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Paramedics to follow ‘rescue first’ rule if in doubt under new end-of-life law

Fire Services Department official says paramedics must first verify physical proof before stopping life-sustaining treatment on patient

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Queen Elizabeth Hospital. Hongkongers will be able to upload orders specifying which life-sustaining treatments they do not wish to receive when terminally ill. Photo: Edmond So
Jess Ma

The Hong Kong Fire Services Department has said paramedics will operate on the “if in doubt, rescue first” principle when determining whether to resuscitate patients in need after the new law on end-of-life directives takes effect next week.

Assistant Chief Ambulance Officer Gary Tong Sze-ho of the Fire Services Department said on Friday that rescuers must verify a physical copy of the do-not-attempt cardiopulmonary resuscitation (DNACPR) order before withholding specified life-sustaining treatments from the patient.

“If we cannot verify the document on-site, we will carry out life-saving measures on the patient based on the principle of ‘if in doubt, rescue first’,” Tong said.

Under the city’s new legislation on end-of-life directives, Hongkongers can specify which life-sustaining treatments, such as cardiopulmonary resuscitation (CPR), they wish to refuse in the future should they lose their mental capacity or reach a defined clinical condition such as a persistent vegetative state. The law will take effect next Friday.

Hongkongers will also be able to obtain a DNACPR order, which instructs rescuers not to perform CPR in out-of-hospital environments when a patient suffers cardiopulmonary arrest.

However, Tong said officers must be able to verify that the patient’s DNACPR form was valid and applicable before they could bring the unconscious patient to hospital while offering other forms of care and treatment applicable.

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