Hong Kong Paramedics to Prioritize Rescue with 'If in Doubt, Rescue First' Principle for End-of-Life Directives

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

Assistant Chief Ambulance Officer Gary Tong Sze-ho of the 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 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.