The signed forms would help to reinforce a common-law principle Terminally ill patients and those in a persistent vegetative state should be able to state in advance on a form whether they wish to live or die, the Law Reform Commission proposed yesterday. They could be 'reasonably assured' that their decisions would be carried out, the commission said. In a report on decision-making for patients with no hope of recovery, the commission argued against a legislative approach, but proposed issuing a form for people to sign, stating their intentions when they are still healthy. The form would help reinforce a common-law principle under which individuals may, while capable, give directions on their future health care once they no longer have the capacity to make such decisions. The lack of an agreed form had created doubts over whether patients' wishes would be carried out, the commission said. A draft standard form issued by the commission yesterday would allow people to direct doctors on whether to resuscitate them. It would require the presence of two witnesses, including a medical practitioner. The commission called on the government to promote the practice. Sophie Leung Lau Yau-fun, who headed the subcommittee on the topic, said the issue was not euthanasia, which is illegal in Hong Kong. It was about whether devices should be used to postpone the death of a patient who is terminally ill, in a persistent vegetative stage or irreversibly comatose. 'Terminally ill' patients are those with a short life expectancy 'in terms of days, weeks or a few months', suffering from advanced, progressive and irreversible diseases. They can choose to stop artificial ventilation, cardiopulmonary resuscitation and treatment such as chemotherapy, but not basic care, food and drink. Commission head Stuart Stoker said the form would make the patient's wishes 'clear and unambiguous' and would override the wishes of the family. But he said people should draft the directives in consultation with their families and doctors to prevent unnecessary stress. President of the Hong Kong Medical Association Gabriel Choi Kin said that without legislation, the advance directive may become 'a useless piece of paper'. 'If a patient chooses not to be resuscitated and have his suffering prolonged when he comes to the end of his life, doctors should be advocates for their patients' wishes. But sometimes, relatives may barge in and may want to prolong things .... this puts the doctor in a difficult situation.' Lawrence Lai, deputy head of the commission subcommittee, said common law already offered adequate protection to doctors as long as they acted in the best interests of the patients or followed their instructions. Kwok Ka-ki, who represents the medical sector in the legislature, said the report did not give clear directions on legislating. A Hospital Authority spokesman said it would study the recommendations, and called on patients and their families, as well as health-care professionals, to consider the issues seriously. The Health, Welfare and Food Bureau said that it would study the matter.