[{"id":"ec531f53-837f-4818-b1e5-5ef5a1fec40b","order":1,"text":"ADVANCE MEDICAL DIRECTIVE","fontSize":"20","textAlign":"center","bold":true,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"6f611a64-9c87-43cf-9c53-40078cc5657d","order":2,"text":"Made under the Advance Decision on Life-sustaining Treatment Ordinance (Cap. 651)","fontSize":"14","textAlign":"center","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"240ceca5-cac6-4c0c-8c90-599b3e210b7e","order":3,"text":"Including a request and consent in respect of a do-not-attempt cardiopulmonary resuscitation (DNACPR) order","fontSize":"12","textAlign":"center","bold":false,"underline":false,"marginBottom":"26","cflou":false,"active":true},{"id":"0712e89d-818d-4254-95b5-14acaed83d85","order":4,"text":"PARTICULARS OF THE MAKER","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"afe030c5-9484-43ef-b834-96a8690938b2","order":5,"text":"Full name (as shown on the Hong Kong Identity Card): [Full name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"9159fad7-5254-4cca-b351-1a0911788c74","order":6,"text":"Hong Kong Identity Card number: [HKID number of the Maker]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"7f7ec710-b2c7-41ee-b6da-f7f76ef45abd","order":7,"text":"Date of birth: [Date of birth]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"3081db7a-1473-478f-a2d8-5da5492fa435","order":8,"text":"Residential address: [Residential address]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"a483fdc5-78ae-4963-87cb-62f2543644b6","order":9,"text":"Contact telephone number: [Telephone number of the Maker]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"af201b4d-5620-406c-a2d3-4c103f4fae9a","order":10,"text":"I, [Full name], of [Residential address], holder of Hong Kong Identity Card number [HKID number of the Maker] (the \"Maker\"), MAKE THIS ADVANCE MEDICAL DIRECTIVE on [Date of signing] in the terms set out below.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"18","cflou":false,"active":true},{"id":"e385af44-2d8c-46fc-978f-e515cf177ceb","order":11,"text":"1. INTERPRETATION AND STATUS OF THIS DIRECTIVE","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S01"},{"id":"b802924d-ff79-4f5d-8ca0-ce303551898d","order":12,"text":"In this directive, the expressions set out below have the meanings given to them, and every expression that is defined in the Advance Decision on Life-sustaining Treatment Ordinance (Cap. 651) (the \"Ordinance\") bears the same meaning in this directive unless the context otherwise requires.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"0978439e-0aab-4660-b044-00ed5a265f6f","order":13,"text":"Advance medical directive means an instrument made by a person that contains one or more instructions to the effect that, if that person is mentally incapable of deciding on a life-sustaining treatment and the specified precondition of the instruction is met, the person is not to be subjected to any life-sustaining treatment specified in the instruction.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"38988380-453e-4a3b-9892-7045b0fb7d0e","order":14,"text":"Life-sustaining treatment has the meaning given to it by the Ordinance and includes, without limitation, cardiopulmonary resuscitation, mechanical ventilation and other forms of assisted respiration, artificial nutrition and hydration, renal replacement therapy including dialysis, vasopressor and inotropic support, the transfusion of blood and blood products, and the administration of antibiotics where the purpose of that administration is to sustain life.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"30d69421-9ff5-4837-824a-d4e6ac623f5d","order":15,"text":"Cardiopulmonary resuscitation, or CPR, means the emergency measures undertaken on a person who is in cardiopulmonary arrest with the object of restoring cardiac output or respiration, including chest compressions, defibrillation, assisted ventilation and the administration of resuscitation drugs.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"105703e2-e549-4ed5-b8ff-2617b72035ca","order":16,"text":"Registered medical practitioner means a medical practitioner registered under the Medical Registration Ordinance (Cap. 161).","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"5d8d6b65-1f05-47ba-b9a9-5df6632e6d0d","order":17,"text":"Mentally incapable of deciding on a life-sustaining treatment describes a person who is unable to understand the information relevant to deciding whether to be subjected to that treatment, or to retain that information, or to use or weigh that information in making the decision, or to communicate the decision.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"6008dbed-f621-4c13-b0b7-ae7737ef8672","order":18,"text":"Specified precondition means a precondition stated in this directive in respect of an instruction, as set out in the provisions of this directive headed \"Specified preconditions\".","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"a8c22c46-29f3-4ecf-bc88-59f10a16dc46","order":19,"text":"Treatment provider means any person who provides, or proposes to provide, treatment to me, including a registered medical practitioner, a registered nurse and any other healthcare professional; and rescuer bears the meaning given to it by the Ordinance.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"6bde3e9b-59b9-4f09-86a1-6922a44ffc0c","order":20,"text":"Designated electronic system means the electronic system designated for the purposes of the Ordinance, being at the date of this directive the Electronic Health Record Sharing System (eHealth).","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"d596ccc7-4a4a-4d02-a6d2-2aeb4a4c8e49","order":21,"text":"Basic care means the care that is essential to keep me comfortable, including the offering of nutrition and hydration by mouth, warmth, shelter, hygiene, the management of secretions, and the relief of pain and of other distressing symptoms.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"c2a50253-4110-4f11-882f-fac1481cca5d","order":22,"text":"This directive is intended to take effect as an advance medical directive within the meaning of the Ordinance. It is not made using a model form set out in Schedule 2 to the Ordinance. The Ordinance does not require a model form to be used, and this directive is made with the intention that its substance complies with every requirement of the Ordinance for the making of an advance medical directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"7c73005b-6854-4753-9ded-8df52d80a6e5","order":23,"text":"Headings are inserted for convenience only and do not affect the construction of this directive. Where this directive refers to another of its provisions, it does so by the title of that provision and not by number.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"ff84afec-9a5b-4168-98b0-ce1c72dba72d","order":24,"text":"2. DECLARATION AS TO AGE, CAPACITY AND VOLUNTARINESS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S02"},{"id":"71c36fa6-e2ff-4438-97b3-4666980a1f48","order":25,"text":"I declare that I am 18 years of age or above, my date of birth being [Date of birth].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"55b574af-ea77-4df1-b2f8-b053e922cafa","order":26,"text":"I declare that, at the time of signing this directive, I am mentally capable of deciding on a life-sustaining treatment. I am able to understand the information relevant to deciding whether to be subjected to a life-sustaining treatment, to retain that information, to use and weigh it in reaching my decision, and to communicate my decision.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"c74c5871-fdcf-41c6-aef4-2311a47f618a","order":27,"text":"I declare that I make this directive of my own free will and after due consideration, and that I have not been subjected to any coercion, undue influence, duress, fraud or misrepresentation by any person.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"b8d1e353-cad2-4951-be32-0b34ff9b8a1e","order":28,"text":"I declare that a registered medical practitioner has explained to me the nature of this directive and the effect on me of each of the instructions in it being followed, and that I have had a sufficient opportunity to ask questions and to reflect before signing.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"4e573400-5c6b-47e3-b211-1bf87b81f490","order":29,"text":"3. MY UNDERSTANDING OF THE NATURE AND EFFECT OF THIS DIRECTIVE","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S03"},{"id":"7618ddfc-6604-4338-8829-ba61bd308874","order":30,"text":"I understand that this directive takes effect only if and when I am mentally incapable of deciding on a life-sustaining treatment and a specified precondition stated in this directive is met. For so long as I remain mentally capable of deciding on a life-sustaining treatment, my contemporaneous decision prevails and this directive is not to be acted upon.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"3cf766e3-9aa0-4049-89fc-e3e73d6fb049","order":31,"text":"I understand that the effect of the instruction given in this directive is that the life-sustaining treatment refused will be withheld or, if it has already been commenced, withdrawn, and that my death may in consequence occur sooner than it otherwise would.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"0fde7969-5e1d-4029-b4e7-5ad9a9c604f7","order":32,"text":"I understand that this directive is a refusal of treatment only. It is not, and is not to be read as, a request for or an authority to any person to administer or prescribe any substance, or to do any other act, with the object of ending my life. No such request may be made by an advance medical directive under the Ordinance.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"ddc6e1c4-c2e7-481e-a84c-9f885e02c062","order":33,"text":"I understand that this directive does not oblige any person to provide me with any treatment and does not entitle me to demand any particular treatment.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"dcaf18c6-5613-4df5-a7e6-d3b1e4279ddf","order":34,"text":"I understand that a treatment provider or rescuer who does not have notice of this directive, or who is not satisfied that an instruction in it is valid and applicable, may lawfully administer a life-sustaining treatment to me, and I accept that consequence.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"511e3a26-25c2-44f3-8ecf-a93fdc69cc26","order":35,"text":"4. SPECIFIED PRECONDITIONS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S04"},{"id":"bcbfbb46-5d6f-4191-885b-ab4980642302","order":36,"text":"The instruction given in this directive is to be followed only if I am mentally incapable of deciding on a life-sustaining treatment and at least one of the specified preconditions stated below is met.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"50790a71-684d-4d1e-952f-1e02a1c075f8","order":37,"text":"Terminal illness. I am terminally ill, that is to say I am suffering from an advanced, progressive and irreversible condition and, in reasonable medical judgment, death is imminent notwithstanding the administration of life-sustaining treatment.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"67205df8-ff9a-453b-8d3e-7820ef4ce076","order":38,"text":"Persistent vegetative state or irreversible coma. I am in a persistent vegetative state or in a state of irreversible coma.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"f51f73b0-9d29-4457-b27f-70f7a4093cb4","value":"terminal_pvs","type":"add","operator":"="},{"field":"f51f73b0-9d29-4457-b27f-70f7a4093cb4","value":"terminal_pvs_other","type":"add","operator":"="}]},{"id":"2a05ea0c-1d81-493d-865c-9c291dbdc5bc","order":39,"text":"Other end-stage, irreversible and life-limiting condition. I am suffering from the following other end-stage, irreversible and life-limiting condition: [Other condition].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"f51f73b0-9d29-4457-b27f-70f7a4093cb4","value":"terminal_pvs_other","type":"add","operator":"="}]},{"id":"c66e73b2-2301-4fd6-82eb-b3fce54a63b8","order":40,"text":"Whether a specified precondition is met is a question of reasonable medical judgment, to be determined by my attending registered medical practitioner in accordance with accepted professional standards and, wherever practicable, after consultation with a second registered medical practitioner.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"456cee5f-e913-4f03-a228-8fc48d9ab566","order":41,"text":"5. MY INSTRUCTIONS AS TO LIFE-SUSTAINING TREATMENT","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S05"},{"id":"6590a933-8175-4c6c-be7a-bbb599c9265d","order":42,"text":"If I am mentally incapable of deciding on a life-sustaining treatment and a specified precondition stated in the provisions of this directive headed \"Specified preconditions\" is met, I give the following instruction.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"1d709b2c-2cc3-415d-8380-4aea51261c61","order":43,"text":"I am not to be subjected to cardiopulmonary resuscitation. This instruction does not extend to any other form of life-sustaining treatment, and every other life-sustaining treatment may be administered to me in accordance with reasonable medical judgment and my best interests.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"e92ddb50-8d7b-4015-b4d4-b5408d7f7970","value":"cpr_only","type":"add","operator":"="}]},{"id":"b5f932e9-6931-49d5-8ae2-70ce9873b4ca","order":44,"text":"I am not to be subjected to any form of life-sustaining treatment, except artificial nutrition and hydration. Accordingly cardiopulmonary resuscitation, mechanical ventilation and every other form of life-sustaining treatment are refused, while artificial nutrition and hydration may continue to be administered to me.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"e92ddb50-8d7b-4015-b4d4-b5408d7f7970","value":"except_anh","type":"add","operator":"="}]},{"id":"b4f44d61-c497-4b50-a744-be4d5693faa6","order":45,"text":"I am not to be subjected to any form of life-sustaining treatment, including artificial nutrition and hydration. I confirm that I have weighed this instruction with particular care, that its consequences have been explained to me, and that it is my informed decision.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"e92ddb50-8d7b-4015-b4d4-b5408d7f7970","value":"all_lst","type":"add","operator":"="}]},{"id":"2b7d6ece-c78d-4a33-b17d-23f53b198aa2","order":46,"text":"I am not to be subjected to cardiopulmonary resuscitation, nor to any of the following other life-sustaining treatments: [Life-sustaining treatments refused]. Any life-sustaining treatment not so specified may be administered to me in accordance with reasonable medical judgment and my best interests.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"e92ddb50-8d7b-4015-b4d4-b5408d7f7970","value":"specified","type":"add","operator":"="}]},{"id":"8db0b650-3039-4b3a-b454-2a2824a1545d","order":47,"text":"This instruction applies even though my life is thereby put at risk, and even though my death may in consequence follow sooner than it otherwise would.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"7f164a22-f7da-4c9e-9d0f-a8001b4e928c","order":48,"text":"6. BASIC CARE, PALLIATIVE CARE AND THE RELIEF OF SYMPTOMS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S06"},{"id":"7070bb1c-87a3-4dee-ae1f-7b83d13d24e0","order":49,"text":"Nothing in this directive refuses, or is to be construed as refusing, basic care or palliative care. I wish at all times to receive the care that keeps me comfortable and preserves my dignity.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"106c814b-8ade-423c-9f3d-921e69f035ef","order":50,"text":"In particular I wish to continue to be offered food and drink by mouth for so long as this can be done safely and comfortably, and to receive warmth, shelter, hygiene, the management of secretions, and mouth care.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"ab32bed7-2b7c-4e6f-a334-742278c79449","order":51,"text":"I wish to receive analgesia and every other measure appropriate for the relief of pain, breathlessness, agitation, nausea and any other distressing symptom, in such doses as are necessary to achieve that relief, even if an incidental and unintended effect of those measures may be to shorten my life.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"6f855f53-66f9-4d7a-b4d7-6f164d8fed8c","order":52,"text":"So far as it is safe and practicable, and consistent with the professional judgment of those caring for me, I wish to be cared for, and to die, in the place where I am then living, rather than to be transferred to hospital for the sole purpose of receiving a life-sustaining treatment that I have refused. This paragraph records a preference. It is not an instruction refusing a life-sustaining treatment and it does not entitle me to demand any particular arrangement.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"f117d02e-3758-4bcc-9380-93a9c1671118","order":53,"text":"7. STATEMENT OF MY VALUES, WISHES AND PREFERENCES","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"2ee906f3-bbba-475f-adb8-757125ab5c24","value":"include","type":"add","operator":"="}],"marginTop":"24","sectionNum":"S07"},{"id":"33b7156c-3d51-4591-86b4-643002c14c96","order":54,"text":"The following statement is not an instruction refusing a life-sustaining treatment. It is recorded in order to assist my treatment providers and my family in understanding my values, and in reaching decisions in my best interests in circumstances that are not covered by the instruction given in this directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"2ee906f3-bbba-475f-adb8-757125ab5c24","value":"include","type":"add","operator":"="}]},{"id":"64faad26-b65a-487e-bdba-70c87e5dc3b4","order":55,"text":"[Your statement of values, wishes and preferences]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"2ee906f3-bbba-475f-adb8-757125ab5c24","value":"include","type":"add","operator":"="}]},{"id":"73a909ab-0b13-4f6b-905a-56206270f5b6","order":56,"text":"If there is any inconsistency between this statement and the instruction given in the provisions of this directive headed \"My instructions as to life-sustaining treatment\", that instruction prevails.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"2ee906f3-bbba-475f-adb8-757125ab5c24","value":"include","type":"add","operator":"="}]},{"id":"1ae3888a-80b1-4868-a472-a64163678afa","order":57,"text":"8. REQUEST AND CONSENT IN RESPECT OF A DNACPR ORDER","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S08"},{"id":"68e0a7b7-8c6f-4d3d-87ef-e1d5e18c7f30","order":58,"text":"I understand that a do-not-attempt cardiopulmonary resuscitation order under the Ordinance is an instrument that has continuing effect and directs that cardiopulmonary resuscitation is not to be performed on a person who is in cardiopulmonary arrest, and that such an order may be made only by two registered medical practitioners, one of whom must be a specialist, using the form prescribed by the Ordinance.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"17180f86-d6d6-468a-8083-25ae2834a0f2","order":59,"text":"I request that, once my condition falls within a specified precondition stated in this directive and this directive is valid, my attending registered medical practitioners consider making a do-not-attempt cardiopulmonary resuscitation order on the basis of my refusal of cardiopulmonary resuscitation in this directive, and that they do so using the prescribed form.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"b043bc39-488f-40fc-bc34-d07c6224e30b","order":60,"text":"I consent to such an order being made, and to the disclosure to the registered medical practitioners concerned, and to any rescuer or ambulance officer attending me, of this directive and of so much of my medical record as is necessary for that purpose.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"88be8a41-d75a-4095-81ca-7d052adbde37","order":61,"text":"I understand that such an order is intended to be relied upon in an emergency, including outside hospital and by rescuers and by the staff of a residential care home, and I therefore ask that the original of any such order be kept with me or be readily available at the place where I am living.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"5aa32312-bc5e-431b-81fe-b583ab5ab575","order":62,"text":"I understand that an order made on the basis of this directive ceases to be valid if this directive is revoked, and that I may revoke such an order at any time while I am mentally capable of deciding on a life-sustaining treatment, whether in writing, orally or by destroying the order.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"f362510a-09b2-4a96-8fd8-ffd1dc0c16d8","order":63,"text":"I further understand that such an order ceases to be valid at the end of the effective period stated in it, and I ask that my attending registered medical practitioners consider making a fresh order before the end of that period for so long as my condition continues to fall within a specified precondition stated in this directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"a1b2c61a-1dac-4e53-a956-dbceecda387e","order":64,"text":"These provisions constitute a request and a consent. They are not themselves a do-not-attempt cardiopulmonary resuscitation order and do not have the effect of one.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"fe71dc3d-f344-4c64-9fd4-8ebcba1fe40d","order":65,"text":"9. PERSON TO BE CONTACTED","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"f96ecfc0-792f-4a80-8948-27cf34aeae50","value":"yes","type":"add","operator":"="}],"marginTop":"24","sectionNum":"S09"},{"id":"49469b67-41f6-47dc-b88b-e88707cf454d","order":66,"text":"I nominate the following person as the person to be contacted in connection with this directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"f96ecfc0-792f-4a80-8948-27cf34aeae50","value":"yes","type":"add","operator":"="}]},{"id":"6e0a0a0d-a183-4681-8db9-ccbbf276177f","order":67,"text":"Name: [Name of the contact person]. Relationship to me: [Relationship]. Contact telephone number: [Telephone number of the contact person].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"f96ecfc0-792f-4a80-8948-27cf34aeae50","value":"yes","type":"add","operator":"="}]},{"id":"62c6fd5d-7774-447a-bd6e-64c9aa95407a","order":68,"text":"I ask that this person be informed as soon as reasonably practicable if a question arises as to my treatment, and I authorise my treatment providers to disclose to this person such information about my condition and treatment as is reasonably necessary for that purpose.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"f96ecfc0-792f-4a80-8948-27cf34aeae50","value":"yes","type":"add","operator":"="}]},{"id":"3d62275c-54c8-4341-8c95-c7c2ca4f20d3","order":69,"text":"This person has no authority to consent to or to refuse treatment on my behalf, and nothing in this directive confers any such authority.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"f96ecfc0-792f-4a80-8948-27cf34aeae50","value":"yes","type":"add","operator":"="}]},{"id":"72675c48-9b17-4c2b-afeb-21993274ef24","order":70,"text":"10. ORGAN AND TISSUE DONATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"3559823c-b402-4e06-b53f-1aad1b16fca7","value":"donate","type":"add","operator":"="},{"field":"3559823c-b402-4e06-b53f-1aad1b16fca7","value":"decline","type":"add","operator":"="}],"marginTop":"24","sectionNum":"S10"},{"id":"8a8d9523-f125-4d99-a6ad-0920145c4fc3","order":71,"text":"The following statement concerns the use of my organs and tissue after my death. It is not an instruction refusing a life-sustaining treatment and it does not qualify the instruction given in this directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"3559823c-b402-4e06-b53f-1aad1b16fca7","value":"donate","type":"add","operator":"="},{"field":"3559823c-b402-4e06-b53f-1aad1b16fca7","value":"decline","type":"add","operator":"="}]},{"id":"eef8127a-7e54-4cad-ba1d-98b2b4545ab9","order":72,"text":"I wish my organs and tissue to be used after my death for the purposes of transplantation. I have recorded, or will record, that wish in the Centralised Organ Donation Register maintained by the Department of Health, and I ask my family to give effect to it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"3559823c-b402-4e06-b53f-1aad1b16fca7","value":"donate","type":"add","operator":"="}]},{"id":"3356c54f-b049-4745-8a94-12c82daa43d6","order":73,"text":"I do not wish my organs or tissue to be used after my death for the purposes of transplantation. I ask that this wish be made known to my family and to those caring for me.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"3559823c-b402-4e06-b53f-1aad1b16fca7","value":"decline","type":"add","operator":"="}]},{"id":"fe5ed075-3f9b-44c4-8d48-4af8bb013014","order":74,"text":"Nothing in this statement requires that I be given, or continue to receive, any life-sustaining treatment that I have refused in this directive for the purpose of making transplantation possible.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"3559823c-b402-4e06-b53f-1aad1b16fca7","value":"donate","type":"add","operator":"="},{"field":"3559823c-b402-4e06-b53f-1aad1b16fca7","value":"decline","type":"add","operator":"="}]},{"id":"e33b7ab1-bfc8-46e6-b9e8-60345408fead","order":75,"text":"11. REVOCATION OF EARLIER DIRECTIVES","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S11"},{"id":"30ea7e68-f03a-454e-acac-4aeddfcd881a","order":76,"text":"This directive revokes and supersedes every advance medical directive and every advance directive previously made by me, whether made before or after the commencement of the Ordinance, and whether or not made using a model form or a form issued by the Hospital Authority.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"e7aa71b0-4152-4bdf-b9d3-87c3ccf314fd","order":77,"text":"Any do-not-attempt cardiopulmonary resuscitation order made on the basis of an advance medical directive so revoked ceases to be valid. I ask my treatment providers to arrange for any such order to be revoked and, where appropriate, for a fresh order to be made on the basis of this directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"d12d6d54-8d4b-4f8d-8902-bad8ccb65916","order":78,"text":"12. HOW I MAY REVOKE THIS DIRECTIVE","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S12"},{"id":"6bfe7c7f-e598-4d46-b357-24a62169d636","order":79,"text":"I may revoke this directive at any time while I am mentally capable of deciding on a life-sustaining treatment. I may do so in writing, orally, by destroying this directive, or through the designated electronic system.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"5941a916-a5c9-4eb3-aef7-282bcda5c6b1","order":80,"text":"No particular form of words is required for a revocation, and a revocation is effective whether or not it is witnessed. This directive is also treated as revoked if I make a later advance medical directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"5f5e8c12-19db-4e4a-941f-0ad977ba3a00","order":81,"text":"I understand that if I wish to add a specified precondition or an instruction not contained in this directive, I must make a fresh advance medical directive covering both the existing and the new matters, because the making of that fresh directive will revoke this one.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"73fd972e-5972-47fb-a8b5-85b008393da6","order":82,"text":"I further understand that this directive will not be treated as valid if I do anything that is clearly inconsistent with the instruction given in it and that indicates that I no longer wish that instruction to be followed.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"a69a6277-2242-4429-b514-b1f2cbfbbc33","order":83,"text":"No person other than me may revoke this directive. No attorney appointed by me under an enduring power of attorney, and no guardian appointed in respect of me, has authority to revoke this directive or to consent on my behalf to a life-sustaining treatment that I have refused in it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"612acf63-22e4-4ddd-9e41-14057542db46","order":84,"text":"13. NOTICE, CUSTODY AND STORAGE OF THIS DIRECTIVE","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S13"},{"id":"4865fe57-2038-4974-af86-14218ed461aa","order":85,"text":"I understand that a treatment provider or rescuer is bound by this directive only if he or she has notice of it. I will therefore keep the original of this directive readily available, and I will inform those close to me and my treatment providers of its existence and of where it is kept.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"3f9082aa-5442-4b8f-9e35-042a31006807","order":86,"text":"I have provided, or will provide, a copy of this directive to the registered medical practitioner who usually attends me and to any hospital or residential care home at which I am receiving, or may receive, care.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"07d5045e-495b-488b-a19c-c3d8a9251aa8","order":87,"text":"I consent to a copy of this directive being uploaded to and stored in the designated electronic system. I understand that the uploading of a paper directive must be assisted by a registered medical practitioner, who will first review it, and that storage in that system assists my treatment providers in having notice of this directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"dd30102a-38f6-476c-9f0d-f6a28f0d8d75","value":"consent","type":"add","operator":"="}]},{"id":"37cf1dea-4f34-4b6b-96ab-3d984c43cffb","order":88,"text":"I do not at present consent to a copy of this directive being uploaded to or stored in the designated electronic system. I understand that my treatment providers will in consequence have notice of this directive only if a validating copy of it is produced to them, and I accept that risk.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"dd30102a-38f6-476c-9f0d-f6a28f0d8d75","value":"decline","type":"add","operator":"="}]},{"id":"f498f723-8dbc-4e86-8054-897c2ac9e7bd","order":89,"text":"I authorise any person holding a copy of this directive to produce it to any treatment provider or rescuer concerned with my care.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"1d628620-3a46-49dd-80b3-dec3990e9e1f","order":90,"text":"Every copy of this directive made for circulation is to be a complete copy of the whole document, including the certificates of both witnesses, so that it may serve as a validating copy for the purposes of the Ordinance. A partial copy is not to be relied upon.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"a55f8b1d-8c78-4bb7-b9b8-c5d3e572e727","order":91,"text":"I ask that the existence of this directive be recorded prominently in my medical record at every hospital, clinic and residential care home at which I receive care, and that a note of its existence be kept with my identity documents.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"2808ceb4-0744-42e5-bf74-b2e9ab1dc53e","order":92,"text":"14. VALIDITY AND APPLICABILITY","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S14"},{"id":"51d48fa4-75aa-4989-a378-5c0ea4e87e27","order":93,"text":"I understand that this directive will not be valid if the requirements of the Ordinance for the making of an advance medical directive were not met, if it was procured by wrongful means, if it has been revoked, or if I have done anything clearly inconsistent with the instruction given in it that indicates that I no longer wish that instruction to be followed.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"49164d9f-6b2b-459c-a9f1-55d5cea4e629","order":94,"text":"I understand that the instruction given in this directive will not be applicable if there are reasonable grounds for believing that a circumstance has arisen which I did not anticipate and which, had I anticipated it, would probably have led me not to give that instruction.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"54eb89de-d174-417c-b683-b1ba97e7abff","order":95,"text":"Having considered that matter, I confirm that I intend my instruction to apply generally to the circumstances described in the provisions of this directive headed \"Specified preconditions\", and not only to my present state of health. An advance in medical treatment that does not alter the fact that a specified precondition is met is not to be treated as a circumstance that I did not anticipate.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"8239f6bb-db15-4f52-b6ca-f40afaa69001","order":96,"text":"15. TREATMENT PROVIDERS AND RESCUERS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S15"},{"id":"44cb8ade-9f9d-4827-8d7f-cae575850959","order":97,"text":"It is my wish that no treatment provider and no rescuer should incur any liability, or be made the subject of any complaint, by reason of withholding or withdrawing a life-sustaining treatment from me in the honest and reasonable belief that the instruction given in this directive is valid and applicable.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"5ebae64d-aa81-4c4d-b507-e04f7bd6ca3f","order":98,"text":"Equally, I do not wish any treatment provider or rescuer to be criticised for administering a life-sustaining treatment to me where he or she does not have notice of this directive, is not satisfied that the instruction is valid and applicable, or has reason to suspect that my cardiopulmonary arrest arises from an unnatural cause or from an injury inflicted by me or by another person. I accept and endorse the principle that, if in doubt, life is to be saved first.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"087ac0eb-8d30-4581-a78a-e9d9b6d1d41e","order":99,"text":"I ask my family and those close to me to respect this directive and not to obstruct the following of the instruction given in it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"4b2d0729-505d-4ceb-b3a1-966e1fefc605","order":100,"text":"16. REVIEW OF THIS DIRECTIVE","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S16"},{"id":"fad1a07d-84be-47db-89f7-eec5840daa50","order":101,"text":"I intend to review this directive from time to time, and in particular upon any significant change in my state of health. The fact that this directive has not been reviewed for any period of time does not of itself affect its validity or its applicability.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"aa836d48-ae66-4c79-a46e-62eaa50fb68b","order":102,"text":"If I wish to change any part of this directive, I will make a fresh advance medical directive in accordance with the Ordinance rather than alter this document, and I will destroy every copy of this directive then in circulation or clearly mark each copy as superseded.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"9bacb7fa-b215-4ef9-a058-d2f72361b866","order":103,"text":"17. EXPLANATION AND INTERPRETATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"a26d0a78-2e51-407d-a378-c0f06d47fba0","value":"interpreted","type":"add","operator":"="}],"marginTop":"24","sectionNum":"S17"},{"id":"4b78f1c7-f456-43f3-b369-d80c59669018","order":104,"text":"This directive is written in English. The whole of its contents, and the explanation given to me by the registered medical practitioner who witnessed my signature, were interpreted to me in [Language] by [Name of the interpreter], who is fluent in that language and in English.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"a26d0a78-2e51-407d-a378-c0f06d47fba0","value":"interpreted","type":"add","operator":"="}]},{"id":"d6b85228-9baa-4818-8056-dd8726ad1c3a","order":105,"text":"I confirm that I understood the interpretation so given to me, and that I signed this directive with a full understanding of its contents and of its effect.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"a26d0a78-2e51-407d-a378-c0f06d47fba0","value":"interpreted","type":"add","operator":"="}]},{"id":"177c838f-a56c-4755-aedb-d0a777760cc5","order":106,"text":"18. SEVERABILITY AND CONSTRUCTION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S18"},{"id":"28fa584f-1086-49e9-a8db-5fd92903cb57","order":107,"text":"If any provision of this directive is held to be invalid, unenforceable or inapplicable, that provision is to be severed and the remaining provisions continue in full force and effect.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"958395da-7632-4575-ae9e-738244ee79b5","order":108,"text":"If any part of this directive is unclear or ambiguous, it is to be construed so as to give effect to my intention as expressed in this directive read as a whole, and in particular in the light of the provisions headed \"Basic care, palliative care and the relief of symptoms\".","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"6b0fab67-44e4-48fb-a5eb-0cd5bbf807c2","order":109,"text":"The English text of this directive prevails over any translation of it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"dc726017-1a6e-46ea-8943-21be589ad368","order":110,"text":"19. GOVERNING LAW","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"24","sectionNum":"S19"},{"id":"6fa918b2-1a26-4eac-9ddd-7e01345098f2","order":111,"text":"This directive is governed by, and is to be construed in accordance with, the laws of the Hong Kong Special Administrative Region of the People's Republic of China.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"cefd79a1-7e95-4ec8-8f0f-ff3eef23acaf","order":112,"text":"SIGNED BY THE MAKER","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20"},{"id":"64edff4b-de87-4fd2-a726-ee08817d4899","order":113,"text":"I have read the whole of this directive, or it has been read and explained to me, and I understand its contents and its effect.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"9a52872d-60e1-4e94-926a-3a4daffe8b95","order":114,"text":"Signed by [Full name] at [Place of signing] on [Date of signing], in the presence of the two witnesses whose signatures appear below, both of whom were present at the same time.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"7cd11a85-9c90-4fdc-9eb8-ed67a7b93a09","order":115,"text":"Signature of the Maker: ..........................................................","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true,"marginTop":"14"},{"id":"2f65f3a9-0ead-4762-b332-b05ac0e39b0c","order":116,"text":"Name: [Full name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"3c3da16d-9d8c-4483-9de1-bb06daa3acf2","order":117,"text":"Hong Kong Identity Card number: [HKID number of the Maker]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"d7d9a2fb-2830-46dc-bf7f-e2466db64b18","order":118,"text":"FIRST WITNESS — REGISTERED MEDICAL PRACTITIONER","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"6e52ec2e-2d5e-48ae-b64e-84384d89e5f3","order":119,"text":"I, [Name of the registered medical practitioner], a medical practitioner registered under the Medical Registration Ordinance (Cap. 161) under registration number [Registration number], of [Practice address], certify as follows.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"60991674-8b8f-4054-802d-bdc48ebfdb58","order":120,"text":"I witnessed the signing of this directive by the Maker, and I was present at the same time as the other witness.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"91f00d29-a942-4d27-8aca-748f7870893d","order":121,"text":"I am satisfied that, at the time of signing, the Maker was mentally capable of deciding on a life-sustaining treatment.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"855bbfb3-45e7-445b-a3d5-bd49053f4fdd","order":122,"text":"I have explained to the Maker the nature of this directive and the effect on the Maker of each of the instructions in it being followed.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"4f932f15-243b-4944-9b66-0529dd5b5070","order":123,"text":"I am not an interested person in relation to the Maker, and I have no interest, whether under a will, on intestacy or otherwise, in the estate of the Maker.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"b044f67a-7d33-475c-b0df-0dcd1a45dc1f","order":124,"text":"Signature: ..........................................................","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true,"marginTop":"14"},{"id":"a85f06f2-29b1-4bb0-90a3-b09ec419a8de","order":125,"text":"Date: ..........................................................","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"379a0745-84b0-432a-b516-0c3a07193c38","order":126,"text":"SECOND WITNESS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"2db254a8-b0ed-4456-863b-ca9a1bb51758","order":127,"text":"I, [Name of the second witness], holder of Hong Kong Identity Card number [HKID number of the second witness], of [Address], certify as follows.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"1b206ea2-075d-47aa-b341-76e3d29d71c0","order":128,"text":"I am 18 years of age or above.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"e787ce3c-7160-48f7-9096-0e0f10678297","order":129,"text":"I witnessed the signing of this directive by the Maker, and I was present at the same time as the other witness.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"a64c9f86-650b-4522-a1f0-db49bb9de768","order":130,"text":"I am not an interested person in relation to the Maker, and I have no interest, whether under a will, on intestacy or otherwise, in the estate of the Maker.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"13932242-9b19-4a44-a1df-4db5c077900c","order":131,"text":"Signature: ..........................................................","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true,"marginTop":"14"},{"id":"c1df7623-b046-42c7-bfff-9bd43545ec23","order":132,"text":"Date: ..........................................................","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"294ba411-f28a-4ca5-a8cf-30a80654f5d0","order":133,"text":"The Maker and both witnesses have signed or initialled each page of this directive.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"cb25eaeb-d544-488f-a5c4-0a1f64345f3d","order":134,"text":"CERTIFICATE OF THE INTERPRETER","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"a26d0a78-2e51-407d-a378-c0f06d47fba0","value":"interpreted","type":"add","operator":"="}]},{"id":"1c8d269a-35b7-42b1-bbc9-67959538b70f","order":135,"text":"I, [Name of the interpreter], certify that I am fluent in English and in [Language], that I interpreted to the Maker the whole of this directive and of the explanation given by the registered medical practitioner, and that the Maker appeared to me to understand that interpretation.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"a26d0a78-2e51-407d-a378-c0f06d47fba0","value":"interpreted","type":"add","operator":"="}]},{"id":"fff3a812-de79-4f4b-b0be-156e6ef4309d","order":136,"text":"Signature: ..........................................................","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true,"displayConditions":[{"field":"a26d0a78-2e51-407d-a378-c0f06d47fba0","value":"interpreted","type":"add","operator":"="}],"marginTop":"14"},{"id":"ce4b241a-871e-4249-ba9a-aa778d74eee4","order":137,"text":"Date: ..........................................................","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true,"displayConditions":[{"field":"a26d0a78-2e51-407d-a378-c0f06d47fba0","value":"interpreted","type":"add","operator":"="}]}]