If you are caring for a minor
Parents or legal guardians generally have the right to access a child's medical records on behalf of the child. Hospitals and clinics will typically only release records to the parent or legal guardian.
If you are caring for an adult (21 years old and above)
If the adult has mental capacity, he or she must consent to sharing their medical records with you. If the adult lacks mental capacity, only a person with legal authority—such as a donee under an LPA or a court-appointed deputy with appropriate powers—can access medical records on his or her behalf. Simply being a family member does not automatically give you that right.
If you are caring for a minor (below 21 years old)
Parents or legal guardians can usually consent to medical treatment on behalf of the child. As the child grows older, his or her views may be taken into account where appropriate. In emergency situations, doctors may provide necessary treatment without prior consent if it is urgently needed to protect the child's life or health.
If you are caring for an adult (21 years old and above)
If the person has mental capacity, they make their own healthcare decisions. Individuals aged 21 and older with mental capacity can make an Advance Medical Directive (AMD) to refuse extraordinary life-sustaining treatment in the event that they are terminally ill and unconscious.
If a person lacks mental capacity, consent for his or her medical decisions may only be given by someone with legal authority, such as a Lasting Power of Attorney donee or court-appointed deputy, however these persons do not have power to refuse life sustaining treatment or treatment to prevent a serious deterioration in condition of the person. In emergency situations, doctors may provide necessary treatment without prior consent if the adult lacks mental capacity and immediate treatment is required. If the person had made an AMD while he or she still had capacity, the doctors have to comply with the AMD.
An Advance Medical Directive (AMD) is a legal document. It is a declaration made in advance by an adult (who has full mental capacity) stating that they do not want extraordinary life-sustaining treatment to be used to prolong their life if they are:
The AMD was developed so that individuals can, in advance, give or withhold consent as required, rather than having these decisions made by others.
An AMD is different from an Advance Care Plan—an AMD specifically deals with the refusal of extraordinary life-sustaining measures in terminal situations.
To make a valid AMD in Singapore, you must be:
The AMD takes effect only when your doctor, after consultation with another medical practitioner, certifies that you are terminally ill and unconscious with no reasonable chance of recovery.
You may revoke your AMD at any time while you still have mental capacity. You can do this by:
The revocation should be notified to the MOH's AMD Registry to update their records.
An Advance Care Plan (ACP) is a voluntary, non-legally-binding document that records the maker’s personal values, preferences, and wishes about the care and treatment he or she would want to receive — especially in situations where they can no longer communicate for themselves.
Unlike an AMD (which legally directs doctors to withhold extraordinary life-sustaining treatment), an ACP is a guide to help the maker’s healthcare team and loved ones understand their wishes.
Anyone who is 21 years of age or older and has mental capacity can make an Advance Care Plan (ACP). If you are caring for an adult with mental capacity with a likelihood of future deterioration, he or she may wish to consider making one while they are well and still have the necessary capacity.
You can make an Advance Care Plan (ACP) by:
There is no formal registration requirement, but your ACP should be shared with your doctor and kept on your medical records.
You can update your Advance Care Plan (ACP) at any time by speaking with your ACP facilitator or doctor. It is a good idea to review and update your ACP whenever your health condition, personal values, or preferences change significantly.
Since an Advance Care Plan is not legally binding, you can revoke or change it at any time simply by informing your doctor, family, or ACP facilitator. You should ask that the old ACP be removed from your medical records and replaced with any updated plan.
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