Friday, 29 September 2023

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On euthanasia and dying with dignity

This caught my eye today and affected me enough for me to break my longtime ban on myself for paying for mainstream news.

Reading Madam Lim’s story was honestly very heart wrenching. Here is a lady whose body is being slowly eaten up by cancer, and she wishes to stop it before it gets any worse. However there is one huge obstacle – the law.

While passive euthanasia is allowed here with the passing of the Advance Medical Directive Act (AMD Act) in May 1996, active euthanasia is still illegal.

Under the AMD Act, a person is allowed to instruct doctors not to take extraordinary measures not to prolong his/ her life is he/ she is terminally ill and unconscious by signing up for an Advance Medical Directive (AMD).

However that is not enough for Madam Lim. She wants to die in dignity and she wants it now with the help of an assisted death at a time and place of her choosing.

“I cannot even go to the toilet to pass motion. I cannot pass motion on my own. The nurse has to help me dig it out. What dignity do I have left as a human being?”

Gathering from the report, it seems that Madam Lim had written to President SR Nathan with the hope that he will kindly grant her that wish.

She had originally intended to speak about it at the Speakers’ Corner but was hospitalised and thus was unable to do so.

Madam Lim and her husband have reportedly considered going to Switzerland where assisted death is not a crime when performed by an individual who is not a medical doctor and who has no vested interested in the death. However that journey would be too ardous for her to attempt given her current state of health.

She was quoted saying,

“Every day I have now is not a gift to me. It is a mental and emotional torture because I know what awaits me. I will become more and more dependent on others. Every day I live now is one day too many.

“I want to die now, in peace, in my loved one’s arms. If I cannot have “an le shi” (happy death), I will simply stop eating and drinking.”

My personal stand.

Personally, I am for the legalisation of active euthanasia because I strongly believe that pain and suffering is a personal and private experience and one has every right to choose to either terminate it or go through it til the very end.

No one should deny a patient who is terminally ill the option of ending the pain and suffering. No one should expect the patient to accept hospice care and painkillers.

I do understand the concerns that many have with regards to what might happen should active euthanasia be legalised. I will explore the concerns along with my suggestions. It will be great if a discussion can be generated here.

1. Elderly patients might feel obligated to die.

First of all, not all terminally ill patients are old.

Anyway, yes there is a chance that terminally ill patients might feel that way because they do not want to burden their family members with the financial and physical exhaustion of the need to take care of them.

Now, before we blame euthanasia for allowing such a thought, why don’t we seek to improve the cost of health care and ensure that the patients and their families get as much moral support as they can with the moral support of the patients’ doctors, nurses and social workers who can be attached to the patients and their families.

Facing impending death does not come without stress, fear and other negative emotions so it is important that the mental well being of the patients and their families are taken care of by providing them with social workers to lessen the emotional pain that comes with the journey towards death.

2. Family members might coerce the patients to choose death out of greed.

Well, once again I would like to stress upon the importance of social workers here.

Once an application for euthanasia is made, social workers attached to the patient and his/ her family needs to come up with an analysis of whether coercion might have taken place, gathering from the daily observations and interactions with the patient and his/ her family.

The report should be analytical and neutral. It will then be submitted along with the medical doctor’s report on the condition of the patient’s health. Only when a patient has been certified to have no hope of recovery and it is satisfied that no coercion has taken place, then a letter of approval can be issued.

3. Active euthanasia contradicts the oath taken by medical doctors to save lives.

Indeed it does and that is why a medical doctor should not be the one to carry it out. Once a letter of approval has been issued, the patient can then check into a euthanasia clinic for it to be carried out by a person trained to carry out the process and who is not a medical doctor.

4. What if the patient wishes to reverse his/ her decision.

I personally think that the patient must be allowed to reverse his/ her decision at anytime he/ she wishes.

In fact, at least 5 hours before assisted death is to take place, a counsellor should be employed to talk to the patient about his/ her decision. He/ she must then be allowed some time to think through to see if he/ she wishes to reverse the decision.

Assisted should not take place without a final verbal or gestural confirmation from the patient at all. There should be chances for the patient to change his/ her mind even til the last second.

5. The legalisation of euthanasia is against religious beliefs and moral values of our Asian society.

Allowing active euthanasia does not violate religious beliefs and moral values of our society since it is voluntary and those who do not believe that choosing euthanasia is religiously and morally right, they do not need to opt for it. Legalising euthanasia only seeks to allow those who want to end their pain and suffering an option to do so legally.

When we talk about religious tolerance, we tend to forget about atheists who do not believe in the words of any gods, the teachings from any holy scriptures. Not all atheists believe that euthanasia is morally right anyway but the point here is that while the government promotes inter-religious tolerance, they should also promote the tolerance between theists and atheists.

What is moral to one might be immoral to another. Why not cater to all instead? No one should impose their religious or moral values onto another individual and expect them to accept it. In alot of ways, criminalising active euthanasia is in my opinion, a form of that.

6. “Those who want to go their way should do it peacefully and should not involve the majority of God-fearing people who believe in the sanctity of life.” (Quoting from a private discussion I was involved in)

My response?

Most of those who want to go their way do not dare to do so because it is illegal and as much as they are suffering and want to die, they want to do so medically without breaking the law because in many societies, breaking the law for whatever reasons is a very ‘lose face’ thing to do.

That is all for now!

The abovementioned suggestions were developed from constant thought about the issue. I might have missed out on some stuff here and there but they will be added on later when they come to mind.

I would love to hear from others what their suggestions and opinions may be. To me, talking about death is not a negative thing to do. It is simply part of life.

So let the discussion flow!

Rachel Zeng /

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