9. Certification of terminal illness

Amended

Last amended by an amending law of 2023.

(1)

Where a medical practitioner, who is responsible for the treatment of any person, has reason to believe that the person —

(a)

is suffering from a terminal illness;

(b)

requires extraordinary life‑sustaining treatment; and

(c)

is unconscious or incapable of exercising rational judgment,the medical practitioner must —

(d)

determine and certify in the prescribed form that the person is suffering from a terminal illness and the reasons for the determination; and

(e)

forward the certificate to the Registrar with a request that a search of the register be conducted in order to ascertain whether the person has made a directive which is in force.

(2)

Upon receipt of a request made under subsection (1), the Registrar must cause a search of the register to be conducted in order to ascertain whether the person has made a directive which is in force and must thereafter inform the medical practitioner accordingly.

(3)

Where the Registrar informs the medical practitioner responsible for the treatment of the person who has been certified to be terminally ill that the patient has made a directive which is in force, that medical practitioner must obtain, in the prescribed form, the opinion of 2 other medical practitioners as to whether they agree with the determination that the patient is terminally ill.

(4)

Where the medical practitioner responsible for the treatment of the patient —

(a)

is not a specialist, the 2 other medical practitioners mentioned in subsection (3) must both be specialists; or

(b)

is a specialist, at least one of the 2 other medical practitioners mentioned in subsection (3) must be a specialist.

(5)

Where the opinions of the 2 medical practitioners mentioned in subsection (3) are not unanimously in agreement that the patient is terminally ill, the issue must be referred for determination to a committee of 3 specialists (called in this section the committee) appointed by the Director‑General from among the panel of specialists referred to in section 8.

(6)

A patient is, on a reference to the committee, determined to be terminally ill only on the unanimous decision of the committee.

(7)

If the committee is unable to reach a unanimous decision, the patient is presumed not to be terminally ill.

(8)

The committee’s determination must be recorded in the prescribed form and sent to the medical practitioner responsible for the treatment of the patient.

(9)

A medical practitioner must not certify or participate in the determination or certification that the patient is terminally ill if the medical practitioner —

(a)

is a beneficiary under the patient’s will or any policy of insurance;

(b)

has an interest under any instrument under which the patient is the donor, settlor or grantor;

(c)

would be entitled to an interest in the moneys of the patient held in the Central Provident Fund or other provident fund on that patient’s death; or

(d)

has registered an objection under section 10(1).

Terms defined in s 2

directive
Defined · s 2
“directive” means an advance medical directive made under section 3;
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Director‑General
Defined · s 2
“Director‑General” means the Director‑General of Health;
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extraordinary life‑sustaining treatment
Defined · s 2
“extraordinary life‑sustaining treatment” means any medical procedure or measure which, when administered to a terminally ill patient, will only prolong the process of dying when death is imminent, but excludes palliative care;
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medical practitioner
Defined · s 2
“medical practitioner” means a person who is registered, or deemed to be registered, as a medical practitioner under the Medical Registration Act 1997;
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patient
Defined · s 2
“patient” means any person (whether or not he or she is undergoing any medical treatment, care or therapy) who is not mentally disordered, who has attained 21 years of age and who has made or desires to make a directive in accordance with this Act;
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register
Defined · s 2
“register” means the register of advance medical directives established under section 6;
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Registrar
Defined · s 2
“Registrar” means the Registrar of Advance Medical Directives appointed under section 6 and includes a Deputy Registrar and an Assistant Registrar;
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specialist
Defined · s 2
“specialist” means a medical practitioner who possesses such postgraduate medical qualifications as the Director‑General may recognise for the purposes of this Act;
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terminal illness
Defined · s 2
“terminal illness” means an incurable condition caused by injury or disease from which there is no reasonable prospect of a temporary or permanent recovery where —(a)death would, within reasonable medical judgment, be imminent regardless of the application of extraordinary life‑sustaining treatment; and(b)the application of extraordinary life‑sustaining treatment would only serve to postpone the moment of the patient’s death.
Open s 2

Report

Read on from s 10