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Advance care planning in the Asia Pacific region: comparative implementation study
Raymond Ng Han Lip1, Masanori Mori2, Cheng-Pei Lin3
1Palliative and Supportive Care,Woodlands Hospital, National Healthcare Group, Singapore raymond.ng@nhghealth.com.sg.
BMJ Supportive & Palliative Care
|May 27, 2026
Summary
Advance care planning (ACP) varies significantly across the Asia Pacific. Key barriers include low public awareness, lack of healthcare professional empowerment, and social taboos, necessitating national and organizational support for effective implementation.
Area of Science:
- Palliative Care
- Healthcare Management
- Cross-cultural Studies
Background:
- Limited understanding of advance care planning (ACP) landscape in the Asia Pacific.
- No prior comparative studies on ACP implementation in the region.
- Need to map current ACP practices within the Asia Pacific Hospice Palliative Care Network (APHN).
Purpose of the Study:
- To map the current landscape of ACP implementation.
- To identify variations in ACP conceptualization, initiation, and accessibility.
- To understand barriers and facilitators of ACP in the Asia Pacific.
Main Methods:
- Cross-sectional survey design.
- Purposive sampling of experts and leaders with >=5 years of ACP experience.
- Data collected from member sectors of APHN.
Main Results:
- Diverse ACP approaches observed across Asia Pacific sectors.
- National/organizational programs linked to higher ACP uptake (e.g., Taiwan, NZ, Singapore).
- Family-led ACP common in many Asian countries, even with patient capacity; key barriers: low public awareness, HCP empowerment, social taboo.
Conclusions:
- National and organizational support are crucial for ACP.
- Cultural competency and targeted engagement are vital for addressing barriers.
- Raising awareness and empowering professionals are key to successful ACP implementation in the Asia Pacific.
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