What is Advance Directive?
什么是预设医疗指示?
The advance directive is classified into instructional directive (a living will) which usually comprises of instructions about what kind(s) of life-sustaining treatment that a patient wishes to refuse/endorse when he/she becomes mentally incapacitated under some specified circumstances. It is legally bound in Hong Kong. A proxy directive (durable/lasting power of attorney for health care) expresses the patient’s wish to appoint another person (the so-called proxy, surrogate, or representative), usually a family member, to make health care decisions on his/her behalf when he/she becomes mentally incapacitated under some specified circumstances. A proxy directive has no legal status in Hong Kong at the current stage. The Law Reform Commission of Hong Kong has recommended in 2006 that the concept of the advance directive should be promoted in Hong Kong by non-legislative means.
An opinion survey was carried out from 9 November 2012 to 16 November 2012 by telephone interview. The interviewees were selected randomly. A total number of 964 phone calls were made and 320 persons responded to the questionnaire. The response rate was 33.2%. Three hundred and eighteen persons (99.3%) had never heard of advance directive. To evaluate the impact of the promotion, another opinion survey was done on 24 September 2018 with random selection of 103 old age homes in Hong Kong. Among the 103 calls, 79 of them (response rate 76.7%) responded to the question. Thirty of them were aware of the existence of advance directive which constituted 38% of the respondents. There is a drastic increase in the awareness.
预设医疗指示分为指导性指示（生前遗嘱），通常包括有关患者在某些特定情况下当精神上无行为能力时希望拒绝或接受什么样的生命维持治疗的指示。 它在香港有法律约束力。 代理指令（持久的医疗护理授权书）表示患者在某些特定情况下当精神上无行为能力时希望任命另一人（所谓的代理人，替代人或代表），通常是家庭成员，代表他/她作出医疗护理决定。 代理指令目前阶段在香港没有合法地位。 香港法律改革委员会在二零零六年建议以非立法手段在香港推广预设医疗指示的概念。
2012年11月9日至2012年11月16日期间通过电话采访进行意见调查。 受访者随机选择。 共拨出964个电话，320人回覆了问卷。 答复率为33.2％。 三百一十八人（99.3％）从未听说过预设医疗指示。为了评估推广的影响力，在2018年9月24日进行了另一次问卷调查。随机选择了103间老人院进行电话访问，其中有79间回答了问题（答复率为76.7%）。当中30间知道预设医疗指示的存在，为回复者的38%。这显示认知率有显著的提升。
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