PRESERVING PATIENT AUTONOMY AT THE END OF LIFE: A LEGAL APPRAISAL OF THE POSITION OF ADVANCED MEDICAL DIRECTIVES IN MALAYSIA AND INDONESIA

Fadhlina Alias; Diah Martina; Muh. Endriyo Susila; Rizaldy Anggriawan

doi:10.33102/mjsl.vol12no2.679

Authors

Fadhlina Alias Faculty of Syariah and Law, Universiti Sains Islam Malaysia, 71800 Nilai, Negeri Sembilan, Malaysia https://orcid.org/0000-0001-7491-7717
Diah Martina Division of Psychosomatic and Palliative Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia / Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia https://orcid.org/0000-0002-0889-223X
Muh. Endriyo Susila Faculty of Law, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia https://orcid.org/0000-0002-1226-3321
Rizaldy Anggriawan Faculty of Law and Political Sciences, University of Szeged, 6720, Dugonics tér 13, Szeged, Hungary

DOI:

https://doi.org/10.33102/mjsl.vol12no2.679

Keywords:

Advance care planning, advance directives, end-of-life care, Malaysian law, Indonesia law

Abstract

Respect for patient autonomy is a bioethical principle that has become increasingly imperative, particularly in the 21^st century. However, in many Asian countries, medical paternalism to a larger degree remains prevalent in the healthcare setting. While a doctor is ethically and legally bound to respect a patient's values and wishes in administering treatment, the duty to do so is more complex in end-of-life care, where the patient is unable to partake in the decision-making process. Accordingly, it has been argued that advanced medical directives (AMDs) could ensure that the patient's right to make autonomous decisions is preserved and will not be defeated by any future incapacity. It also serves to extenuate the ethical dilemma faced by doctors in determining the course of treatment according to the incompetent patient's wishes. In turn, this facilitates healthcare providers to manage the distribution of scarce medical resources effectively. The need for AMDs is seen to be increasingly pressing in ageing countries such as Malaysia and Indonesia, where end-of-life care has yet to be integrated into mainstream healthcare services. This paper seeks to discuss the viability of integrating AMDs into the Malaysian and Indonesian regulatory frameworks on health care, by employing the qualitative method of content analysis of both primary and secondary sources of the two countries. Findings show that statutory reform is both recommended and necessary to ensure better management of medical resources, as well as to promote the delivery of a more inclusive and compassionate healthcare system.

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