Conceptual and Contextual Foundations of End-of-Life Decisions in Malaysia

This chapter lays the foundation for the discussion on end-of-life decisions in Malaysia by establishing the conceptual, social and legal foundations within which such decisions arise. It begins by examining the meaning and scope of end-of-life care and clarifying its relationship with supportive care, palliative care and hospice care. The chapter then identifies the principal medical decisions that arise at the end of life, including active euthanasia, assisted dying or assisted suicide, withholding and withdrawal of treatment and pain management in the form of palliative and terminal sedation. It further traces the development of palliative care in Malaysia, drawing attention to recent policy and service developments as well as the continuing challenges relating to access, integration and quality of care. The discussion also situates end-of-life care within Malaysia’s socioreligious context, highlighting the significance of religion, spirituality and family-centred decision-making in a plural society. In this light, the chapter considers religious guidance on end-of-life decisions, with emphasis on the Islamic perspective alongside the broader multi-faith landscape in Malaysia. It concludes by explaining the relevance of common law in the Malaysian legal system and its continuing importance in shaping the medicolegal analysis of end-of-life decisions.