Making an AMD

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Anyone who is aged 21 years old and above, and is not mentally disordered can make an AMD. All you need to do is complete an AMD form, sign in the presence of two witnesses, and return it to the Registrar of AMDs.

Step 1: Obtaining the AMD Forms

The forms are available from medical clinics, polyclinics and hospitals. You may also ask your doctor for the form if you have decided to make an AMD. Alternatively, you can also download the AMD form online.



Note: When printing the form, please print on both sides on a single sheet of paper.

Step 2: Consulting a doctor & Obtaining Witnesses

Consulting a doctor

The AMD must be made through a doctor (you do not need either a lawyer or legal advice to make an AMD). The doctor whom you consult will act as the first witness, whose responsibility is to ensure that:

  • You are not being forced into making the AMD.
  • You are of sound mind.
  • You understand the nature and implications of making an AMD.

Witnessess

One of the two witnesses must be a doctor, preferably the patient's family doctor. The other witness must be at least 21 years old.



Both witnesses must not have any vested interests in the patient's death. If the witnesses are relatives, so long as they have no vested interests in the patient's death, they would be allowed to act as witness. 



A doctor who for any reason objects to the AMD and registers his objection with the Registrar can refuse to witness the signing of an AMD. You can then approach another doctor to make your AMD.



You can pre-fill your details on Form 1. However, both witnesses must be present together to witness the person signing the AMD, as well as to sign the AMD form. As the first witness is your doctor, the second witness may be his nurse or any other suitable person.

Step 3: Returning form to Registrar of AMD

The completed form should be sent in a sealed envelope by mail or by hand to the Registrar of Advance Medical Directives at the address given below. Faxed copies will not be accepted.

The Registry of Advance Medical Directives

Ministry of Health, Singapore
College of Medicine Building,
16 College Road,

Singapore 169854

Tel: 63259136 Fax: 63259212



The advance medical directive is only valid when it is registered with the Registrar of Advance Medical Directives. The Registrar will send the maker of the directive an acknowledgement when the directive has been registered.

Cost of making an AMD

To make an AMD, you will have to consult a doctor who, as a witness, is required to explain the AMD to you. You may have to pay the doctor for the services rendered. However, the AMD form itself is free. 



Making the AMD while overseas

As long as the first witness is a doctor currently registered with the Singapore Medical Council (SMC), and the AMD is filed with the AMD Registry in Singapore, the AMD is considered valid.



Other matters to note

  • Validity

    It is NOT compulsory. The AMD is valid only when it is made voluntarily. No one can force another person to make an AMD.



    No one can make an AMD on behalf of another person, whether child or adult (even if the person is mentally incapable of making an AMD on his own)
  • Coercion

    It is the doctor's responsibility to fully explain and discuss the matter with the person and to ensure that he/she fully understands what he/she is signing.



    Forcing or misleading another person into signing an AMD is an offence punishable under the law.



    If convicted, such a person can be fined and imprisoned and disqualified as a beneficiary.
  • Family objections

    If you have made an AMD regardless of objections from members of your family, the doctors will have to respect your AMD.



    Hence, while making an AMD is a very personal decision, we encourage you to discuss it with your family members and loved ones. This will help them to understand and respect your wishes should you become terminally ill.
  • Admission to hospital

    Hospital staff, including doctors and nurses do not know who has made an AMD as it is confidential and they are NOT allowed to ask you if you have made an AMD.



    However, if your attending doctor has reasons to believe that you are terminally ill and unable to make your wishes known to him, he can check with the Registrar of Advance Medical Directives on whether you have made an AMD.
  • Terminal illness

    It is actually best to make an AMD when there is no pressure to do so - when you are well and healthy. If your family opposes it, you may wish to obtain their understanding before making the AMD. If you do not wish to inform your family, you can still proceed to make an AMD, which will remain confidential, until you wish to disclose it to someone.
  • AMD is NOT euthanasia or mercy killing

    Euthanasia/mercy killing is the deliberate ending of the life of a person suffering from an incurable and painful disease by unnatural means, such as the administration of lethal chemicals.



    An AMD acts as advanced instruction for your doctor not to prolong your life with extraordinary life-sustaining treatment, and to let the dying process take its natural course when you become terminally ill and unconscious.



    The AMD Act does NOT encourage euthanasia. On the contrary, the AMD Act is explicitly and categorically against euthanasia.

  • The Act states in:
    • Section 17(1)

      Nothing in the Act shall authorise an act that causes or accelerates death as distinct from an act that permits the dying process to take its natural course.
    • Section 17(2)

      It is hereby declared that nothing in this Act shall condone, authorise or approve abetment of suicide, mercy killing or euthanasia.

A terminally ill patient CANNOT use the AMD to commit suicide, nor does the AMD allow doctors to assist in any suicide attempt. This is punishable by law.