An ethico-legal study on end-of-life decisions in Malaysia : the need for a comprehensive regulatory reform

Abstract

The world of medicine is swiftly evolving with pharmaceutical and technological advancements that have redefined the dimensions of treatment and care. This is particularly pertinent in end-of-life care, where the development of medical equipment such as life support devices have further blurred the line between life and death. Accordingly, this has led to the need to analyse the pressing issues that have arisen from such a situation, namely the ethical enigmas, religious considerations and questions on the legality of end-of-life decisions. These matters of contention are further augmented by the increasing prevalence of patient autonomy in today’s practice. In Malaysia, issues in end-of-life care are an emerging area of concern, particularly as the country heads towards becoming an aging nation. To date, such issues have yet to be properly regulated by ethical codes and specific laws. This research sought to identify the ethical dilemmas, religious quandaries and legal standards relating to end-of-life decisions, as well as analyse the competency of the existing regulatory scheme in Malaysia to address such issues. It further examined the current framework and practices of advanced common law jurisdictions, such as the UK and Australia in the management of end-of-life care and the extent of their applicability to resolve the inadequacies in the context of the local scenario. To this end, this study employed the qualitative methods of content analysis and fieldwork interviews. Consequently, the findings of this research presented the need to address the inadequacies of the existing local ethical codes and legislation, and proposed recommendations towards the construction of a viable and holistic regulatory framework to govern end-of-life decisions in Malaysia.