AMD vs DNACPR: both about “no CPR” — completely different tools
One is your advance decision; the other is a doctor’s clinical order. Know the difference before it matters.
In one glance
| Aspect | AMD | DNACPR |
|---|---|---|
| Who decides? | You (signed in advance) | Doctor (after consensus) |
| Refuses what? | Any life-sustaining treatment | CPR only |
| When effective? | Loss of capacity + qualifying condition | When heart/breathing stops |
| Signed by? | You + 2 witnesses (1 doctor) | Attending + specialist doctor |
| Legal basis | Cap. 651 | Ordinance + HA clinical guidance |
What is an AMD?
An AMD is a legal document you sign while competent, stating which life-sustaining treatments you refuse under three qualifying conditions.
It is a statement of wishes — activation depends on a doctor confirming the qualifying condition.
What is a DNACPR?
A DNACPR is a clinical order signed by doctors instructing teams not to perform CPR if the heart or breathing stops.
It is immediately effective — paramedics and hospital staff who see it will comply.
Remember with one diagram
Who decides?
AMD
- • You decide
- • Refuse multiple LSTs
- • Terminal / PVS etc.
- • 1 doctor as witness
Who decides?
DNACPR
- • Doctor decides
- • CPR only
- • When heart/breathing stops
- • 2 doctors sign
Simply: AMD is your wish; DNACPR is the doctor’s execution order based on that wish.
Detailed comparison
| Aspect | AMD | DNACPR |
|---|---|---|
| Signed by | Patient | Doctor (two signatures, including a specialist) |
| Nature | Legal document (patient's wishes) | Clinical order (doctor's instruction) |
| When it takes effect | When a doctor diagnoses the qualifying condition | Immediately upon sight of the document |
| Scope | All life-sustaining treatments (not just CPR) | CPR only |
| Witnesses | Two witnesses (one must be a doctor) | No witnesses required |
| Revocation | Anytime orally or in writing | Cancelled by doctor reassessment |
| Paramedics comply? | No — cannot verify qualifying conditions on-site | Yes — follow the order immediately |
| Effective at home? | Partially (depends on doctor's assessment) | Yes (paramedics will comply) |
Real scenarios
Scenario A: AMD only
Uncle Chan signed an AMD refusing CPR. He dies at home with terminal cancer. No DNACPR is needed outside hospital — the family presents the AMD and the doctor confirms the conditions are met.
Scenario B: DNACPR only
Granny Cheung is in hospital. Doctors agree CPR would be futile and issue a DNACPR after discussing with family. Only CPR is refused; other treatments may continue.
Scenario C: Both
Mr Lee signed an AMD while healthy (refusing CPR, ventilation, and dialysis). In hospital, doctors issue a DNACPR based on his AMD. When his heart stops, no CPR; when dialysis is needed, it is withheld per the AMD.
Which fits me?
| If you… | Suggestion |
|---|---|
| Healthy and planning ahead | ✅ Start with an AMD |
| Already diagnosed terminal | ✅ Arrange both AMD and DNACPR |
| Family in hospital; doctor advises no CPR | ✅ DNACPR (doctor-led) |
| Unsure what you want | ✅ Consult a doctor about AMD first |
| Refuse CPR only; other care continues | ✅ Consider CPR-only arrangements (Form 2) |
AMD, DNACPR & the “Three Peaceful Documents”
The “three peaceful documents” are three separate instruments. We focus on AMD — we are doctors, not lawyers.
AMD
Refuse life-sustaining treatment
✅ Doctor home visit
EPA
Appoint someone for finances
⚠️ Can arrange together
Will
Distribute assets
❌ See a lawyer
Home death scenario
For a planned home death, a private doctor can issue a Medical Certificate of Cause of Death at home — no ambulance or A&E. In that case you may not need AMD or DNACPR because you will not enter hospital.
What matters most is a doctor team willing to provide home-based end-of-life care — which DoctorNow Home offers.
Want to learn more?
WhatsApp us — our team will answer your AMD and DNACPR questions.