your medical preferences are respected.

While family members may express concerns, their opinions cannot alter the directive.

The only way an AMD can be overridden is through a legal challenge, where a family member may contest its validity, but the burden of proof lies with them.

The directive remains enforceable unless a court rules otherwise.

Can I revoke the AMD if I change my mind?

Yes, you can revoke your Advance Medical Directive (AMD) at any time if you change your mind, as long as you are still mentally competent.

This flexibility ensures that your directive always reflects your current values, preferences, and circumstances.

To revoke it, submit a written notice to the Registrar of Advance Medical Directives at the Ministry of Health (MOH), either in a letter or a revocation form.

The notice must be witnessed by at least 1 person who can confirm that you are acting voluntarily and understand the decision.

Once your AMD is processed, it will be removed from the registry, and healthcare providers can no longer act on it.

If your preferences change, you can create a new AMD after revocation by following the standard registration process.

Is my AMD confidential?

Your AMD is a personal and private document.

The Ministry of Health (MOH) ensures that all registered directives are securely stored and accessible only to authorised personnel when required.

While confidentiality is maintained, it’s recommended to inform trusted family members or close friends about your AMD.

This helps avoid confusion and ensures they are prepared if the directive needs to be followed.

Can I name someone to make decisions for me if my AMD is not applicable?

Yes, you can name someone to make decisions for you if your Advance Medical Directive (AMD) is not applicable.

This can be done through a Lasting Power of Attorney (LPA).

An LPA allows you to appoint a trusted individual, called a “donee,” to make decisions on your behalf regarding personal welfare and financial matters if you lose mental capacity.

While the AMD is limited to end-of-life medical decisions, the LPA provides broader authority, covering scenarios where your AMD might not apply, such as non-terminal medical conditions or routine healthcare choices.

What happens if healthcare providers cannot locate my AMD in an emergency?

If healthcare providers cannot locate your Advance Medical Directive (AMD) in an emergency, they will proceed with the necessary treatments to stabilise your condition and preserve life.

Without access to your AMD, they have no legal proof of your preferences.

To prevent this, it’s crucial to ensure that your AMD is properly registered with the Registrar of Advance Medical Directives and that your loved ones and healthcare team know its existence.

Informing them where to access the document during critical moments can help ensure your wishes are respected.

Can my AMD be used overseas?

No, your Advance Medical Directive (AMD) cannot typically be used overseas.

The AMD is governed by Singapore’s Advance Medical Directive Act and is only legally recognised within the country.

Other jurisdictions have their laws and requirements regarding medical directives, which may not align with Singapore’s framework.

If you want your healthcare preferences to be honoured while abroad, it’s advisable to create similar documents that comply with the legal requirements of your destination country.

Will an AMD apply if I am in a non-terminal condition?

No, an Advance Medical Directive (AMD) will not apply if you are in a non-terminal condition.

The AMD is strictly limited to situations where you are certified by doctors as terminally ill, unconscious, or incapacitated with no chance of recovery.

For non-terminal conditions, other tools like a Lasting Power of Attorney (LPA) or Advance Care Planning (ACP) may be more appropriate.

These allow you to outline your preferences or appoint someone to make decisions for your care in scenarios that fall outside the scope of the AMD.

Use the AMD alongside other legacy planning tools

Lasting Power of Attorney (LPA)

While an AMD focuses on end-of-life medical treatment preferences, the Lasting Power of Attorney (LPA) allows you to appoint someone you trust – a “donee” – to make decisions on your behalf if you lose mental capacity.

This includes decisions about your property, finances, and even personal welfare.

However, unlike an AMD, an LPA does not cover specific medical treatment preferences.

This is where the 2 tools work in tandem.

The AMD ensures your medical wishes are followed, while the LPA empowers someone to handle broader aspects of your care and well-being.

Advance Care Planning (ACP)

Advance Care Planning (ACP) takes a more holistic approach to future healthcare decisions.

It’s an ongoing conversation between you, your family, and healthcare professionals to outline your preferences for medical care.

Unlike an AMD, a legally binding document, ACP is more flexible and explores your values, goals, and fears about medical treatments.

These conversations often feed into the creation of an AMD or help guide your donee under an LPA.

Wills

A will is a legal document that specifies how you want your assets, such as property, savings, and personal belongings, to be distributed.

It also allows you to appoint an executor who will manage your estate and carry out your wishes.

For parents, a will can also designate guardians for minor children, ensuring their well-being.

Read more about wills here.

Trusts

A trust, on the other hand, offers more flexibility and control over how your assets are managed and distributed.

It allows you to transfer assets into a legal arrangement managed by a trustee for the benefit of your chosen beneficiaries.

Trusts are especially useful for situations where:

  • You want to provide ongoing financial support to dependents, such as minor children or family members with special needs.
  • You aim to protect your assets from potential disputes or creditors.
  • You seek to minimise estate taxes or simplify the distribution process.

 

Unlike wills, trusts can take effect during your lifetime (living trusts) or upon your death (testamentary trusts).

Living trusts are particularly helpful in avoiding probate, a potentially lengthy and costly legal process.

Read more about trusts here.

Conclusion

Planning for your healthcare decisions is never easy, but an Advance Medical Directive (AMD) can make all the difference.

We’ve explored what an AMD is, its benefits like ensuring dignity in care and easing the burden on loved ones, and what it doesn’t cover.

We’ve also looked at how to create one, where to do it, the costs involved, and the flexibility to revoke or amend it if your circumstances or preferences change.

But we get it – this is a complex topic, and there might still be lingering questions or uncertainties.

If you’re feeling unsure or need more guidance, don’t worry.

Our trusted financial advisor partners can walk you through the details of legacy planning, including AMDs, all for free.

It’s a no-pressure way to make informed decisions that are right for you and your family.

Reach out today – you’ve got this!

References

Picture of Firdaus Syazwani
Firdaus Syazwani
In 1999, Firdaus's mother bought an endowment plan from an insurance agent to gift him $20,000. However, after 20 years of paying premiums, Firdaus discovered that the policy was actually a whole life plan with a sum assured of $20,000, and they didn't receive any money back. This experience inspired Firdaus to create dollarbureau.com, so that others won't face the same problem of being misled or not understanding what they are purchasing – which he sees as a is a huge problem in the industry.

Disclaimer: Each article written obtained its information from reliable sources and should be purely used for informational purposes only. The information provided by Dollar Bureau and its affiliated parties is not meant to be construed as financial advice. Dollar Bureau shall not be held liable for any inaccuracies, mistakes, omissions, and losses incurred should you act upon any information listed on this website. We recommend readers to seek financial planning advice from qualified financial advisors. 

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