By Ravi Philemon
In April 2009, Health Minister Khaw Boon Wan categorically stated that, “euthanasia, which means helping the patient to commit suicide, is not what Ministry of Health (MOH) is promoting” and that MOH is actually “promoting palliative care for the terminally ill so that they, and their family members, will be able to cope with terminal illness with the least pain and being cared for in the most appropriate setting, which usually means the home they live in.”
When the Health Minister has categorically stated his position that he will not promote euthanasia, Ms Toh Puay San, a deputy public prosecutor (writing in her personal capacity), and National University of Singapore law don Stanley Yeo, seem to have taken the back door approach to push for the issue of dying with aid, with their controversial article in the latest issue of the Singapore Academy of Law Journal.
Although euthanasia is not the same as Physician Assisted Suicide (PAS) in that euthanasia generally means that the physician would act directly (for example, by giving a lethal injection to end a patient’s life), while PAS refers to the physician providing the means for death (most often with a prescription) and the patient (not the physician) ultimately using that means to end his life; they are similar in that it is intentional assistance given to a person by a physician to enable that person to terminate his own life upon that person’s request.
The arguments for euthanasia and PAS are often not cogent.
For example, pain and other symptoms causing discomfort and suffering, which is often cited by the proponents of assisted dying for euthanasia or PAS, are treatable.
Even where patients are considered to be terminally ill, there remains the frequent prognostic uncertainty.
A terminally ill person’s expression of a desire for death is very often a cry for help, to which a physician can respond in many non-lethal ways.
There are also no secure safeguards that euthanasia or PAS may lead to abuse through the singling out of the disenfranchised like the poor, people with disability, the elderly and the very young, who have no ‘voice’, to conclude their lives out of coercion, or even worse making such feel that they have a ‘duty to die’.
Focusing on euthanasia and PAS also diverts the much needed resources and energies away from patient-care and research on palliation.
As studies have shown that two-thirds of seniors over the age of 65, who receive long-term care, rely exclusively on family, friends and other informal caregivers, MOH’s emphasis on palliative care is the right one.
Mr Gerard Ee, the chairman of the Council for the Third Age, is indeed right in slamming such talk as going down a slippery slope, as there is too great a danger of abuse in legalising euthanasia or PAS.
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Picture courtesy of Jeffrey Leow
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“Because we understand the metaphor of conflict so well, we are easily sold on the idea that we must resolutely fight against our afflictions (although there was once an article in The Onion titled “Man Loses Cowardly Battle With Cancer”). And there is a place to contest an abnormal metabolism, a mutation, a trauma, or an infection. But there is also a place to surrender. When the organs have failed, when the mind has dissolved, when the body that has faithfully housed us for our lifetime has abandoned us, what’s wrong with giving up?”
http://www.theamericanscholar.org/to-die-of-having-lived/
It should not be a case of allowing/ disallowing euthanasia, but rather WHEN should it be allowed and when should it be disallowed.
When the illnesses is no longer treatable and the pain is just too unbearable, it might just be more merciful to just end the patient life painlessly than having to suffer the antagonizing months.
The morality of euthanasia is still widely debatable. As the Hippocratic oath goes, “First do no harm.” Which is more harmful? Ending someone life painlessly or allowing someone to pass away in pain?
The debate, I shall leave to the medical and ethical bodies. But if I were to ever be in such situation, at least I should be given the choice to either pass away painlessly or painfully.
Playing the devil’s advocate here, how does relying on familial support in one’s latter years make it right for MOH to focus on palliative care? How does legalising euthanasia lead to MOH lessening its focus on palliative care? For if MOH, patients and medical practitioners in general attach such great value to palliative care, that value should remain, and the support and research for it should not diminish with the introduction of another terminal option.
The lack of safeguards is not valid reason for not legalising euthanasia, whatever other valid reasons there may be. Are safeguards so difficult to put in place so that abuse does not occur? Who in his right mind would want to prematurely end his life? On abuse by medical staff, if there are medical practitioners out there who would wantonly end the lives of their patient, it really points towards a failure of medical education and candidate selection.
If prognostical uncertainty were a reason for not allowing euthanasia, than doctors should not be allowed to send patients home, telling them that there is nothing more that can be done, that patients should just make their final arrangements and focus on relieving terminal pain.
Terminal pain is often treatable? I don’t think the jury is yet in on this. There have been reports on how pain medicine draw out the dying process, yet keep the patient so mentally confused, uncommunicative, or practically comatose, so that little extra quality time with loved ones is materially added. In some cases, loved ones are thus dragged into the dying process, having to witness vicarious helplessness their loved ones slipping away a little each day, so that the dying becomes more lastingly traumatic than it has to be.
The issue of euthanasia is really mind-bogglingly complex, it isn’t absolute, so some middle ground may yet be found that is ideal for all involved. Such a middle-of-the-road solution might much more likely be equitable all around. But this cannot happen if either advocates or opponents to dig themselves into an unmoving position. The minister probably had that in mind when he rejected the promotion of euthanasia, rather than assert that it was “wrong.”
“For example, pain and other symptoms causing discomfort and suffering, which is often cited by the proponents of assisted dying for euthanasia or PAS, are treatable.”
I disagree with the above statement. It is only when the pain of terminally ill patients cannot be alleviated without numbing and horrible side effects that the consideration of PAS comes in. Not every instance of ‘pain’ and ‘discomfort’ is can be medically or holistically treated. My father who was wracked in terrible pain for years and was always wishing to end his life; in the end, his death was sad, wasted and without any dignity cos of all the pain and hurt he went through.
“Even where patients are considered to be terminally ill, there remains the frequent prognostic uncertainty.”
A contradictory statement without facts to back it up. A terminally ill patient IS terminally ill because he has been given very limited time left to ill. Is the author then speaking of miracles when for example, cancer is eating away internal organs day by day relentlessly? In cases where the progonostics is uncertain, then the patient is certainly not terminally ill.
I am in no means supporting PAS but there has to be debate on this issue as more and more people are not willing to go through the horrifying experience of living is acute or numbing pain for months on end without any dignified resolution or solution in sight.
If we are given the right to live their lives with dignity, then we should also be given the right to leave it with dignity after all other medical avenues are exhausted to solve their terminal problems. To waste away before the eyes of your loved ones, to have your mental and physical faculties slowly eroding away without realisation and finally to live the days of your life in utter pain – that is a choice that is best left up to the individual to choose, not others who want to dictate their morality, or choices, upon them.
You say:
‘For example, pain and other symptoms causing discomfort and suffering, which is often cited by the proponents of assisted dying for euthanasia or PAS, are treatable.’
‘Even where patients are considered to be terminally ill, there remains the frequent prognostic uncertainty.’
‘A terminally ill person’s expression of a desire for death is very often a cry for help, to which a physician can respond in many non-lethal ways.’
These statements strike me as adopting a somewhat paternalistic attitude towards the patients, no? In other words, what you’re saying is that the patients don’t really know what they’re going through; what they’re feeling; the pain they’re experiencing. If they contemplate PAS, it must be because the pain isn’t treated adequately; they’re simply expressing their anguish in ‘a cry for help’ – what exactly does this mean? In all these cases, the patient’s wishes are not to be taken as being carefully considered, for they don’t know any better!
The article also seems to oversimplify the issues involved. For starters, it is not only the case that physical, bodily pain is the overarching reason for patients to choose to be put out of their misery. You have cases whereby people become mere shells of their former selves because the illness has taken such a toll – the shame and embarrassment involved in being incontinent, or of being disfigured or disabled, or from experiencing your body turn into a prison custom made for one – as in ALS: one feels woefully inadequate in front of one’s loved ones. For could it be that it is not death that most people are afraid of, but merely dying? The protracted, agonising path to oblivion brings not only physical pain, but much psychological turmoil. And I think it may just be the case that it is the latter, and not the former, that leads one to think of PAS.
sloo,
I couldn’t agree more with your post. There are many bare assertions in the articles that I was going like ‘huh?’ every other sentence.
Opponents of Euthanasia feel that euthanasia should never be allowed as this may create a scenario whereby the kins/legal guardian may exert pressure on the patient (out of financial motivations or psychological stress) to make that decision.
Proponents like sloo support euthanasia for the well stated reasons above.
Both have valid points. Should euthanasia be banned for its propensity to be abused by unethical relatives or guardians?
Do we own our own bodies or does the State? If we do, then we have the right to choose our own time and manner of death. If the State does, then are we just pieces of national property? (from http://www.righttodie.info/)
Since Zhengxi left i’ve stopped reading TOC on a regular basis because the quality of articles has gone to the dogs. This article, sorry Ravi, is disappointing, especially coming from an editor. Why? Because the substantive portion of it consists of 5 sentence-long assertions. Sorry to get all GP-teacher and condescending on you, but i think you need a massive kick up the backside.
For example, pain and other symptoms causing discomfort and suffering, which is often cited by the proponents of assisted dying for euthanasia or PAS, are treatable. - Unsubstantiated assertion. to what extent are these treatable, and in what way? do cite examples. any qualifications to make here?
Even where patients are considered to be terminally ill, there remains the frequent prognostic uncertainty. Unsubstantiated assertion. How frequent? perhaps cite a study? how often is the prognosis wrong/uncertain? is this to do with limitations in medical science or practitioner incompetence?
A terminally ill person’s expression of a desire for death is very often a cry for help, to which a physician can respond in many non-lethal ways. Unsubstantiated assertion on both counts: cry for help, and response. Any studies you can cite on patient psychology? perhaps demonstrate that no one terminally ill can make a rational decision to commit suicide? or even better, show that no suicide decision can be made rationally?
There are also no secure safeguards that euthanasia or PAS may lead to abuse through the singling out of the disenfranchised like the poor, people with disability, the elderly and the very young, who have no ‘voice’, to conclude their lives out of coercion, or even worse making such feel that they have a ‘duty to die’. I’ll overlook the dodgy English in the first bit of the sentence to focus on the lack of substantiation. The abuse argument is a good one to raise, but again, you need to bring in evidence. How about the Swiss example? They have erected safeguards – an effective approach is to show that they failed. You can just copy from a lobby group article like this one
http://www.independentliving.org/docs5/Wolbringeuthanasia.html
Focusing on euthanasia and PAS also diverts the much needed resources and energies away from patient-care and research on palliation. How much does implementation of PAS/euthanasia cost? In what ways does it divert resources? Again, the Swiss example would be good to examine for bits of evidence you can pick out to support your argument.
As studies have shown that two-thirds of seniors over the age of 65, who receive long-term care, rely exclusively on family, friends and other informal caregivers, MOH’s emphasis on palliative care is the right one. I fail to see the link between the first half of the sentence and the next.
Now you know why i stopped reading TOC? I like you guys. Your hearts are in the right place. But if you’re not going to get intelligent, cogent, original analysis, but mere I THINK THIS THEREFORE THIS IS RIGHT then sorry, expect to lose readers.
Moderating Editor (who is not Ravi): I appreciate your comments and points. However, whilst we can have (and still do) academically-rigorous articles, we aspire to facilitate the community rather than just debate. Thus, we place priority on placing the content for readers to think about instead of worrying about whether our articles stand up to academic (or GP-level) scrutiny. The point for us is to get our readers to think and discuss – and find/verify information for themselves and through the commenters, rather than have an air-tight article that readers feel is beyond them to comment. Taking this approach, we understand we might disappoint readers such as yourself, but we would like to have 10 issues being discussed passionately rather than 5 solid articles that readers nod their heads to – and move on. I sincerely hope that you will support us in our endeavour to be part of the solution as opposed to becoming elite-minded, thank you.
weak argument
@Pascal: You miss point. Tis not argument but praise.
This may seem like a silly question-
but if someone wants to commit suicide, why does he need a prescription from a doctor?
There are many ways of doing it- without a doctor.
The debate about euthanasia matters because we are talking about giving someone (doctors) a license to kill another person, without having any consequences. But if a person wants to do it himself, he is able to do it. And given the circumstances, there isn’t going to be any consequences for trying. Realistically, no one can jail/hang a dying man.
p.s. i must preface by saying that this is the first time i am hearing about physician assisted suicide, so this is new to me. Hence, I am going by my own logic- if anyone who has more knowledge can shed some light, pls feel free to do so.
The biggest argument for assisted suicide, whether administered by the doctor or the sick individual himself, is centered around ‘pain’. The pain is unbearable, so the choice to commit suicide.
Everything else is relative to this pain.
Does it then mean that once the element of pain is taken away so would the discussion on assisted suicide? The straight answer would be ‘yes’, but then again, how does one take pain away in terminal medical conditions? Numbing it is one way but this will compromise the ‘quality of life’ of the sick person, as some had pointed out.
However, what quality of life are we talking about when one is already in a terminal state of illness?
We are so often caught up in our argument that we forget to realize that we are talking about alleviating pain so that the patient can have any hope of recovery, no matter how remote. That’s what the medical profession is all about – to give hope when all hope is lost.
Now, to take away that hope for one suffering the end days of his life, is more cruel than to inject him with a substance to let him die, and ending all hopes for the patient as well as for his family.
Finally, the suffering of the family is no reason why the suffering patient has to decide to die.
RW,
Good point.
Sloo,
(1) One must question why he went through all the pain and suffering he did, why he wanted to keep on living. And that question is not resolved by the appeal to a red-herring issue of the legalization of PAS or euthanasia. In fact, I sometimes wonder if advocates of euthanasia and PAS are merely satisfying their desire to evade experiencing pain with their loved ones when their loved ones are dying: would that be showing love or showing selfishness?
(3-4) Let’s look beyond the rhetoric.
The experience is not so much painful and numbing because of the physics, but because of the emotional experience of loneliness. Dignity is lost by cutting off a person from humanity, which involves cutting the person away from other humans (e.g. loved ones) as well. “wasting away before loved ones” involves an objectification – rather than a subjectification – of the people involved with respect to the dying person, and the objectification of the dying person with respect to the loved ones.
Also, the problem with PAS and euthanasia is that it would be likely served as a service or a quasi-service across hospital receptions, which trivializes the entire matter. In such a form, it manipulates people’s fear of pain; it puts them into a vulnerable position and then exploits the vulnerable positions.
RW
Mar 22, 2010 7:02
There are many ways of doing it- without a doctor.
Yes. But I would think that they are not as ‘foolproof’, as well as less painful.
And given the circumstances, there isn’t going to be any consequences for trying. Realistically, no one can jail/hang a dying man.
Not sure if they have hospital jails or something like that … for prisoners and such?
In any case, there is at least one consequence I am pretty sure of. That is, if the patienti is still housed in an hospital (for prisoner or otherwise), they may be put on ‘guard’ of future suicide attempts. Meaning, you have one ‘easy’ chance to do it. And then you may be left with alternatives that may be more painful or drastic (such as jumping off a building .. or cutting your own throat with a spoon).
Dear A&E,
you said ” Who in his right mind would want to prematurely end his life?”.
Exactly the point, who in the RIGHT mind would think of that? Those emotionally too stress, those who think it is the end of the road. There are many people who are so depressed that they sees no way out, despite sunshine at the corner.
Hence you are right to say that no one in the “right” mind will do that… but how do we know that they are sane? Or if someone so argue flawlessly that he/she should end his/her life, even they do not suffer any illness (physically, emotionally, mentally etc), we should let them do it nevertheless?
pickitup
Mar 22, 2010 9:17
There are many people who are so depressed that they sees no way out, despite sunshine at the corner.
Please stop lumping people with terminal illness and in pain with people simply down with depression. I don’t think there was any proponents for assisted suicide to be used for the latter. Not in this thread, nor, I think, anywhere in the world where it is practiced.
In my youth, i have always spoken against euthanasia and upheld the value of life. I thought that those who advocated euthanasia are cruel and heartless people.
As I mature and grew older and saw the suffering and pain my loved ones went through battling their terminal disease, i am not so convinced now that euthanasia or PAS is without its merits.
My dad had throat cancer. In his last days, he could not speak and could only communicate with us by writing notes. He was suffering constantly and was in pain 24/7. Sleep for him was almost non existence . To see tears in his eyes every day and to see him suffer so much was extremely heart wrenching for all the family members. He has written in many of his notes to us to ask the doc to give him something for him to die in peace……
Several years later, my mum had cancer of the osesophagus. In her later days, she could not swallow any food. She was extremely hungry but could not swallow.. She was extremely deepressed and was in so much pain that she thrown her head against the wall so that she could be unconscious and hopefully die. The doc gave her sedatives but that lasted only a few hours.. once the effect is over, the pain come back…. She suffered a major bruise on her head that only aggravated her pain… it was equally heart wrenching for all of us to see her desire to die…
Both had to live through the horrors of pain and suffering for some months before passing on.
Having live through these personal experiences, i am now not so sure that letting them die in dignity and with as little pain as possible is a bad thing. I am not sure … i am not sure now..
It is perhaps ill-fitting when Ravi claimed that the pro-euthanasia arguments are not cogent, because sloo above has pointed out, the anti-euthanasia arguments provided are not entirely justified.
If there is one thing I agree with in the article, it is the statement regarding safeguards, and I think the solution is to place strict guidelines instead of disregarding the option altogether.
Personally, based on my current stand, if I have a terminal illness, I’d rather choose a planned death than fight it to my last breath. And I am not alone in wanting that choice; e.g. Arthur Koestler, author of Darkness at Noon, chose suicide instead of a lingering death.
again, morality and legality comes into question.
A doctor can assist a suicide passively too, with and without the patient’s concurrence.
Its like prostitution or alcohol consumption – legal or not, it happened anyway.
So why not legalise to regulate than allow unregulated abuse to continue to happen. It will be the lesser of two evils.
And BTW Gerard Ee is a hypocrite.
Joe, stay strong, stay strong …
Wee Long,
Whether Gerard Ee is a hypocrite does not affect the truth of what he says. Anyhow, alcohol and prostitution are different. Alcohol can be controlled. It is much harder to control prostitution; legalising prostitution does not make the sex industry any less problematic; all it does is allow the brothel operators to work behind a veneer of legality. Honestly, how many brothel operators can you confidently cite who follow purely the free labour market for their industry, and how many can you know of that relie on deception, human trafficking and the “coolie” trade to obtain their staff?
We should all give ourselves a pat on the back for discussing such a difficult and complex issue. One thing we have to realize though: that this is a case of ‘Damn if we do, and damn if we don’t’.
The only factor we should consider is that of the suffering patient. We should not even talk about perceived suffering from those who watch by the side. Every individual has a different threshold for suffering and to provide a one-solution approach for one and all is not the way to go, especially on an issue that concerns one’s life and death.
Let me relate my story, lame it may be but it does help bring across the point I am going to make.
For many years, since 2002, I had this cornea problem with my left eye. Whenever it flared up, usually due to infection, I would hide in my room, switched off all the lights, draw all the curtains after getting the missus to change them all to dark coloured one, and suffer the unbearable pain of the infection.
To those who have such experienced, they will know what I am talking about. Even with medicine, the pain was never going to go away and every shade of light will bring you a new stab in the eye, and this would go on and on – with painful suffering by the second, by the minute, the hour and for indefinite days.
Many a time, I had wished to end it all. No one around could provide me any comfort or help I so needed, and death was an option ‘worth’ considering, just to end the suffering.
However, deep inside, I knew I had to continue on. There is a family to look forward to. There is the knowledge that they are suffering silently with me. I just could not bring myself to let them down.
So in my moment of unbearable pain, common sense still dictates that there are reasons why I should live on.
Won’t we be offering the suffering patient an easy way out especially when we do not know what struggles he is going through even as we think he wants to end it all. How sure are we?
@ gemami - What if the patient is conscious and are explicitly requesting for their lives to be be ended as did my dad and mum and yet all our hands are tied (as did the hands of the doctors) who just cannot do anything else besides seeing him agonise in pain and hopelessness and keeping a watch on them to prevent them from attempting to end it all on their own ?
Very tough situation.. very tough…..
gemami
Mar 22, 2010 13:17
Every individual has a different threshold for suffering and to provide a one-solution approach for one and all is not the way to go, especially on an issue that concerns one’s life and death.
Yep. That is why I think the OPTION should be allowed. Now, the ‘one-solution’ is to do everything else or nothing, if nothing is the only thing to be done.
Arix…
I never said my father wanted to live despite the pain – he wanted to end his life many times pleading with us even in moments when his pain subsided due to sedatives. In his moments of mental clarity before he lost his mind to the encroaching illness, he begged and pleaded with us and the doctors to end his pain. My family just held on to hope – not the hope of recovery – but the hope of a peaceful, painless end for him. That he did not have. He was in pain, incoherent and a physical mess, right to the very painful end. My wish for his early end is not for selfish reasons at all: who would want to see a love one go through what I went through with my father?
His wish for an early painless end has nothing to do with a disconnect to humanity or lack of empathy or love from those around him – but it had a lot to do with loneliness. The utter loneliness of experiencing such physical horrors that no one else around him could ever understand – a constant nightmare 24/7 for him the ones who loved him. Very much like Joe’s experience.
The whole point of this debate is the human right to live – and die – with dignity. As Takumi stated before, are these rights decided by us or others? If there ever comes a day when we are going through what many millions have gone through – this mind-boggling and painful nightmare – would we want to have the right to decide on how to end our lives?
Against the arguments of the terminally ill making unwise or mistaken choices, declare your intentions when you are still in a healthy state of mind. Exercise your right to determine how, if ever you are caught in such a situation when there is no hope for recovery or a peaceful end, you would want to end your life.
After its my life, its my choice and no one else (least of all The State) should make it for me.
Pickitup,
If you are physically fine, you won’t be looking to a doctor to help end your life, so that is not the point of the article, nor my comment. The author mentions abuse in a way which suggests that he thinks legalising assisted dying is going to create hordes of sick people who suddenly want to end their lives prematurely merely because the option is now available. This scenario does not seem likely, therefore it does not seem like valid reason against euthansia.
Additionally, for whatever reason euthanasia is/remains outlawed, it shouldn’t be so that the conscience of the physician can be appeased, or that inconvenience in administration and law can be avoided, or worse, so that we can be sensitive to the distaste in totally uninvolved, yet-to-be-afflicted commentators like you and me.
Euthanasia and physician-assisted suicide aren’t just about avoiding pain and suffering. It’s also about each person’s freedom to live her life according to her deep-seated convictions — a freedom which must include a choice to die a dignified death. Each of us has asked the question, “How would I, on my deathbed, like to look back on my life?” Having a choice over the way in which we die (e.g., in a morphine-induced coma rather than gasping for air as one’s lungs fill with phlegm and blood) is therefore every bit as crucial (if not more crucial) as life-decisions such as marrying, having children, and choosing a career.
Conversely, having to suffer through a painful, terminal illness without any personal belief that one’s tortuous suffering is valuable or redemptive is a grave indignity no one should be forced to undergo. Contrary to what Arix says above, it is the illness itself (rather than one’s family and friends) which objectifies the person. His body betrays him, renders him incapable of living out his plans and aspirations — and sometimes, incapable even of bringing about his own death. Assisted suicide here would humanize the person, prevent him from being viewed as just an amalgamation of vital signs, heartbeats and nerve impulses (sustained for its own sake). It acknowledges him as a choosing, moral being who is finally responsible for his own life and death.
Hi Joe,
I understand your point and it is a tough decision to call isn’t it? What I was trying to put across with my personal account was to point to the fact that I was actually calling out for someone to end my life for me. But then again, deep down inside of me, I also knew I did not want to die.
So, for one standing by the bedside, he might read such a call from one who is desperately ill and whose only recourse to his suffering is seemingly death, that he wants to die, but is this so?
Please do not get me wrong. I do realize there are real cases where a patient really wants to end it there and then, and he is clear abour it – but the questions remains, how sure are we when making a call to provide assistance, that the patient really and truly wants to die?
Hi lobo76,
I beg to differ. I believe we should do nothing until we are sure the something we are going to do is the right thing to do.
weak praise
@ gemami - Yeah, i get you. It is a tough call and one which everyone has to be absolutely certain about and a call made by the patient himself and no one else. Even then, we have to be absolutely sure that the patient is coherent enough to make the call…
Like I said, as I mature, i am not so sure that euthanasia is such a bad thing…
Thanks to M&E for such a penetrating article. I am against PAS persoanally but appreciate the education I got by reading him.
Maybe an interesting aside: in the UK, under curernt legislation, a doctor who feeds an arsenic tablet to a patient who wants to die can be charged with murder. But if he puts it next to the same patient, and the patient consumes it, he is innocent.
my upstair auntie died @ the aged of 102..when she was already 90..she wanted to end her life as she was sufferin in pain on a wheelchair based…her unmarried daughter hav so much stress takin cared of her..for she (her sister) ain’t no riched taistais..hav to struggle tryin to keep their sicked mom alived..every moanin without failed i would hugged her give her a grandson( even though we are not related) kiss before i goes to work ahdoc…
this is where our stupid law comes in…peasants sufferred..dr khaw says medicines too costLEE..yet the sicks cannot volunteer to die without pain nor shames
if people whose minds have “dissolved” want to die, they should be allowed to if they have written such a will beforehand.
To damagedDNAs,
You just wanted to politicized the article with your post. If you think your aunt wanted to end her life at 90, and you think it is really compassionate, do you really have to wait for PAS before taking the step? Why pass the buck to the physician? If you think it is filial piety to end old age, you should have graciously volunteered.
Personally, I do agree that euthanasia should be legally allowed since all human beings have their own rights to decide to live or end their own lives. And these rights shouldn’t be undermined by the law itself. Also, according to Deontological Theory, PAC is in fact ethically right since means to the end is done out of GOOD WILL and the physician himself has also fulfilled his duty to respect others’ right to decide about their own lives.
onefatcat
Mar 22, 2010 23:17
… is done out of GOOD WILL
The trick then, is to establish that ‘good will’? Maybe a judge, plus 2 doctors (one from the hospital where the patient is staying, and one from a different hospital) have to sign off the ‘form’ for it to take place?
There was an incident some years ago where a man got into an accident and was hastily declared brain dead, much to his family’s anger and anguish. A mini scuffle broke out, the police were called in and his organs were quickly harvested.
Many Singaporeans opted out of HOTA after that incident. It even made the news about a record number of people opting out. As recent as I can recall, think around last year, MOH started going on a PR offensive to discourage people from opting out of HOTA.
We have long since slipped past the point of no return. I predict euthanasia will be legalised in a not-so-distant future, especially with a rapidly ageing population. You must get rid of the unproductive and undesirable parasites, you see. They’re a drain to the country’s resources, unlike money spent on military toys, community events for integrating new citizens and those remarkable overseas investments made by Ho Ching and her band of prolific scholars.
lol…
actually, one of the ppl here said that there is a possibility that the gov is importing FTs from other countries and encouraging old ppl to go to Malaysia to stay, since the medicare thing can be used there, and everything is a lot cheaper there.
it sucks. but what to do….
I find people with loose morality have an inclination towards legalizing Euthanasia and P.A.S. I am 100% certain that this same group of people also believe that abortion,gambling,
homosexuality are okayed as long as they are state sanctioned.If one does not stand for something,one would fall for anything.
Hi onefatcat,
To a certain extent, yes, every human has the right to decide for himself whether to live or to end his own life, or, for anything else for that matter.
Unfortunately, making a decision when one is well is very different to the decision one would make when one is painfully unwell. Like I asked before, what is the acceptable benchmark that we should work at, especially when one is so sick and in pain, to be certain that such a decision made during such time is what the sick person really wants?
Is his decision based on a real desire to die or is it because of the unbearable pain, or rather, the desire to get rid of the pain? Which one should we accede to? How sure are we that a decision is made based on a real desire to die? This is based on the simple logic that no one desires death if one can help it.
In this sense, we should be working at how we can alleviate pain (palliative care) instead of eliminating pain by death.
All said, this is just my opinion. I cannot claim to be speaking on behalf of those who are genuinely so sick that death might be a worthwhile consideration. On the other hand, we have to be absolutely sure before we legislate anything that allows death for the wrong sets of reasons.
Hi WTF,
Strange that you mentioned Ho Ching. It brings to mind the article written by Lee Wei Ling in last Sunday’s Insight column where she quoted Ho Ching as saying, when her nephew asked whether he should adopt a western name, that “western names are for waiters and waitresses in China”.
I am surprised that TOC did not pick this out for its ‘Quotes’ column.
Anyway, I deviate from the topic.
@ preston loon
u r extremely conservative in your views. people should be able to do what they want if it does not harm other people. do u really want your government to tell u that it is illegal to get a girl to blow u?
the RWS will definitely help the economy. just because the RWS is there, will it mean that the population will be affected adversely? only time will tell.
but, wat about illegal gambling dens? the internet? if a person is an addict, he will do anything to get his fix.
u r against the RWS because of the casino, because it might affect the population adversely? write to LKY to block access to all gambling websites too.
i hasten to remind u that homosexuality is still against the law. why discriminate against homosexuality behaviour? myself, i want every guy (except myself) on the planet to be a homosexual so that i can have a huge harem of girls.
Legislation for legalizing PAS is similar to prostitution. What I mean is that whether prostitution is legal or not, some will still engage in it and there will be customers.
Therefore, if someone is in pain or otherwise, and is determined enough to end his life either on his own or by PAS; I believe that he would just do so, if the means and methods were available to him. There is sufficient material widely available for anyone to learn of the different methods of (painless?) suicide such as CO poisoning, plastic-bag over the head, KCL/sleeping pill injection or just blowing off the head with a shotgun.
What we are actually afraid of is that legalizing PAS would lead to abuses by the authorities, allowing them to legally snuff out those whom they deem undesirables etc. Also, such a law would conflict with the moral and religious upbringing of many, and doctors who uphold the Hippocratic oath. Thus I am opposed to PAS.
insurance and health-care are multi million dollars industries…
it pays(others) to keep these patients suffering and alive….
i support PAS… only if decision making is left to the patient and families themselves…
(then we end up with insurance problems again)
not some administrator who needs the organs fresh…..
man, all this talk about taking my organs…
okok. i go n opt out liao.
Lol, Ccchia,
There are many ways for the “authorities” to snuff out the lives of “undesirables”, should they so wish, regardless the legality of PAS. Cmon.
Doctors who are morally and ethically incapable of performing PAS, as well as those in the lay public who are opposed to it on similar grounds should just give it a wide berth, not outlaw it for others who have different moral and ethical points of view on the matter. That is incredible selfishness and arrogance – to deny others what is subjectively undesirable only to you. This argument is as gross as that of the tingtong woman on the ST Forum, who proposed that men be made to have to defecate without privacy in public loos, so that her innocent son will be safe from sex predators. Such selfishness, arrogance and unbelievable narrowness of mind is quite breathtaking.
la nausee,
(1) A coma is a dignified way to die??? The point is moot because no matter how you look at it, death, by virtue of its definition, strips a person of dignity. Dignity is derived from the status of a human distinguishable from animals and/or non-living objects. Death converts the person back into an assemblage of non-living material, and so thus removes the dignity.
I don’t see how memories of life have anything to do with your deathbed.
So, I find all this talk of a “dignified death” quite amusing. Have you not heard the phrase “In death, everybody is equal”? What one could talk about however, is a dignified experience of death by the people who remain alive.
(2) In jest, I would reply to your first statement by saying: then it is your fault for refusing to have that belief when you had all your life to embrace it. You made your choice; now be an adult and accept the consequences, for God’s (or the Universe’s or the Void’s) sake!
More seriously, contrary to what you say, the illness has no capacity to objectify anything or anyone, because it is not a conscious being and lacks rational capacity. Conversely, the patient has the ability to use the illness as a tool to objectify himself/herself from his/her loved ones, and the loved ones on their part may (in the modal sense) do the same.
Most importantly, I also think you are conflating PAS/euthanasia with letting a person die. When a person truly wants to die, you should let that person die, and not sustain that person as an “amalgamation of vital signs”, but that is different from inducing a desire to die, which is what a euthanasia/PAS policy does. If the latter wasn’t present, we would not have countries like Switzerland branding themselves as the “Suicide Capital of the World” (as was reported in Straits Times last year). Seriously, before anyone ever thought of legalizing PAS/Euthanasia, nobody would have been cheerful at having such a title. How times have changed!
A&E,
Unless you are too naive or young to understand this, there is nothing to prevent anyone from doing anything except family and social upbringing, religion and moral conviction. We also do not need to legislate every activity in life in order to make it legal to do so, except maybe in Singapore (remember to thing about “no U-turns”?).<br>
In response to what you have written:-<br>
” There are many ways for the “authorities” to snuff out the lives of “undesirables”, should they so wish, regardless the legality of PAS. Cmon. “<br>
Precisely my point. There is nothing to stop the well-informed to do what they wish including PAS or suicide, but we certainly do not want the authorities to hide behind the veneer of “legality” to do what at least some of us do not want them to do.<br>
” Doctors who are morally and ethically incapable of performing PAS, as well as those in the lay public who are opposed to it on similar grounds should just give it a wide berth, not outlaw it for others who have different moral and ethical points of view on the matter. That is incredible selfishness and arrogance – to deny others what is subjectively undesirable only to you. “<br>
Perhaps you should just state your stand (although it appears that you are in favour of PAS and suicide), and do you realise that you are guilty of the same “selfishness and arrogance” by forcibly legalizing (and thus imposing your views on others) all those things that you are in favour of, which you have given examples?
ccchia
Mar 24, 2010 6:09
do you realise that you are guilty of the same “selfishness and arrogance” by forcibly legalizing (and thus imposing your views on others) all those things that you are in favour of, which you have given examples?
I don’t understand. How is legalizing it to make it an OPTION, imposing one’s view on other people? You only ‘impose’ on others when you leave them with no choice. i.e not legalizing it.
Ccchia,
Saying “You can’t do this, because I do not like it. My ethical standards do not allow it, my religion forbids it.” is, at least to me, selfish and arrogant. Saying “Do it if it please you, it’s your life, but I demur.” is, if not more democratic, at least more considerate of the fact that others have likes and dislikes as well, they have their own standards and needs quite different and apart from yours.
Come back and bitch about being imposed upon when you are “forcibly” compelled to swallow a poison pill against your will on your deathbed. Otherwise, let others have it if you prefer drooling mindlessly, or writhing in agony in your final days so that your loved ones may better remember you by.