OBJECTIVE. To examine the attitudes of Hong Kong Chinese elders with chronic disease with regard to advance directives and life-sustaining treatment.

DESIGN. Cross-sectional questionnaire survey.

SETTING. Medical unit of a regional teaching hospital in Hong Kong.

PARTICIPANTS. In-patients aged 60 years or above with chronic disease.

MAIN OUTCOME MEASURES. Demographic profiles and attitudes towards advance directives and life-sustaining treatment.

RESULTS. A total of 219 elderly patients completed the questionnaire. Their mean age was 73 (standard deviation, 8) years; 133 (61%) were female. The majority had neither heard about advance directives (81%), nor discussed the issue with others (73%) before participating in this study. After they were informed of the concept of advance directives, about half (49%) said they would consider using it if it is legislated in Hong Kong. The respondents generally supported the withholding or withdrawing of life-sustaining treatment in medically futile situations. In all, 55% of them believed that the patient alone should make the decision on withholding or withdrawing life-sustaining treatment, if competent to do so. If the patient became not competent, 44% believed that the individual's family alone should make such a decision.

CONCLUSION. The fact that most of the respondents had never heard about advance directives or discussed the concept with others points to a lack of knowledge and to the necessity to step up public education about such issues.

Key words: Advance directives; Chronic disease; Decision making; Ethics, medical; Life support care

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