Advance directives and life-sustaining treatment: attitudes of Hong Kong Chinese elders with chronic disease.

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.