By Alex Liu and Hannah Liu

Hong Kong, 8 October 2026: A new law that formally recognises a terminally-ill patient’s right, under certain circumstances, to refuse life-sustaining treatments is now in effect. It gives Hong Kong a much-needed legal framework for this highly sensitive area of care services and support, respecting patients’ autonomous choices while offering protection for healthcare professionals and rescuers.

Under the Advance Decision on Life-sustaining Treatment Ordinance (Cap. 651), mentally capable adults can specify in writing, in advance, whether or not life-sustaining treatments may be applied if they fall terminally ill and lose their mental capacity.

It offers greater clarity to a regime in which residents can sign advance medical directives (AMDs) and do-not-attempt cardiopulmonary resuscitation (DNACPR) orders. These two key instruments have been available under common law for many years, but the new legislation provides clearer protection and removes legal uncertainty.

An AMD allows a terminally ill patient to specify which life-sustaining treatments they wish to refuse should they become mentally incapable. Such treatments may include cardiopulmonary resuscitation, artificial ventilation, or artificial nutrition and hydration. However, an AMD does not allow the refusal of basic or palliative care.

In line with the principle of “cautious making, easy revoking”, the patient must, before making an AMD, fully understand and carefully weigh the implications of each instruction and the AMD must comply with a number of statutory requirements. The patient may also revoke it at any time by tearing up the document, issuing a written declaration, or simply expressing their wish verbally to an adult witness.

A DNACPR order, made by registered medical practitioners for a patient who has met specified preconditions, seeks to ensure that, in settings outside hospitals and even when no healthcare professionals are present, rescuers will act in accordance with the relevant DNACPR order and will not perform cardiopulmonary resuscitation.

Healthcare professionals and rescuers are required to act in accordance with the patient’s AMD or DNACPR order when they have notice of it. Under the principle of “if in doubt, save lives first”, the Ordinance provides legal protection for medical workers, exempting them from the relevant legal liability.

In conclusion, we can say the new legislation is a milestone in care services in our city. Humane and compassionate, it allows terminally ill patients to complete their life journeys with dignity and enjoy greater autonomy while protecting healthcare workers going about their duties.

Further information about the Ordinance is available on the Health Bureau’s thematic webpage. As well, we recommend that anyone considering making an AMD should seek legal advice. Here at BC&C, we actively assist clients in making AMDs in the prescribed statutory form. We have a team experienced in dealing with sensitive issues surrounding mental capacity, vulnerable clients, estate planning and related matters.

Alex Liu is Managing Partner of BC&C. His key areas of practice include commercial and corporate litigation, investigations by governmental bodies, wills and probate, estate and succession planning, insolvency and debt restructuring, intellectual property and employment matters. He can be contacted at alex@boasecohencollins.com.

Hannah Liu joined BC&C as a Trainee Solicitor in 2024, having earned both her law degree and Postgraduate Certificate in Laws from the Chinese University of Hong Kong. She will soon be admitted as a Solicitor in Hong Kong. She can be contacted at hannah@boasecohencollins.com.