Abstract
The right to refuse treatment is generally accepted in the legal and bioethics discourses; however, the use of advance directives remains contentious. Some jurisdictions have introduced statutory frameworks to govern the creation and implementation of advance directives, underpinned primarily by the recognition of respect for personal autonomy. Although there are no legislation and judicial decisions on advance decision-making in Malaysia, the considered view is that healthcare practitioners perceived its utility in managing patient care. This paper examines the potential and challenges of applying a statutory framework in Malaysia, drawing from relevant regulatory examples. It argues for greater public awareness within the healthcare discourse and knowledge dissemination regarding the availability, usage and clinical guidance on advance decision-making. The main conclusion drawn from this exploratory analysis is that further understanding of and education about advance decision-making within the population and healthcare practitioners should precede the implementation of a statutory regime in Malaysia.
Highlights
Advance directives (ADs) provide the opportunity for people to express their treatment preferences which will become effective when the person is unable to refuse consent at a future time
There are no legislation and judicial decisions on advance decision-making in Malaysia, the considered view is that healthcare practitioners perceived its utility in managing patient care
The main conclusion drawn from this exploratory analysis is that further understanding of and education about advance decision-making within the population and healthcare practitioners should precede the implementation of a statutory regime in Malaysia
Summary
Advance directives (ADs) provide the opportunity for people to express their treatment preferences which will become effective when the person is unable to refuse consent at a future time. The MCA example clearly illustrates that there are pre-requisites for ADs refusing life-sustaining treatment which affect their implementation These requirements in turn necessitate knowledge and information regarding how to create legally compliant ADs. further restrictions on the scope and language of the ADs have modified the way they are made under the common law. While the law adopts the prevalent interpretation of autonomy in decision-making, this notion appears to be incompatible with its established socio-cultural practices In this sense, the challenge faced by Singapore is similar to Malaysia and it is essential to re-evaluate the idea of introducing a legal framework underpinned by ethical concepts that are unsuitable to a particular social demography. The following section considers the appropriateness developing an AD law for Malaysia, considering the various challenges and potential
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