Some lives are not worth living?
Friday, 24 October 2008, 8:01 am | 1,682 views
Ravi Philemon / Writer
“Do we allow euthanasia or assisted dying?” asks the Health Minister, Mr Khaw Boon Wan when he spoke on challenges in the healthcare sector recently at the Institution of Engineers’ annual dinner and dance. A Straits Times article reports that, “End-of-life issues are expected to be on his ministry’s agenda next year”. So what direction would the government take in addressing this problem?
Euthanasia or the so-called “right to die” is not a future problem but a problem of the present. It is happening now and is becoming increasingly embraced by governments, courts and the media.
There is anecdotal evidence that elderly people in the Netherlands, where euthanasia is legalized, are now afraid to check into hospitals, for fear that they will be killed. According to Rita Marker of the International Anti-Euthanasia Task Force, euthanasia now accounts for 15% of the deaths in the Netherlands. And according to the Dutch newspaper NRC Handelsblad, “humanitarian terminations” by doctors occur at the rate of ten thousand per year in the Netherlands.
Economics indeed plays an important role in motivating Netherland’s culture of euthanasia. Faced with bloated fiscal deficits the state is rationing the use of new technologies. Moreover, Holland which do not use prices to allocate heath care, have taken the economic incentives for extending life away from physicians. And because extending the lives of old people who are ill can be costly, the economic incentives run in the opposite direction in this state. In these budget-balancing times, the doctors at public nursing homes and hospitals are under severe pressures to keep costs down. There is of course an economic value to the state in promoting euthanasia as it brings in the suicide tourist dollars, from all over the world.
It is highly probable that the government of Singapore, who rates the worth of the individual Singaporean by his economic value, will move towards legalising euthanasia, citing the same reasons. But if that happens, what does it say about our society, when we say that we will stop caring for a person because he is “unproductive” or is considered as “surplus”? I do not believe that the value of a human life can be measured by how productive he is at work or how much he is able to pay taxes. We must engage in the economy to live; but this is not why we live. The purpose of economics is to sustain human life; the purpose of human life is not to sustain economics. A crippled person, a mentally retarded person, or an old person is no less valuable than a young and healthy person. The fact that they contribute less to the economy has nothing to do with their value as human beings.
Do we really have a “right to die”? Many people now speak of such a thing without properly understanding the terminology. A “right” is a moral claim. We do not have a claim on death. Rather, death has a claim on us! A few years ago Governor Richard Lamm of Colorado said that the “terminally ill elderly have a duty to die and get out of the way”. (“Elderlys’ Duty to Die”, New York Times, 29 March 1984) It is very easy to transition from discussing “a right to die” to “a duty to die”.
Purposely seeking the death of a patient is contrary to the Hippocratic Oath that a physician swears to abide by. But as Singapore’s Health Minister is not medically trained he has not taken the Hippocratic Oath. As such, I am sure this oath will not be a hurdle too large for him to cross if he comes to it, while he tries to rationalise euthanasia.
Ravi Philemon also blogs at Singapore Social Activist.
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I think the question of euthanasia is, if a sane person, in a proper frame of mind (i.e. not under influence of drugs or mental illnesses etc.) wishes to end his life, can he legally do so?
Personally, I think he should, and thus I disagree with your statement
A “right” is a moral claim. We do not have a claim on death. Rather, death has a claim on us!
I do think a person should have the right over the control of his life, and the right to end it. Other people, doctors and society in general can attempt to dissuade him, but they cannot coerce or force him to go contrary to his will.
That being said, I find that your article took the term “euthanasia” too blindly. There are many different forms of euthanasia, from the willing end of oneself’s life to the termination of someone who is not contributing to the society/economy. Your argument,
what does it say about our society, when we say that we will stop caring for a person because he is “unproductive” or is considered as “surplus”?
concerns the latter, but using the term “euthanasia” to describe this mixes up the situation with the former.
Frightening thought ! You know I suppose the Government now wants those whom it considers to be a burden, to be non-pro, to be “different” etc to submit themselves to euthanasia ! 20 years ago – they spoke of eugenics. Now euthanasia !
Singapore should say Heil Hitler ! SS Javohl !! Sieg Heil ! Singapore – the perfect home for the Neo-Nazis !!
this is a tricky one and having Dr Syed Alwi responding to this article so swiftly speaks volumes on the impact it going to have on the medical profession.
bills like this will need the support of the doctors and we do know that there is a dearth of doctors, not only in Singapore but worldwide. the doctors will play an important decisive role on this one.
There aren’t enough doctors in SG to tend to the needs of an aging population – even with the continuous recruitment of doctors from around the world.
Could this be one of the factors that this govt is attempting to ‘get rid’ of the very aged and sick citizens? Kill two birds with one stone.
Euthanasia gets rid of the patient so that doctors are freed up to attend to the ‘productive’ patients. . who when cured, will get back to continuing to contribute to the economy. Could it be so simple – gee, i don’t know but i’d still like to think out loud.
i’m with Jackson on this.
I find Ravi Philemon to have similarities with our PAP govt. When we talk about foreign talents taking jobs away from Singapore citizens, they inevitably switch topics to talk about Foreign WORKERS doing construction work, etc that Singaporeans DO shun.
Now on euthanasia, Ravi changed the type from people who want to die, to economics deciding to kill off people who are no longer contributing.
I want to say I am a strong supporter of euthanasia. I agree with what #1 Jackson Tan had said.
The decision to end one’s life if he/she is suffering a terminal illness is for him/her to make solely. Nobody else can make that decision. This is most basic principle we have to adhere to should we allow euthanasia in S’pore.
It is morally wrong to decide one is allowed euthanasia based on his/her economic value. I will consider it criminal should the State or any doctors to end the life of any terminally ill patient if that is not what he/she desire or even plant such idea in his/her mind or even his/her immediate family and put undue pressure on them to do so.
If what you said about the Netherlands system is true, then, quite obviously, it is not a system we should adopt or even given due consideration. Just because we don’t agree with how Netherlands is doing it, it doesn’t mean we should not support euthanasia. We can develop our own system based on principles Singaporeans subscribed to.
We do not have a choice when we are born, our parents decide and if we happened to have been the fastest sperm we come into this world not knowing what lies ahead for all fo us.
As we develop from a sperm into a human our brain and thinking faculties evolve. When we grow up and live in this world , I honestly believe each human being has the individual right to decide for himself whether he wants to live or not.
No other person has the right to decide for you. If they do are they God. Its easy for others to pass judgement and come out with thier moral individual views. But if I am of sound mind I think that decision lies with the individual person anbd thats my own personal opinion.
And if and when I decide to leave this world and end my life thats my own decision and evryone should respect it. i will definitely respect any others person to decide for themselves.
Your assumption that the old and dying are not contributing to the economy of any country is just way off tangent. Think for a moment how many hospital will close, how many old folks home and hospices will close without this category of people. How many more will lose jobs if there aren’t the old and dying to keep some of their jobs. Keeping the old and aged alive is an entire industry itself.
I do not support euthanasia. But that is easy for me to say now that I am still strong and healthy. Nonetheless, I have given specific and clear instructions to my family members, that in the unfortunate event that I have to be artificially keep alive without any other known medical help or cure to improve the quality of my life thereafter, then it is best that they let me go. It’s painful for the moment, but it is pointless and costly to my family members trying to fight the inevitable.
Come on. Let’s not be hypocrites. Let’s just take any illness as an illustration. How many people can openly say they enjoy that moment when they are down and out? No one. But where there is hope for recovery, we ought to do everything we can to get things right. But if I have to be artificially kept alive, that’s cruelty. Because I would be suffering against my will, with no way of expressing or showing the pains I am going through with all the tubes in and out of my body.
Let’s also not start pointing fingers when things are now just being discussed, not even finalized.
In fact, there is more economic value to keep the old and terminally ill from dying. Sorry. Contrary to much what your article is trying to say.
When your time comes, prove me wrong, Mr. Ravi. I am of course assuming you will not die peacefully and suddenly in your sleep, without any pain or prolonged illnesses. Your article also do give me the little hint that you don’t mind being shafted all over just to be kept alive. Talk is cheap. Try walking that talk. I wish you good luck.
Euthanasia is a very complex and complicated issue to tackle. However, i think we should not even go into the realm of who the person is; meaning; we should not treat a human life based on his nationality, race, belief or any other descriptions that describes his identity.
I feel we ought to look at the dying person from the point of view that he is a human being – a life … and, who has the right over this life to make decisions or passed any bills that decide whether he should live or die.
therefore, Yamasan, i have to disagree with your proposal to “develop our own system based on principles Singaporeans subscribed to”. The subscribing to such principles must be unanimous for it to be accepted. . . nothing less. It cannot be a majority wins situation because we are dealing with each individual life or case that is different from each other.
The person should have a right to decide for himself/herself whether they want to contimue living should they be terminally ill.
Legalizing euthanasia has its own implications.
what if the terminally ill gives consent out of pressure from family members?
that they are unable to take the burden as it is both emotionally and financially straining. yes euthanasia is an easy way out, to lessen the burden, to lessen the pain. humans are born selfish and always trying to be God.
as far as i know, in the case of euthanasia, it can be one from any of these – doctor, spouse, relatives or legal directives – that can decide whether the patient has the right to live or die.
the difference between ‘euthanasia’ and ‘advance directives’ is that the latter allows the individual to take the decision to live or die while he is still in a healthy state of mind to do so – as described by weaskforit and loop above.
with euthanasia, the patient is no longer in a healthy state to make sound judgement on such an important matter as to whether he should live or die.
therefore, no one else can make this decision on his/her behalf.
To #8 Gemami, It’s fine with me that you disagree.
Let me further clarify. What we need is to put in place a system where the individual is allowed to make his/her decision solely on his/her own without undue pressure from anyone. Such a framework must adhere to principles that the majority of Singaporean subscribed to. It is the framework we are putting in place and not what the decision of the individual should be. How the individual comes to decision whether to end his/her life in entirely up to him/her and his/her values and principles.
Once there is a framework in place to prevent abuses by the State, the family members or the medical professionals, then we can reasonably assume that when a terminally ill patient decides to end his/her life, it is out of his/her own free will.
Will the framework be water-tight ? I don’t know because this subject is new to everyone and there is good precendent to make any reference to.
We can’t possibly have a unanimous agreement from all Singaporeans before putting in place a framework/system because there will always be someone who does not support euthanasia per say.
If euthanasia is legalized, so must suicide(self murder) be removed as a criminal act, for those who committed self immolations did their acts out of their own decisions.
Living does become unbearable for some, especially the sick and elderly and it is quite common to see and hear these folks saying it’s better for them to die. More often than not, the ’sayings of wanting to die’ is not indicative that they do not want t live, but an expression that they are suffering unbearable pains, physically and or emotionally(mentally). Another reason is to beg sympathy.
Having said the Above, I think Euthanasia is a very touchy and emotional issue, I have seen bedridden old folks left all alone at homes(house) with no one to care for them. How and what caused their situations aside, some of these folks may indeed wished and liked to pass off painlessly which is what euthanasia is all about. There are wishes to die and there are complex implications such as inheritance, funeral expenses and arrangements, consensus of the families etc.
The Rights of the Medical Authority to end the life of a person who wishes to die by euthanasia itself is fraught with complex and sensitive considerations. It would not be easy to apply euthanasia to the satisfactions of all parties, namely: the spouse, family, relatives or even close friends. Friends have hardly being factored in and considered as one party that matters, but friends do matters in one life. Some friends are more caring and loving than kins and clans, this complicates the Issue of euthanasia, but it is an important concern.
When medically proven that patient is suffering unbearable pains and medications WILL NOT free him/her from the pain without making the patient unconscious. And the sufferings can be superficially witnessed by everyone and showed unbearability when patient is conscious, euthanasia maybe a peaceful mean to end the life of sufferer. THE DECISION MUST HAVE THE APPROVALS OF THE DOCTORS, FAMILY MEMBERS, RELATIVES, FRIENDS AND ALL OTHER CONCERNED PARTIES SUCH AS BUSINESS PARTNERS, DEBTORS EVEN EMPLOYERS
If and when all conditions are fulfilled, the wish for euthanasia MUST BE A REQUEST MADE BY A CONSCIOUS PATIENT HIM/HERSELF VERBALLY OR IN EXPRESSION UNDERSTOOD BY ALL PARTIES CONCERNED.
Life is precious to all though some may find it not worth living, BUT THE RIGHTS TO DECIDE ONES’ DESTINY IS A PERSONAL ONE, HE/SHE MUST BE CONSCIOUS PARTY TO THE DECISION FOR EUTHANASIA.
Above are personal feelings and ideas, do forgive me it is badly expressed.
patriot
No easy answer. Having witnessed lung cancer victims who live their last moments in torture, gasping for every breath, hoping that death comes quickly, I sometimes wonder how cruel humans can be to allow such torture esp when the end result is the same.
If there is a way to alleviate the suffering without euthanasia, then perhaps we can rave and rant about how euthanasia is inhumane.
Nobody wants to kill themselves if they’re healthy humans. Often it is because of the pain and suffering that they chose this option. For me, who have no understanding of the pain and suffering, to stand and judge their actions would be hubris indeed.
Doctors do not support euthanasia for economic reasons.
In fact, the choice to life shouldn’t be in the hands of anyone else either. What hubris to think that anyone should have control over whether other people live or die but in reality it happens (in war, in the courts, in hospitals, in everyday life, of would-be murderers, in test-tubes etc).
Research should be focussed on eliminating pain and suffering for terminal patients not just on cures. I support providing alternative options like permanent anaesthesia if one can afford it and support partial assistance by public funding.
13) patriot
you’ve said about all there is to be said except for one thing (well, as far as my opinion is concern).
there is also the religion factor. some religions forbid one to end his/her own life.
“some religions forbid one to end his/her own life.”
To what extent can a religion actually forbid a person to end a life? Ultimately, it is still the choice of the person. I dun blame religion.
“thou shall not kill” . . . it is a commandment in the Christian faith. I believe some Buddhist practises also forbids killing (I might be wrong here).
yes; the choice is up to the individual, but can the individual make sound decision when he is in pain? he might want to die when in pain but he would surely want to live if the pain is taken away.
so what do we do, take the pain away or take the life away?
also, if a medical professional who is (for illustration only) say, an athiest, was to decide whether an individual ought to be kept alive or not, how sound can such a judgement be, if he does not take into account the religious belief of the individual?
@ why u bring in OTHER people to decide when a irrevocably sick person wants to die?
On when people are in pain and cannot decide, have u heard of ADVANCED medical directive?
18) lobo76
see my earlier post #11.
I wish to give my personal views on this matter.
All life is worth saving, if it is the desire of the person who is to be saved. It is the right of a person to reject medical treatment, if he or she considers life to be not worth living (I am not saying that this person should commit suicide).
I know of many elderly people who decides that they do not wish to be treated, as the treatment is painful and is not likely to be successful. They also do not wish to improverise their family with a big medical bill. It is their right to decide what is best for themselves.
As we grow old, there is a time to pass on. We have to accept our fate and meet our maker.
Can a doctor assist someone to pass away? There is no need to consider this point If the doctor does not give medical attention, nature will take its course.
To end one’s life with assistance is tentamount to suicide and no one should have the right to it just as no one can decide whether you can be conceived or not.
However, one can be given the right whether or not to receive further treatments to prolong his/her life from a dire situation. In this case, medical science can assist in making it more painless for the person to leave this world.
Hence, the living right of a human being is protected yet at the same time, he can still make a choice whether to continue receiving endless treatments and pain.
Hi gemami;
religious aspect was left out as I believe the patient and family involved will factor that in, in their decisions.
Euthanasia seems an effective mean to end the sufferings, but it could also be badly exploited by party(ies) with interests in inheritances, avoidance of responsibility and liability etc.
All in all, it is a very complex matter and really it is almost impossible to say that the decision for euthanasia will always be proper and sound. The implications are too far reaching, death may end the suffering and problem, but it is the interests of the living kins that are the problems.
Personally, I will never be able to determine euthanasia for anybody except myself. Thank You gemami.
patriot
i totally disagree…
our life is not we or others can control..
if u can control to die…
hahas…u also have the right choosen how to die ba..
jump down mrt station.??
just want to end yr life with tat…??
will not regreted??
hahas..do u think u r free or freedom when u die??
it is all just the beginning when u die…
so …
think carefully..
exactly, and it should not even have a place in our national legislation because even if it is only one life – wrongly ended – it must be the determining factor against such legislation.
Dear People,
The problem with euthanasia is three fold :
1) Who decides when someone should die and for what reasons ?
2) Who will ensure that euthanasia is not exploited for whatever reasons ? Its too easy to slip into abuse especially when the lines drawn are vague..
3) Religion ? Islam does not accept euthanasia………
Regards
Neat rhetorical trick Religious Philoman, but here’s a simple question: who does your body belong to?
As the religious fundies believe that your body belongs to God, therefore only He has the right to choose for you what you can or cannot do with it, therefore not only is anal sex criminal, choosing to end your own life also is.
You’d like to characterise the issue as being treating humans as economic units versus a “moral” stand, but my moral question to you is, do I not have a right to decide for myself what to do with my own body? Who are you to interfere? Who are you to use the power of government to interfere?
The simple honest truth is that religious fundamentalists are moral hypocrites. They reject the use of government power when it is against their beliefs, but are enthusiastic supporters of using the power of government coercion to enforce their own beliefs on OTHER people.
#20)
Mr. Tan, if you do not mind, I have a few questions . . . .
1) “….not worth living”
2) “I know of many elderly people who decides that they do not wish to be treated, as the treatment is painful and is not likely to be successful. They also do not wish to improverish their family with a big medical bill. It is their right to decide what is best for themselves”
Q1. Are these elderly people properly informed? (like minibond?).
Q2. Do we allow them to make decisions based on the perceived/hearsay pain?
Q3. Do we let them decide because they think they will impoverish their family? So often we hear of family members fighting to keep their aged parent alive even if it just for one more day.
Q4. Do you think they would not have decided this way if there is a glimmer of hope that they would not be contributing to any of these perceived circumstances?
3). “Can a doctor assist someone to pass away? There is no need to consider this point If the doctor does not give medical attention, nature will take its course.”
Q. Are doctors allowed to turn away from a suffering patient? It is tantamount to killing which is against the oath taken by the medical professionals.
Point is, if we start to allow people to ‘decide’ what action is best for them based on informations that are slanted then I am sure you can only imagine the consequences; for example: parents may decide that their children need not have go to school? It’s their right to decide.
So, instead of opening up a can of worms, why not channel the resources to finding ways to eliminate pain to sustain life? I might be naive, or, am I?
Firstly, I would like to welcome back two old friends; Patriot and Dr. Syed Alwi. It is nice to see you both commenting again after a long hiatus. Your perspective wisdoms, I am sure will be cherished by many readers.
I find at odds that of all challenges concerning our Health Care Systems, this subject matter should be brought up in an Annual Dinner and Dance gathering. This just personified the kind of wisdoms our high paying ministers possessed. If this subject matter was tabled as a public discourse in a scheduled broadcast engaging public audiences without any implication to monetary issues concerned, I would applaud such an effort and be gratified to know that at least the governing party still has some conscience and compassion towards its elderly citizenry.
Without a doubt, it is indeed a very intricate subject matter to contemplate. When situation arises, morally speaking (from a human perspective), it is not right for anyone to end their life with a switch. However, in some practical cases such as terminal illnesses without any foreseeable possible cure in sight, it could indeed be a relief for that person suffering such excruciating pain living or dying.
In the animal world, the rule of nature has always been survival of the fittest. The rule of the day is the weak and old will always had their lives taken away or die of natural causes. As a human living being and a strong advocate of freedom of choice, I would certainly want to exercise my rights and decide my own destiny. The rights should be accorded and it is within and during our sober mind state where we should plan and define what action to take in the event that any terminal illness strikes us and that we have lost all consciousness to make that important decision to possibly avoid any abuse and complications.
It is an entirely different perspective if you rope in the religion values and believes. The economic link perspective of this subject matter is not something I would advocate.
To each its own la. You want to live , good for you. Others dont want to live thats their buisness. Who are you to decide who loives and who dies. Nobody should be given that right to decide for another person.
So lets all cut the crap. As it is we cannot decide our own government. Human beings are full of shit. Especially those who are finacially well off. Got money know how to talk big and try to be moral leaders.
Each human being has their own right. They have their own brain and body. Are you attached to their body. So stop all this bull shit about everyones reason or religion.
You want to live , I am happy for you. Others dont want to live , be happy for them for what they want to do with their own life. You dont own me, I dont owe you , Period.
Dear People,
Like eugenics, euthanasia won’t fly in this part of the world. Our society is still very much traditional. For mainstream Singapore – religion still has a very strong grip.
Too bad – looks like the Gov will have to spend on medical care for the aged. The Gov simply cannot shirk its responsibility – and neither can filial children !
I would never trust the Gov with euthanasia – in case we get another round of inappropriate and misleading advice a-la the Lehmann Minibond fiasco ! And this time – they are messing with your life !
how do you think the govt will decide if the vote is 50/50?
i ask this because we already know the outcome of such a discussion – divided.
so, what do you think they will do?
yes; the decision will be taken upon that which is economically good for the country.
I – am pro-LIFE – this is what gives me the hope and reason to live. I admit I am beyond reasoning where this topic is concern.
If people want to follow their religion, I’d say go ahead. Good idea. No one is stopping anyone from following religion.
But if people start to say everyone else must follow their respective religious practices or beliefs. Sorry, I respect most religion but religious belief or practice shouldn’t form (can influence but not form) the basis of action.
Can one imagine if your doctor has a different religion from you. Do you expect your doctor to follow his religious beliefs in respect of medical treatment? Not a good idea.
Classic example would be abortion (but to go further, I’d digress from topic).
patriot (#13):
“If euthanasia is legalized, so must suicide(self murder) be removed as a criminal act, for those who committed self immolations did their acts out of their own decisions.”
i would advocate for suicide to be removed as criminal act even if euthanasia is not legalised, cos this would allow families of suicide attempt victims to seek relevant help.
Tan Kin Lian (#20):
“It is the right of a person to reject medical treatment, if he or she considers life to be not worth living”
there will be problem to look into as well. 1stly, is the person in the right state of mind? 2ndly, what if there is possibility of treatment in the near future, especially with the rapid medical advancement, that the patient might not be aware of?
there will also be concern that patients who are suffering might take the easy way out by ending his life.
Hi germami (#27)
My reply will be short.
The elderly knows and can make an informed decision. They have lived a lifetime and have seen their parents and relatives passed away.They have also seen how many people suffered in large medical bill, to no avail.
The doctor can relieve the pain and suffering. It is called palliative medicine. They will not prolong life (where there is no hope). They make the last few days more pleasant.
“I would advocate for suicide to be removed as criminal act even if euthanasia is not legalised, cos this would allow families of suicide attempt victims to seek relevant help.”
No point. A person who is dead will not be brought to court. A person who attempts suicide, is normally incarcerated with IMH for his/her own protection. Removing/decriminalising that action must be replaced by adequate action. In this case, I fail to see how the current law as it stands is wrong.
The question in other countries and in Singapore is, should it be a criminal act for doctors to assist in euthanasia eg providing advice and medicine on how to die painlessly? In Singapore, I think the scenarios are too diverse to contemplate it as anything other than a criminal act at this time.
To legalise euthanasia, it is not so simple as saying it is ok to do it. Laying the boundaries could take years of debate and even then, it would be severely contentious within society. I doubt if Singapore will do that. It is already a bold act to even suggest the possibility.
“The doctor can relieve the pain and suffering. It is called palliative medicine. They will not prolong life (where there is no hope). They make the last few days more pleasant.” – Mr Tan
Research in palliative care is very much in its infancy esp in Asia. Only in Mar of this year was asia’s first research centre in palliative care set up in Singapore. I think it was by the lien foundation. There should be more focus on this rather than on euthanasia.
If the PAP were to move towards legalising euthanasia, with the requisite checks to ensure that the system isn’t abused, they will have my full support.
Dear Robs
Well – wasn’t MAS in charge of all these banking stuff ? Yet they bumbled in the Lehmann Minibonds affair. There is never an adequate check and balance in a one-party state ! Especially when the Gov has an incestuous relationship with all the watch-dogs !
I will never entrust my life with the Gov. Who knows ? They might jolly well encourage euthanasia in place of expensive medical care for the aged. And thats when the system gets thoroughly abused !
34) Tan Kin Lian
no arguement if the decision is undertaken after full deliberation while still in a sound and concious state.
however, i must still stand my ground when it comes to making decisions based on what one has seen or heard in their lifetime. having said this, i think whichever side of the fence we are on we will have our own vaild arguements to make the decision for ourselves and we must respect this.
Dear People,
The solution to all these ethical, philosophical dilemmas lies in a system change. We need the adversarial, multi-party, Liberal Democracy.
We cannot rely on the obsolete, outdated wisdom of a one-party system.
Indeed – bring back the TRIAL BY JURY ! One thing for sure is that I no longer believe in a one-party system. Its open to abuse and obsolesence.
I will never trust in Singapore hospitals if they allow euthanasia……
“35) lim on October 24th, 2008 4.49 pm
To legalise euthanasia, it is not so simple as saying it is ok to do it. Laying the boundaries could take years of debate and even then, it would be severely contentious within society. I doubt if Singapore will do that. It is already a bold act to even suggest the possibility.”
Even experts like doctors & philosophers cannot clearly agree on the boundaries. So let us not kid ourselves that this can ever be settled even it takes milleniums.
At the end of the day, the views of the powerful (either by some individual few or at times the collective lot) will always prevail like in most things.
I think when you have a choice than just decide for yourself. If you think your choice is good for others too and insists that they follow you than you should pay for their medical bills. I will call you a hero.
This is a win-win, winner for those who agree and winner for those who doesn’t because no one force you. So long as you reserve your rights for yourself and others for themselve, who gave you the rights to deside for others?
Its a matter of time b4 Euthanasia is allowed, takes time to change the general perception. Maybe till the generation past Dr Syed Alwi.
I used to be pro choice with regard to euthanasia – the thought of suffering ‘needlessly’ is too much to bear. Having worked with patients who are terminal, being there to hold their hand in their frailty, I have to confess I do not wish to be in their shoes. Yet, in all their incapacity and pain, there is still humanity and soul there. There was an old lady at an elderly hospital I used to visit who was totally incapacitated. She feeds through a tube and there are only so many moments in a day she is clear headed, the rest of the time she is doped up on painkillers. At each weekly visit throughout the year there, I would hold her hand and sing her that same Cantonese song. During her clear moments, only her eyes tears – she looks straight at you and there is love there, and her eyes tears. The nurse in charge of the ward said that the elderly lady is there, the tears is her way of communicating. It has been more than 10 years now and those eyes remain in my memory.
Now I have a little daughter 18 months old. I do not think I have the right over my own life anymore because I have given birth. I have taken that bold step to bring a life into this world. With all my love to nurture and love her, I wish to leave my life into her hands should that day come, if I would be totally incapacitated, that she makes that decision to let me go when she is ready, whether it be the removal of drugs or starving me to death, or care for me till I go naturally. Life is not about control for me anymore, but letting go, and letting love rein.
“I used to be pro choice” – SSC
Actually you still are. Choosing to let your children decide is a choice.
lim,
Be sensitive and less analytical. SSC is sharing her real life experiences and none better when she worked in areas where most of us may not have to stomach for it. It is a tough job. There is no right or wrong answer in this subject matter and this is going to stay that way for a long time to come.
I think all humans, have the right to end their own life.
Although, I’m more concerned over the legal loopholes that may occur if this gets legalized.
What if a patient, while in a sane mental and physical condition, willingly consent to Euthanasia in a will-like legal contract, that can be executed when the patient is “terminally ill, handicap … etc”, but regrets the decision that he made while he is incapacitated and unable to voice his opinion (coma etc.)
This is quite a touchy subject, and there’s no real answer to it. I’m all for governments getting out of our lives but if we do legalize, we have to consider carefully and draft out a law that cannot be exploited.
DC – This is quite a touchy subject, and there’s no real answer to it. I’m all for governments getting out of our lives but if we do legalize, we have to consider carefully and draft out a law that cannot be exploited.
My dear, every law can be exploited. In this case, the interpretation of the law, circumstances in which the patient finds himself, the doctors attending, differing medical theories and modes of treatment – these all come to play when we sign on the dotted line. Who is to say when the time comes, if a person has already signed for his life not to be prolonged, and is incapacitated, that the person hangs on to life, when all organs are failing – for just that one last glimpse of a loved one faraway rushing home to say goodbye? What if the machine is plugged off by doctors before the patient is ready to go? My mother died very suddenly after she collapsed one day. She was resusitated with mega efforts and hung on for many hours more. I was rushing home, trying to get a flight out in high summer from Europe to see her one last time and say goodbye. I did not make it, only bidding her farewell on the phone. I would like to believe that she hung on when everything was failing her to just get to see me one last time.
When the time comes for me to go, I would like to go when I am ready to go and when my loved ones are ready to let me go, if they have that choice. We hear of patients who hang on for years in coma and just will not let go of life. Who is to know what their last attempt at clinging onto life is for? How do we justify ending someone’s life and last wishes on the basis of cost?
Hi SSC,
I do agree with you on that aspect which is why I feel its really a touchy subject.
On morality though, I personally do not want the government to decide whether or not I can or cannot live. That decision should be made by me and me alone.
This reminds me of HOTA. I remember reading about the case of a family who was denied the right for their son to live while braindead because the doctors want to harvest fresh organs.
I think the government shouldn’t impose HOTA on all citizens. An Act like this shouldn’t be opt-in by default.
Hi DC, there are enough films and fiction addressing euthanasia and what can go wrong in the hands of unethical, money loving people. I remember vividly a film with Mel Gibson signing away his life with some futuristic company when his young son was diagnosed with a life threatening disease. The whole episode of his son’s illness etc was a hoax with I recall someone needing the organs or some parts of the son or was it the father. Anyhow, the film highlighted the scenario when pharmaceuticals, government and firms have all sold their souls in exchange for money. Here, first we talk about paying people for organ donation, next we ask people to sign away their lives should something untoward happen to them. Who is to prevent someone from staging a near fatal road accident, just so that the targeted victim’s good matched organs could be transplanted into a rich person’s ailing body?
When as a society we place money and that material dream before this sacred thing called life and humanity, true decay and evil will creep in, corrupt and kill us all off. When we diminish another person’s life or dignity or humanity, we kill off a part of ourselves because deep down, we know we are just the same – helpless, vulnerable human beings. Designer clothes, all the money in the world cannot cover that fragility all of us share which is called life.
IF MERCY KILLING BECOMES LEGAL
Many people support the right of a terminally ill patient to die – but what if the right becomes an obligation??? And what of the potential for abuse by impatient heirs???
Should dying patients have the right to order their doctors not to start or continue medical treatment? Should doctors be protected from prosecution if they shorten a patient’s life expectancy with pain-killing drugs?
Most of us would answer yes to both questions. But does this mean we need a “right to die” law? Or is there more to the issue than first meets the eye?
Public discussion of the treatment of dying patients often confuses two separate issues. First, is the right of the terminally ill person to be allowed to die without being subjected to invasive medical procedures? Second, is the question of whether a dying person should also have the right to hasten his or her own death, and require the help of doctors and nurses to do so.
PATIENTS RIGHTS
It is often overlooked that patients have the common law right to refuse any medical treatment. A doctor who treats a patient against his or her express wishes can be charged with assault. It would be wise to educate people as to their right to refuse treatment. There is no need to convert this well established legal principle into legislation.
Regardless of the intention of “right to die” or “aid in dying” laws, they could very easily open the door to active euthanasia.
In the present climate of opinion, it is easy to imagine a doctor giving a lethal dose of pain-killing drug and then claiming that death was the best way to eliminate physical suffering. If the doctor could also show that the patient had requested the lethal dosage, the court might well interpret the law in the doctor’s favor.
Many do not find the prospect of legal voluntary active euthanasia in any way alarming. But two things should give us pause.
First, as a soon-to-be-published Canadian study will show, most health care professionals who work with the dying endorse the patient’s right to refuse medical treatment, but oppose legalizing active euthanasia. The professionals recognize that if pain is controlled, as it can be in virtually all cases, very few terminally ill people ask to be put to death. Second, experience in Holland tells us that voluntary Euthanasia can quickly become involuntary euthanasia.
DUTCH EXPERIENCE WITH EUTHANASIA
Holland is widely regarded as one of the world’s most civilized countries. Active euthanasia is legal there, but for the past decade the government has not prosecuted doctors who report having assisted their patients to commit suicide.
A recent Dutch government investigation of euthanasia has come up with some disturbing findings. In 1990, 1,030 Dutch patients were killed WITHOUT THEIR CONSENT. And of 22,500 deaths due to withdrawal of life support, 63% (14,175 patients) were denied medical treatment WITHOUT THEIR CONSENT. Twelve per-cent (1,701 patients) were mentally competent but were NOT CONSULTED.
These findings were widely publicized before the November 1991 referendum in Washington State, and contributed to the defeat of the proposition to legalize lethal injections and assisted suicide.
The Dutch experience seems to demonstrate that the “right to die” can soon turn into an obligation. This concept is dangerous, and you could find yourself the victim if Euthanasia becomes legal in North America.
We have all heard and some of us have experienced, moving stories of elderly people in great pain, unable to perform even the most basic human functions, who have asked to die, or have perhaps brought about their own deaths.
What these stories overlook is that today, in almost all cases, it is possible to kill pain without killing the patient. When someone’s pain is relieved that person usually wants to go on living. We need to reflect carefully on the consequences of legalizing active euthanasia. If we enshrine the absolute right to die, will it then become illegal to intervene to obstruct would-be suicide? Will pharmacists be obligated to sell a lethal dose of hemlock to anyone who is temporarily depressed?
POTENTIAL FOR ABUSE
We need to think of the potential for abuse if mercy killing becomes legal. What if someone stands to inherit one million dollars when Aunt Gladys dies? Might the heir not find it tempting to nudge her in the direction of accepting a lethal injection? Or, if she didn’t get the hint, to make her miserable enough to want it?
If voluntary euthanasia is made legal for “persons of sound mind” there will inevitably be tremendous pressure to provide it for those who “would request it if they were able to” – the mentally ill or handicapped, the senile, etc.
Finally, despite genuine compassion for the suffering of dying people, does there not also lurk in many hearts a less admirable motive? Few people are so tasteless as to link euthanasia and health care costs in the same breath, but there is a widespread few that medical care for the elderly costs more than we can afford. These financial pressures will multiply in the coming years as our population ages.
Many elderly people are already responding to this not-so-subtle message by declaring their willingness to die when their lives are no longer productive. Their reluctance to be a financial burden on the young is admirable, but the long term consequences could be brutal.
What will happen to the trust that people still feel toward their doctors if our country follows Holland? What emotion will elderly or seriously ill patients feel when the nurse approaches them with a full syringe? How soundly will they sleep in the hospital?
THE ALTERNATIVE TO EUTHANASIA
The alternative to legalized euthanasia is not extraordinary, futile treatment to hopelessly dying patients. The alternatives are appropriate medical care – including 1) the withdrawal of treatment upon patient request, or if that treatment serves no therapeutic purpose; and 2) dispensing drugs as necessary to control pain. No doctors, laws, or organizations oppose ceasing care when the time to die has arrived.
WHAT CAN I DO?
Each of us should talk to our loved ones openly about these subjects. Talk to yur doctor, and if you are not comfortable with his or her approach, change doctors. Find out about palliative care and Hospice programs in your community. These emphasize care and comfort for the dying. Support their growth, as this will reduce the attractiveness of legalized euthanasia. Keep informed about the issue of euthanasia and make your views known to politicians and the media. Your actions can help shape the way you and your loved ones will be treated in your last days.
Those who want to go… should just go. More food left for the remaining inhabitants of the earth.
But I draw the line on those who assist and hasten the process.
Wow I’m amazed by the leaps of logic and wrong statistical data presented here. This online community has just lost it’s credibility by an inch by hosting such an article. Bravo.
actually it has gained credibility.
you see, everything under the sun can be discussed unlike controlled media.
The twisted facts and logic in his article is an insult to intelligent discourse.
It is better to be roughly right than to be precisely wrong.
John Maynard Keynes
1883 — 1946
There are some other blog posts out there that challenge the facts presented in this piece, so Ravi Philemon has work to do.
As for euthanasia itself as a moral issue, my stance:
1. If somebody is in terminal condition and wants to forego treatment in order to die, so be it. The professionals (doctors, counselors) ought to provide full information, but the decision lies with the individual.
2. Doctors are trained to help save lives, not take them. It is not fair to put the burden of euthanasia on them. Certainly they should never be allowed to directly administer death e.g. overdose morphine.
3. In cases where the patient is not conscious, follow the AMD. No AMD means we try to keep her alive.
4. As a previous comment suggests, if the problem is physical pain, then surely we can find ways to alleviate the pain without resorting to death.
Yet another slippery slope
Hopefully mr Khaw will not institute something stupid like automatic opt-in for euthanasia once you passed your usefulness to society, e.g. when your children will not look after you, your bank accounts are fleeced by usurious bankers, the govt has sucked every cents of your CPF and then the govt did not want to pay for you to live on and be a burden to society.
#55) Lunarmon
we await enlightenment from you then. give us the facts and logics- if you can, please.
I oppose doctor-assisted suicide, or any other types of suicide. However I understand the pain that patients go through in the course of their illnesses. I saw my father in law and 9-year old cousin succumb to cancer. I think there is a distinct difference between doctor-assisted suicide, and gradually winding down life support systems for a terminally ill patient. I hope the Health Minister is talking about the latter rather than the former.
Dr Syed Alwi
“Well – wasn’t MAS in charge of all these banking stuff ? Yet they bumbled in the Lehmann Minibonds affair. There is never an adequate check and balance in a one-party state ! Especially when the Gov has an incestuous relationship with all the watch-dogs !
I will never entrust my life with the Gov. Who knows ? They might jolly well encourage euthanasia in place of expensive medical care for the aged. And thats when the system gets thoroughly abused !”
Essentially, what you’re saying is that as long as the PAP is in power you’ll oppose anything they do regardless of its merits because you do not trust them enough to do it. Society must stand still until the party is overthrown and the system changed. One must remember that government is merely a means to an end – and if this government does something one feels is right, one must stand by it. Otherwise it’s a straight choice between utter stasis and revolution. You may be ok with that, but you cannot subject the citizens to that choice. Besides, true change is bottom up. To get the liberal democracy we all want, society must liberalise first.
There’re alot of things about the incumbent party I don’t like, but one thing about them you must admit is that they operate through he rule of law. The laws may be heavily skewered,but they cannot arbitrarily step in and kill individual citizens. Besides, it is not government that decides who gets euthanised – we’re hardly Nazi Germany – it is the patients in concert with family and medical professionals. Our hospitals are mostly privately-ran (too much so, IMO) and your scenairo of an evil government euthanising patients for expediency is needless scaremongering.
And about all the complaints about euthanasia – abuse etc, I agree that they must be stopped. But all these are peripheral problems that can, and must, be checked through regulation. But none of these arguments have convinced me of the core moral right of euthanasia – that a person has a right to die, or to entrust his life to someone else, if he so chooses. The core of the argument still stands.
I have tried to answer some of the queries here and elsewhere on my blog: http://singaporesocialactivist.blogspot.com/2008/10/work-cut-out.html
Dear Observer(SG-HKG);
thank You very much for the kind compliment #Post 28. I have been greatly encouraged by the many comments You made, since we first met in Cyberspace.
Should I say I find your comments carried the substances of reason, experience and intellect. Most importantly, You have made them educational as well.
You did get me back here without having to call, I just got spur on by You, not accusing You of inciting of course.
Yours Humbly: patriot
Dear Patriot,
You are most kind and humble. I did learn from you and many others. Old people like us will pass on someday. While we are still kicking and able to share our humble thoughts and not necessary all sharings to be well received, I had my fair shares of challenges when my comments were at the other side of the fence. Sometime can be very tiring for me to get fully engaged as I still have to make ends meet. My time management is deteriorating as I ages. Sometimes, the mind just black out for no good reasons. I hope this is not he sign of Alzheimer.
Regardless, I have always believed and to this day that one need to speak their mind. Policies, Hard and Fast Rules…etc however bad they can be can never dictate what a people’s mind think if you have the will. I have been a fighter since 12 and never allowed others to influence my frame of mind and train of thought albeit I am not a “Graduate”. Pardon the pun.
Ending with that note, I hope whatever contributions seen in this community blog will somehow enlighten the experiences and exposures (for the young ones in particular) of any readers or conrtibutors seeking an alternative views on subjected matters where it is of their interest and concerns. It is okay to disagree for whatever reasoning (as we are only human beings, not saint) and hopefully people will maintain their composure and engage their exchanges in a friendly manner and not resort into emotional rambling. That I think it is not only not healthy and constructive, but it sends a wrong message to the young ones who are trying to learn a thing or two so that they can be better informed to face the reality of this not so beautiful world. More or less, our generation had been through that and am gald that some of us remain true to our inner-self, let’s not taint our young one’s mindset.
At the end of the day, it also boils down to your faith and belief system. An example, Christians have a no no approach to euthanasia.
some religion do not accept euthanasia, but how much power do they have over someone who has already undertaken euthanasia (already dead)?
not all followers of any religion are that pious. i saw muslims who eat pork, drink alcohol and gamble, against the tenets of islam, but they still go on committing these sins anyway. what is to stop people from undergoing euthanasia, to end their suffering?
and we are not talking about normal people seeking death. if they really want to die, they can die anywhere, anytime, by committing suicide. they don’t have to get assistance from doctors and healthcare providers.
we are talking about those who are too ill to take their own lives. those who don’t even have strength to take up a knife and cut their wrist.
from the tv and the papers, there are increasingly more cases whereby terminally ill patients tried to commit suicide by drug overdose, telling us that there is a trend where people do really want to end their suffering.
healthy people like us don’t understand the pain and suffering terminally ill patients have to undergo.
they have to eat a cocktail of drugs for every meal for the rest of their life, (untill they recover or die). for terminal stage cancer, taking these drugs simply means prolonging ur life. nothing more than that. you have almost zero chance of recovery.
at the terminal stage of cancer, all of your organs will start to stop functioning. do you under the pain of kidney failure patients? well, they only have 1 set of non functioning organs (their kidneys). imagine when your entire set of organs are all not functioning. your pancreas, your kidneys, liver, intestine, heart, lungs, brain etc. it would be “OUCH” 24/7.
can you tahan that kind of pain? at that point of illness, even drugs like morphine would have lost its effectiveness, and you are condemn to die a slow and painful death. do you want to die like that?
68) donthc
most of your points are valid and true, however they are at the same time ‘open-ended’. it means that you are making assumptions based on what you have probaby seen, heard and felt – possibly with direct contact with these sort of patients as well. forgive me for using the word ‘assumption’ because i feel that one who is not in pain can only imagine what pain is and this ‘imagining’ comes in different degrees.
it also means that no person or institution can therefore claim a right to make such an important decision as to whether one should live or die.
i agree we do come across many articles and reports of people wanting to die because of the unbearable pain they go through but as i have mentioned in my earlier post, these same people do not want to die if the pain is taken away from them. do we give up on them just because the medicine no longer works to alleviate their pain? do we let them die because of this? we need to look at what sort of palliative care we can provide instead of deciding if a patient should die.
you are also correct to point out that healthy people do not understand the pain these patients go through. again, we have to acknowledge that different people can bear pain differently. how then do we decide at which level of pain would we let the patient go?
i can feel the ‘pain’ you try to bring across by your 24/7 example but somehow i also feel that if we start using such ‘criteria’ to assist in our decision making, than there is a danger that any patient who calls out in pain will be ‘let go’ regardless of other considerations.
65) Observer(SG-HK) & patriot
i’d like to put on record that i have learnt so much since i became aware of this blogsite. i have read and re-read most of your sharings and have gained so much from them.
there are other posters whom i also pay close attention to, particularly, Donaldson, logicalman, blade, james, Daniel, TKL and so many more…. all those who have offered differing in-dept views.
please continue to share as much as you can so that we can learn and pass on what we learn to the next generation.
wishing all of you good health.
thanks.
After reading through, I’d put my vote on Palliative practices. When it’s time to go, might as well go in the most pleasant environment as possible. It is a one way trip after all.
I’d rather not put the decision on whether to continue living on other people’s hands, nor be in a position where I have to decide whether another person is to live or die.
Hi gemami;
I am much encouraged by your remark(Post#70) and sincerely believed the others will be motivated as well.
The pain a patient suffers may or most likely comprises of physical and spiritual(emotional/sentient), as both are immeasurable(unmeasurable?), which is more intense maybe difficult to determine. Whereas physical pain can be alleviated and overcame by medicines, sentient pain is almost impossible to be numbed or overwhelmed. It could be reduced or triggered on whence sufferer get consoled, comforted or agitated by presence or absence of emotionally linked people(kins, friends and medical staff etc).
Both physical and sentient pains can be crippling and unbearable, while medicine is effective on most physical pains, medicine is only effective on sentient pain sufferers when it(medication) sedates him/her or put them into slumbers. Sentient pain to some could be more painful than physical ones and based on the effectiveness of medications on both, sentient pain is a far more complex suffering that is beyond medical help. Counselling maybe an avenue, but how effective can it be to a desperate person?
Having read this thread repeatedly, I would say, other than myself, I will not be able to approve euthanasia on anyone else.
thanks patriot #72…
allow me some time to digest your post
gemami;
my last post could indeed be difficult to understand, I must be guilty for fumbling in writing the above.
Simply put, a patient may suffer more severely when he/she feels useless, abandoned, deserted, neglected and a burden to others. The feelings become sort of pains, emotionally/psychologically and mentally, as these pains are non-physical, they can breakdown the sufferers spiritually. Many, especially the elderlies, tend to need more attentions from close ones, however, few are able to get them. Medicines alone is hardly able to remove the emotional pains from these patients.
Youretruly: patriot
patriot,
thanks for elaborating. . . . and very true indeed.
what adds on to the pain is when these patients are made known of the fact that their sufferings cannot be healed and that there is only one outcome at the end of their sufferings, it plays on the mind every minute of the day. . . the only consolation medicaine can offer is, sedation, and it is very, very difficult for healthy folks to comprehend . . . . impossible is a better word …………