Legal framework for refusing future life‑support takes effect

Patients must meet statutory requirements before signing one.

Hong Kong's Advance Decision on Life-sustaining Treatment Ordinance entered into force today, the government announced.

The ordinance creates a legal framework for advance medical directives (AMDs) and do-not-attempt cardiopulmonary resuscitation (DNACPR) orders, and shields healthcare professionals and rescuers from liability when following them.

An AMD lets a mentally capable adult with an advanced, irreversible disease pre-specify which life-sustaining treatments to refuse if they later lose mental capacity and preset conditions are met.

However, it cannot be used to refuse basic or palliative care. Patients must meet statutory requirements before signing one and can revoke it at any time.

A DNACPR order is issued by a registered doctor for a patient meeting specified conditions, directing rescuers not to perform CPR even outside hospital settings and without medical staff present.

From today, healthcare professionals and rescuers must comply with a patient's AMD or DNACPR order once notified of it and its conditions are met.

Under the principle of "if in doubt, save lives first,” they are legally protected if they administer treatment because they were unaware of a valid order, or withhold treatment based on a reasonable belief that a valid order exists.

The Legislative Council passed the ordinance in November 2024. The Government set a roughly 18-month preparation period before gazetting 31 July as the commencement date on 22 May 2026.