Wednesday, 4 October 2023

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Should the state let me choose how and when I die?

Andrew Loh / Deputy Editor                                          

“We need to overcome taboos about death and communicate better — both among ourselves as well as between doctors and their patients,” said Health Minister Khaw Boon Wan last month. (See here).

I agree with the minister.

More often than not, we would rather not talk about death, or the possibility of our dying. It is indeed still quite a taboo subject. It is a cultural thing, some say. Couple this with our religious beliefs and it gets very personal, emotional and spiritual as well.

Yet, looking at what the minister has said over the last few years on the issue, I do believe that he is not just looking, simply, to letting Singaporeans choose to die – whether it is through the Advance Medical Directive or legalised mercy-killing, to put it another way. Rather, Mr Khaw has obviously adopted more of a holistic approach than just a simplistic one of whether one should take one’s own life or allow another to do so on one’s behalf.

The main point I believe he is trying to get across, perhaps not very well so far, is one of dying with dignity.

In this, there can be little argument or disagreement with the principle. It is in the definition of the word “dignity” itself, however, which is the bone of contention. Some say that taking one’s own life is not dignified no matter how it is achieved. That the act of suicide or assisted-suicide, whether legal or illegal, through the AMD or legalised euthanasia, is just plain wrong.

“We will go down a slippery slope”, is a phrase used.

While I do agree that there are many – many – issues involved, I am in agreement with Mr Khaw that we should be allowed to “die with dignity”. And that, in my opinion, should be one of the main points of this debate. In this respect, I am glad that the minister is looking into palliative care and palliative medicine and making these more easily-available. A pilot scheme to bring such care to nursing homes will be implemented next year.

More needs to be done, of course. Besides getting doctors themselves to understand the AMD better, the bigger challenge, I feel, is getting the average Singaporean (especially the less-educated and literate) to know what the issues are.

The one thing which we should not fail to address is the notion, already in some people’s minds, that assisted-suicide is directed at the “less-able” or that it is the less-literate and less-educated who will be targeted for “elimination”.

My hope is that the minister will not rush through any changes in legislation but allow as much time as possible for discussion, debate and feedback to take place.

Every life is precious. When the time arrives, and each of us will face this, we will have to decide (if we are able to) how we will die. Personally, to have the choice to decide how I would die is a gift as not everyone gets to have this choice.

Thus, if there were legislation in place which would allow me to do this, to make this choice, and it gives me dignity in my death, I welcome it.

But first, lets address the many issues involved for the concerns are real and important.


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