Could you choose to stop further treatment?

One common scenario that families face is the question of what to do when all treatment options have been exhausted. Their doctor may begin to use words like ‘futile’ or ‘poor prognosis’.

It can feel like being on a high speed train, and suddenly hearing that you’ve run out of rails. Even worse, everyone is looking to you, because somewhere along the line, you signed a document saying that you accept the responsibility to speak for the patient should they lack capacity to do so.

You’re the captain of this high speed train.

Or so it seems.

But it isn’t true.

Even when you’ve signed a document accepting the responsibility to do so, the law in Singapore does not place you in a position of final authority. The Mental Capacity Act places the authority in the hands of the doctor. They are the ones who will make the final choice.

Your role, as a spokesperson, is to represent the wishes of the patient as best you can. Your role, as a spokesperson, isn’t necessarily to act on your own, but to gather the opinions of others who matter. The family should make the decision together, and communicate it to the doctor. The doctor, who has the skill and knowledge to do so, should then apply the expressed preferences to the context, and return with a professional recommendation on care. It’s a shared decision.

Nobody needs to captain this train alone.