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Otherwise, it is pointless to sign in advance.” from citizen’s education instead of legislation,”
says Shea.
Changes starting from education Developing a culture of respect among mem-
Public awareness about end-of-life issues is also bers of the public is crucial in promoting advance
low in the socio-cultural context. Statistics from directive. “Doctors will bring out the topic to pa-
the Hospital Authority show a slight increase in tients when a bleak future is foreseeable… Family
the number of patients signing ad- members who have taken care
vance directives from 937 in 2016 to To promote of patients around the clock are
1,557 in 2018. Another population- more likely to respect patients’
based cross-sectional telephone a measure, you should start decisions,” says Shea. And he
survey of 1,067 adults in 2017 by the from citizen’s education thinks that the public, espe-
Chinese University of Hong Kong instead of legislation, cially secondary school stu-
indicates a total of 85.7 dents should be more exposed
per cent had not to life and death topics, so that
heard of advance directive. But af- they have a clearer concept of advance directive
ter explanation, 60.9 per cent said and higher acceptance of it. “It should be done by
they would make their own ad- the Education Bureau because Hospital Authority
vance directive if it is legislated. is only a medical department,” says Shea.
Chung agrees that the pub-
lic mindset about death can be
Roger Chung changed through education. Edited by Civi Yap
Yat-nork
“Take Taiwan as an example, end-
of-life education is covered start-
ing from kindergarten, so they are more mentally
prepared when discussing death,” says Chung.
The Taiwanese government includes life and
death topics into the education system to break
down cultural taboos against discus- Left: The current Advance Directive form provided by Hospital Authority;
sion about death. The concept of pal- Right: A program about End-of-Life care and planning launched by the CUHK
liative care is also introduced through Jockey Club Institute of Ageing.
mainstream and social media to in-
crease public awareness. In the 2015
Quality of Death Index conducted by
The Economist, Taiwan ranked sixth
among other 80 countries with a
score of 83 over 100.
While Hong Kong
only ranked 22
with a score of 67.
The power of
education is ech-
oed by Dr. Paul
Shea Tat-ming, co-
Dr. Paul Shea chairman of the
Tat-ming Hong Kong Med-
ical Association
of End of Life Care, and a specialist
in Geriatric Medicine. He believes
people with higher education com-
prehend life planning easier. “To
promote a measure, you should start