The Statutory and Regulatory Position on End-of-Life Decisions

This chapter examines the regulatory framework governing end-of-life decisions in Malaysia. In the absence of specific legislation on palliative care and end-of-life decision-making, doctors must rely on a combination of criminal law provisions, professional ethical codes, clinical guidelines and palliative care standards. The chapter considers how these instruments apply to active euthanasia, withholding and withdrawal of treatment and palliative or terminal sedation. It argues that although Malaysian law has yet to provide a comprehensive regulatory framework, the position is not entirely without guidance. Local professional and clinical instruments increasingly recognise the importance of patient autonomy, medical futility, best interests, family involvement, palliative care and advance care planning. Recent developments, including the 2024 Advance Care Planning Guide, the revised Malaysian Medical Council Consent Guideline, National Standards for Palliative Care with Implementation Guide and ongoing mental capacity reform, further indicate a gradual movement towards a more patient-centred approach. Nevertheless, these developments remain limited by their non-statutory nature. The chapter therefore contends that clearer legal regulation is still needed to support patients, families and medical practitioners in navigating difficult decisions at the end of life.