Hong Kong Med J 2011;17:105–11 | Number 2, April 2011
Advance directives and life-sustaining treatment: attitudes of Hong Kong Chinese elders with chronic disease
Fion H Ting, Esther Mok
Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
OBJECTIVE. To examine the attitudes of Hong Kong Chinese elders with chronic disease with regard to advance directives and life-sustaining treatment.
DESIGN. Cross-sectional questionnaire survey.
SETTING. Medical unit of a regional teaching hospital in Hong Kong.
PARTICIPANTS. In-patients aged 60 years or above with chronic disease.
MAIN OUTCOME MEASURES. Demographic profiles and attitudes towards advance directives and life-sustaining treatment.
RESULTS. A total of 219 elderly patients completed the questionnaire. Their mean age was 73 (standard deviation, 8) years; 133 (61%) were female. The majority had neither heard about advance directives (81%), nor discussed the issue with others (73%) before participating in this study. After they were informed of the concept of advance directives, about half (49%) said they would consider using it if it is legislated in Hong Kong. The respondents generally supported the withholding or withdrawing of life-sustaining treatment in medically futile situations. In all, 55% of them believed that the patient alone should make the decision on withholding or withdrawing life-sustaining treatment, if competent to do so. If the patient became not competent, 44% believed that the individual's family alone should make such a decision.
CONCLUSION. The fact that most of the respondents had never heard about advance directives or discussed the concept with others points to a lack of knowledge and to the necessity to step up public education about such issues.
Key words: Advance directives; Chronic disease; Decision making; Ethics, medical; Life support care
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