My Advance Care Plan (ACP)
Medical Development Division
Ministry of Health Malaysia
Kompleks E, Presint 1
W.P. Putrajaya
BM
OVERVIEW
Advance Care Planning (ACP) is essentially a proactive discussion among loved ones, expressing one’s wishes as to the extent of medical care he / she wishes to receive / decline in the future, should his / her health condition deteriorates for the worse and they can no longer make decisions for themselves anymore. These discussions are not easy to initiate and may be difficult to guide and navigate. This can be a helpful guide with more general information to answer frequently asked questions and address specific queries.
These discussions should be facilitated with accurate information about the condition, outlook and prognosis of the patient. Therefore, appropriate discussions with treating healthcare providers are necessary before making decisions or any changes to any decisions previously made.
Often, the outcome of these discussions are written down to be recalled when required, or to be communicated to healthcare providers when needed. The documentation of these discussions and the decisions made are important, especially for patients dealing with progressively debilitating illnesses or deteriorating clinical conditions. However, the requirement to document any decision should not override the need to have any ACP discussion; often such decisions need time for reflection and further deliberations. Discussions should still continue unhindered.
PURPOSE & SCOPE
This general website aims to provide general guidance as well as useful resources for members of our community intending to obtain more information about advance care planning in Malaysia. It intends to help increase awareness and use of ACP in general.
An Advance Care Planning program comprises a wide spectrum of activities – ranging from community directed actions for the general population, to hospital directed initiatives aimed at patients with diagnoses of progressively debilitating illnesses, and to hospices and nursing care facilities, for those at the end of life.
Activities to encourage Advance Care Planning on the whole must address general concerns, provide information, answer queries and address misconceptions. To be effective, these activities must be directed at the general community at large, via public health agencies and NGOs, and delivered via social media and other public awareness campaigns. These cannot be doctor-based nor solely hospital-centered. That is the primary scope of this website.
Advance Care Plans that involves decisions for patients with progressively debilitating illnesses must be made with treating doctors – covering detailed deliberations on expected prognosis, treatment goals and jointly agreed targets – which is usually done during in-person communications between healthcare providers with patients and their loved ones. These ACP discussions may incorporate refusals of certain interventions, indications of scope or location of end of life care and generally any type of care or refusal of care would also be covered in these detailed discussions. That is beyond the scope of this website. Those needing assistance in these areas should be directed to discussions with their healthcare providers.
I am a Health Provider
This means I am viewing these information and guides as a treating clinician, giving advice to others who may need them in a professional capacity. I understand that each patient may be different and every condition deserves to be considered individually to serve the best interests and wishes of the patient.
I am a CareGiver
This means I am viewing these information and guides in the context of providing assistance to loved ones and those under my care; I am often among the ones who spend the most time with my patient, and may understand or help to communicate their wishes more easily. I may also be better equipped to assist with the best care of my patient at every stage of their illness. Therefore, my intention is to serve the best interests and wishes of the patient.
I am an Individual
This means I am viewing these information and guides as a normal individual, regardless of whether I am healthy or informed and in need of medical assistance or not. I understand that Advance Care Planning is entirely voluntary, without compulsion, at all times. I know that it is essentially a communicative plan discussed with my loved ones, to put into place my wishes and preferences, towards the end of life, regardless of when that may happen. I realize that my Advance Care Planning can be done at any age, at any stage of life. I know that I can change your mind at any time if I wish – if I do, I just have to see that I communicate it in the same way to all my family members and loved ones. I understand that each person is different, every circumstance in time may differ and every situation deserves to be considered individually; ultimately the best interests of the patient being treated may be the deciding factor.
