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

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

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

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

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

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

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

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

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

She was quoted saying,

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

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

My personal stand.

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

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

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

1. Elderly patients might feel obligated to die.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

My response?

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

That is all for now!

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

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

So let the discussion flow!

Rachel Zeng / rachelzeng.wordpress.com


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66 Responses to “On euthanasia and dying with dignity”

  1. lobo76 6 May 2010

    First and foremost, it should be clarified that we are talking about terminally ill patient here. Not a person who is down and out due to financial problems, etc.

    In the above case, it is really bad. So bad, that anyone who opposes, should be tasked to help her pass motion everyday. Unless they want her to die of not being about to pass motion so that it can fall under the AMD.

    ALL cases should be evaluated individually. To have a generic set of criteria only opens it for abuse. A committee of sorts may be the best option. Financial background of the patient (most often, the reason for abuse) should NOT be included as part of information for the committee to make a decision. The committee would only know the health condition, and based on that, make a decision.

    Reply
  2. Old Guy 6 May 2010

    Rachel baby,

    you are too young to know anything about life yet..

    Every person should live to his last moments.. this is one’s own fate and life and destiny

    you must not ‘escape’ the illness by taking your own life.

    IT is WRONG to commit suicide or rather, to ask another person to take your life away when you are ill.

    Reply
  3. Piso 6 May 2010

    This is an issue that even the Western Society struggles with.

    Do you seriously think Singapore has a solution for it????

    Reply
  4. lobo76 6 May 2010

    Old Guy,

    You are too healthy to know about the suffering of life? Maybe you can visit Madam Lim to appreciate her situation more.

    Piso,

    What’s with your Western Society is superior attitude? Because they can’t, means we can’t possibly do it?

    Reply
  5. Ryvyan 6 May 2010

    Old Guy,
    why assume that it’s only the youngsters who feel this way just because the author of this article seems young?

    So are you going to resign to fate should you contact a curable disease and let death take you?Medical science has allowed us to prolong our lives unnaturally. Moral/religious extremists might find it going against the will of their gods.

    Personally the extent of my limits stop at a situation in which I suffer from brain damage (because the mind is more than the body), but I think it’s selfish and only obnoxious self-righteous people would presume to think that suicide is “wrong” and to limit the decisions of others. That’s the individual’s life, and if done responsibly, I see no problem with that.

    This issue ranks as high up on my annoyance list as people who presume with age comes wisdom and people who think atheists lack morals, but hey, out of topic here.

    Reply
  6. devil 6 May 2010

    Since when is dying a natural death undignified? Who calls a terminally ill patient that needs help to defecate undignified? Perhaps the main problem is not about euthanasia but rather about how we perceive a proper death. It seems a proper death is to quietly depart in the comfort of our family all around us. Is that a realistic expectation? Or is the reality, death alone on a hospital bed, in a much less glamorous way, with all your loved ones arriving late, miles away, or at work?

    There is also the issue of mental condition. If not well managed, the patient’s mental state can be altered, become depressed, and seek an active death. This itself is a form of disease. Can you trust the patient’s wishes then?

    How about the impact on those carrying out the act? Will it affect them? Does a executioner feel anything about hanging those that “deserve” to die?

    How confident are we that the act results in overall less suffering for the patient? There’s no survey after that. All is in theory.

    Indeed it is difficult to judge the merit of legalising active euthanasia. This is more so when we yet to achieve a high standard of palliative care.

    Reply
  7. leesjuanpat 6 May 2010

    We live to die one day. Living a healthy life is deemed a tall order in this modern world of diversions and materialism, of chemical induced food, of diseases association with our life style of simple living or extravagant living.

    Sickness and ill-health is for real in every living.

    When terminal illness strikes, the mental and pschological anxiety affect the whole family.

    Euthanasia, is a controversial topic to discuss in our Asian context of life. But as the world progress into a wider knowledge base entity and quality life while living; many will not like to die with indignity. The personal sufferings, anguish, medical high cost and the prolongation of life in the face of long excruciation death at the end, is hard to imagine.

    Many of us will not experience the real pain and suffering of terminally ill patients. We only can empathise their sufferings. But the implication is much greater, only the terminal patients will be qualified to decide on their own life.

    I am not against euthanasia to die with dignity. Human failings may subject it to abuse in certain areas.

    Reply
  8. Young guy 6 May 2010

    Old man, you are too old that u forget the true meaning of life. Every person should have a choice to live OR die in his/her last moment. This is one life and you decide for what u wan. (fate, life and destiny are just bullshit invented 2000 years ago to mass-control people)

    You must not ‘escape’ the illness by insisting of NOT taking your own life. Again this is a matter of choice, if u wanna fight till the end, pls go ahead.

    It is wrong to impose rightness in NO suiciding or rather to impose on other NOT to ask another to take your life away when u are ill

    Reply
  9. sarek_home 6 May 2010

    Old Guy,

    You said “you must not ‘escape’ the illness by taking your own life.”

    Everyday, people ‘escape’ the illness by taking medical treatment.

    The real matter here is some people are opt to preserving life blindly instead of appreciating life and know when to let go.

    If we were to truly meet our fate, we should eliminate all medical treatment.

    Reply
  10. Old Guy 6 May 2010

    WHEN you are old enough,

    you will not want to die so fast

    Why not?

    because you DO NOT know where you are going next…

    Will it be a place where there is greater pain?

    Or will it be total nothingness when you die and cease to exist on earth?

    do you know ??

    death is a lonely thing

    Reply
  11. theonlinecitizen 6 May 2010

    Hi everyone,

    While we welcome all comments, we would like to request that your comments do not make suggestions on the methods of how to die.

    Such comments will not be allowed and will be removed.

    Thanks.

    Reply
  12. chiper 6 May 2010

    Old Guy, whether or not you want to die so fast is only your own business, not Mdm Lim’s. You have no right to say that because you don’t want to die so fast, others cannot.

    You want the freedom to choose to live, it’s only fair that you give the same freedom for others to choose death.

    As long as there are sufficient legal safeguards to prevent abuse by greedy family members and to ensure that the consent from the patient is truly her will, there is nothing wrong in principle with suicide or euthanasia.

    We have the highest claim of sovereignty over our own lives. If you wish to relinquish that sovereignty to religion or whatever, by all means, but do not make others relinquish their sovereignty to your beliefs. It’s really as simple as that.

    Reply
  13. Chiper 6 May 2010

    And here’s a lovely quote that I think is pertinent to this topic.

    “Civilization is the progress toward a society of privacy. The savage’s whole existence is public, ruled by the laws of his tribe. Civilization is the process of setting man free from men.”

    Reply
  14. Brendan 6 May 2010

    I have an alternative plan. Send her across the causeway to malaysia. Singapore cannot afford to treat you.

    Reply
  15. Brendan 6 May 2010

    Oh, and gahmen cannot afford to pay for your funeral if you die. So if “she die, her business” just don’t on sg soil.

    *Wash blood of hands*

    Reply
  16. steve 6 May 2010

    The name An Le Si or Happy Death says it all. It is not about dignity, it is about fear of a painful death. There are a lot of ways to commit suicide that are fast and easy. But it is the desire for a painless death that drives the craving for others to assist in one’s own murder.

    All these talk about using social workers and counselors to help justify taking one’s own life, why not better use them to help prepare the patient and his or her family to accept the coming death instead?

    Reply
  17. steve 6 May 2010

    It is strange for TOC to reject comments with methods of suicides and yet publish an article tell people that they can go to Switzerland should they seek assisted death.

    Reply
  18. gemami 6 May 2010

    ok, fair enough, TOC is refering to my comments. Hope this one’s ok.
    -
    The main issue preventing Madam Lim from seeking death as a way out of her pain has nothing to do with legislation but everything to do with the need to have someone help her die.
    -
    Very simply, if she wants to die to get out of the pain she is going through, and, if she thinks dying is more dignified than a life in pain, then no law can stop her from choosing one of the many ways to die a painless and dignified death.
    -
    There is no need to compel someone else, by lawful legislation, to lend assistance to help her die. This is one of the starting point where the debate over euthanasia begins.
    -
    Imagine a physician being forced to help a patient die even when he himself is against performing such an act?
    -
    It is a question of who the law should protect over who the law should oblige.

    Reply
  19. Gemami – supposing we can find a match of a doc and patient willing to do so ? could the law be amended to allow this to be done legally ?

    that is what is being debated here, i think.

    Reply
  20. gemami 6 May 2010

    Hi Joe,
    -
    It will be difficult to put into effect a law that does not cut across the whole spectrum of society. How to apply it to one and not the other?

    Reply
  21. mmmm…. the details…mmmm..

    i just hope that when my time comes, i will be able to have an option to end my life peacefully and painlessly, if necessary….

    Reply
  22. Kandy 6 May 2010

    Hi Joe and Gemami,

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

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

    As long as the person is not a physician but a trained personnel who is certified to carry out euthanasia, it is good enough I think.

    Reply
  23. Chiper 6 May 2010

    @gemami

    i’m assuming you’re not referring to the hippocratic oath (because then all doctors will be prohibited) but rather the personal moral/religious beliefs of individual doctors?

    I agree that doctors should not be forced to do this if it’s against their personal beliefs. but i do disagree with you that the legislative solution is a difficult one.

    It’s essentially an issue of consent, and the law has always dealt with consent, like in legislation dealing with the age of consent or rape.

    it can be as simple as adding an exception like “no physician shall be compelled to provide this service.”

    the entire legislative scheme will be based on the consent of the doctor and the patient, no one else.

    Reply
  24. lobo76 6 May 2010

    gemami 6 May 2010
    [It will be difficult to put into effect a law that does not cut across the whole spectrum of society. How to apply it to one and not the other?]

    You are avoiding the question.

    You might as well ask how we found the people to carry out the death sentences. We did, and these people can similarly to tasked to ‘assist’ if needed. Now will you answer the question?

    Reply
  25. mic o mic 6 May 2010

    For a country with no qualms about a mandatory death sentence, I find it strange for us to find euthanasia morally objectionable. Especially in a case like this.
    Perhaps to alleviate the nation’s guilt, a court hearing could be arranged where a judge could decide based on available medical evidence from the patient’s and court appointed panel of doctors and psychologists.

    Reply
  26. Stranger 6 May 2010

    The son of Mdm Lim said that her quest to push for physician assisted suicide gives her a purpose to live. What irony!

    Perhaps that’s what she needs now more than PAS. A purpose to live.

    Reply
  27. lobo76 6 May 2010

    mic o mic
    [For a country with no qualms about a mandatory death sentence, I find it strange for us to find euthanasia morally objectionable. Especially in a case like this.]

    I think you are grouping too many people together. There are people who:
    a) object to MDP, okay with E
    b) object to MDP, object to E
    c) okay with MDP, okay with E.

    You try finding someone to give you some perspective on (a) since you found it strange. Shouldn’t be hard.
    It’s essentially a clash of ‘sanctity of life’ vs ‘pro-choice’.

    Me, I am (c) actually. So no issue for me. =)

    [Perhaps to alleviate the nation’s guilt,...]

    going by the above, it has nothing to do with nation’s guilt. However, your suggestion is not without merit.

    Reply
  28. The question of euthanasia has no right or wrong answers.

    Objections to Euthanasia may not be inconsistent with MDP. MDP has a clear process (not necessarily perfect). Euthanasia, despite its implementation in other countries, does not imho.

    I can understand the condition and indignity that Mdm Lim suffers and truly empathise. But I do not believe Singapore has exhausted all possibilities of palliative care to consider euthanasia.

    Allowing Euthanasia as a temporary solution until we have better palliative care is a hard decision as well. One I would not take.

    Arguments restricting it to terminally ill patients is a fine line. Everyone will die. Should knowing roughly when and not knowing when a person die determine whether euthanasia is implemented? I think not.

    Ultimately, we need to recognise that what Mdm Lim wants is a “peaceful” death. So do all of us.

    More investment should be made into palliative care and its related research even to the extent of removing the indignities suffered by Mdm Lim. I believe that if palliative care progresses sufficiently, perhap we have a chance to live peacefully in terminal illness and contradictorily hope that we can live longer to enjoy that peace and time with our loved ones.

    Reply
  29. lobo76 6 May 2010

    lim,

    reading your post, made me wonder if there is difference between terminally ill, and ‘fatally ill’?

    Both are incurable, but the former has a much longer period to suffer, and the latter could actually depend on AMD for ‘release’.

    In any case, I am looking at a scenario where one’s illness is
    - incurable
    - persistent pain that palliative care cannot address
    - too long a period to wait to die (i.e AMD no applicable)

    Without going into details, and assuming that knowledge (of cures and palliative care) is exhaustive, would you grant such a person euthanasia?

    Last question: does drugging a person (yes, terminally ill one) to unconsciousness and allowing the person to die of hunger/dehydration considered to be euthanasia?

    Reply
  30. gemami 6 May 2010

    Chiper,
    -
    It is both actually. When one becomes a doctor, his primary objective is to save lives. I have not heard of anyone getting his PHD to help another die.
    -
    I do not doubt that there will be doctors who will have no qualm in helping another die. However, the next question that follows is “where do we draw the line?”
    -
    You mentioned ‘consent’ but in an earlier article published by TOC, we get to hear that there are times a patients thinks he wants to die, mainly because of the unbearable pain at that time, but would rather choose to live if the pain can be managed. How then do we ascertain the actual ‘value’ of consent?
    -
    How then do you suggest such a law can be enacted?

    Lobo76,
    -
    Good question. That’s why I am against it too.
    -
    As pointed out by Lim, we should do more about palliative care than to focus our energy on whether we should grant the wish of someone who wants to die.
    -
    Believe me, these will thank you for it if we can have the sort of palliative care that can help them manage their pain. This is the most dignified thing to do.
    -
    If they do not enjoy the fruit of their pain now, then at least they will die knowing that their suffering will help those of the future.

    Reply
  31. Astarte hamster 6 May 2010

    The hippocratic oath only works if society is compassionate and not obsessed by money. Everyone deserves a right to live or die under their own terms. So the best way is to adopt a individualistic approach. If it something like criminal law then I can understand why there is a need for a one law for all. But when it comes to this. The law should be flexible and give ppl choices.

    I am not legally trained. Maybe someone like Miss Dotty from Dotseng@wordpress.com can advise?

    Reply
  32. lobo76 6 May 2010

    Gemami,
    [Good question. That’s why I am against it too.]

    Not sure which ‘good question’ you are referring to. My post was in reference to joe’s who basically asked that, if you can find someone to do the ‘job’, is it okay?
    My question was to ask you if you will answer the question after addressing your concerns.

    Hence I can’t see how you arrived at ‘that’s why I am against it too’. Can you elaborate? Is it because you CAN find somebody to do it, so it is bad? I am not sure how that qualifies as a reason….

    [Believe me, these will thank you for it if we can have the sort of palliative care that can help them manage their pain.]
    Yes… if such palliative care CAN be found. Shall we, for the sake of argument, say that a panel of 10,000 doctors have agreed that it is not available? What then?

    [If they do not enjoy the fruit of their pain now, then at least they will die knowing that their suffering will help those of the future.]

    Well, it’s up to you believe whether ‘helping those of future’ is something that people who are dying keep on their mind in the first place. I personally doubt it.

    Reply
  33. mic o mic 6 May 2010

    Hi Lobo76,
    I was refering to the govt’s position. I just thought it seemed hypocrital thats all. The govt represents the people. Whether we like it or not.

    Personally I am (a) I object to the “M” bit more than anything else.

    Reply
  34. eaglefly 6 May 2010

    what she needs is a good surgeon to assist the flow of waste through another tube to a plastic bag.

    there are some who lost the ability to discharge via the normal passage to have it via tube to a bag.

    to suffer in this way in my opinion as a catholic, is good as you pay your sins through suffering here and less in purgatory.

    could this suffering also be God’s mercy and for the family to embraced God’s love for salvation.

    Reply
  35. I think lobo raises good questions.

    Palliative care is to tackle the issue of pain and suffering not find a cure.

    http://en.wikipedia.org/wiki/Palliative_care

    I have the perception that palliative care in Singapore is in its infancy and we have not really focussed on alleviating suffering (rather focus on cures).

    Before the drastic step of allowing euthanasia, can we put our hand to our hearts and say that we have done everything humanly possible to alleviate patient’s suffering? Mdm Lim’s case already proves that we have not.

    Reply
  36. I personally do not support euthanasia, partly because of my religion, as I believe that only God has the right to take our lives.

    But I do feel that if the patient is in too much discomfort and is going anytime soon, he/she should be allowed the option of euthanasia, but only at the doctor’s discretion, and family’s requests should not be taken into consideration because doctors are at the end of the day, the experts.

    Reply
  37. lobo76 6 May 2010

    Shawn Lim

    To summarize.. you DO support euthanasia. Did you think supporters of euthanasia do not have conditions for supporting it?

    Reply
  38. yani 7 May 2010

    i think the writer overly simplified many things in her article. for instances, yes, i see possibilities of social workers in the picture, but she has definitely simplified what would be one of the biggest ethical dilemma of the profession’s ethics.

    Reply
  39. gemami 7 May 2010

    Lobo76,
    -
    I am against the death penalty, never did support it and neither will I support anyone who is tasked to carry out the sentence.
    -
    Never mind whether it is legalized or not, what’s the name given to one being paid to kill another?
    -
    Science, like most other progressive subjects, has three parts to it. The past, the present and the future.
    -
    We learn from the past to make the present better. We learn from the past and present to make the future even better.
    -
    A doctor who only looks at the present can never hope to contribute to the future. Yet, in the field of medicine, the future is always more important than the present and the past. Else, we will never discover new treatments, better healings and ultimately, cures.
    -
    This is what our short moment of suffering can do to help achieve this end.

    Reply
  40. hopeless 7 May 2010

    She should have the right to take her own life, the law got no rights to stop her since the law isn’t helping her when she is suffering. This should be a two way thingy.

    Reply
  41. gemami 7 May 2010

    Hopeless, she has the right to take her own life alright. What she does not have is the right to ask somebody else to take her life away for her.

    Reply
  42. gemami 7 May 2010

    Most of our arguments centers around pain, how bearable or unbearable they are, and to set some benchmarks for us to gauge at which level is pain so unbearable that it warrants the legalizing of euthanasia.
    -
    Let me present two scenarios, the first about dentistry and the other about appendicitis.
    -
    This earliest form of dentistry involved curing tooth related disorders with bowdrills operated, perhaps, by skilled bead craftsmen, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.
    -
    Throughout the 19th century, dentistry was not a profession in itself, and often dental procedures were performed by barbers or general physicians. (http://en.wikipedia.org/wiki/Dentistry).
    -
    Imagine the pain as your read these words. Imagine yet again, if people had called out for euthanasia, the right to die, because of such pain. Would we have achieved what we have today in the art of dentistry and all the painless treatments and cosmetic effects of orthodontics?
    -
    In the case of appendicitis, in the past (and in some medical textbooks that are still published today), it has been commonly accepted that pain medication not be given until the surgeon has the chance to evaluate the patient, so as to not “corrupt” the findings of the physical examination. This line of practice, combined with the fact that surgeons may sometimes take hours to come to evaluate the patient, especially if he or she is in the middle of surgery or has to drive in from home, often leads to a situation that is ethically questionable at best. (http://en.wikipedia.org/wiki/Appendicitis).
    -
    In the 1800s, most cases of appendicitis were left untreated, resulting in a high mortality rate, mainly because of peritonitis (inflammation) and shock.
    -
    Imagine the pain as your read these words. Imagine yet again, if people had called out for euthanasia, the right to die, because of such pain. Would we have achieved what we have achieved today in the way we treat and heal appendicitis?
    -
    Some may argue that a vegetative state is devoid of pain, and therefore the above does not apply, and a patient ought to be given the right to leave since he is no longer of any use.
    -
    Why then do we need to let the patient die if he is not in pain? Is it because of the time and trouble it takes to care for him? Is it the cost involved? Is it the pain felt by those around him? Is it about the so-called ‘dignity’.
    -
    If these are the reasons, then the more it stands to reason that euthanasia should not be legalized. The simple reason is because we can work around these ‘outside’ conditions. Most importantly, these have nothing to do with the ‘sufferings’ of the patient.

    Reply
  43. lobo76 7 May 2010

    Gemami,
    This is what our short moment of suffering can do to help achieve this end

    What I don’t understand is why do you think that by helping some to stop their suffering, necessarily means that we will stop research on palliative care? Is it that palliative care needs subjects to experiment on, and by ‘releasing’ the terminally ill patients, we are depriving them of guinea pigs?

    Is that all suffering terminal ill patients are to you? guinea pigs?

    Reply
  44. lobo76 7 May 2010

    Gemami,
    Imagine the pain as your read these words. Imagine yet again, if people had called out for euthanasia, the right to die, because of such pain.

    But they didn’t. Mdm Lim did. So.. what is the relevance? My point is about ‘choice’. Yours is the advancement of medical science regardless of cost?

    -In the 1800s, most cases of appendicitis were left untreated, resulting in a high mortality rate, mainly because of peritonitis (inflammation) and shock.

    You might want to note that despite the most cases that died anyway regardless of euthanasia, medical science advanced and now it is curable. Your point on suffering to aid medical science (to save others in the future) seems to have no basis. I might say you have just scored an own goal….

    Reply
  45. Yup. But allowing euthanasia as a temporary solution due to the fact that palliative care is currently not adequate is a difficult decision.

    Advances in palliative care is far more easy to achieve e.g. medication that ease pain, devices that reduce indignity than finding cures to incurable diseases. Some of which may be already available, just not in Singapore.

    If Mdm Lim had access to these advances, would she have considered euthanasia? In accepting that she should be allowed to be euthanised, would a doctor breach the responsibilities by reason of convenience and an easy way out?

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  46. let me just add (throw a spanner ?) to say that everyone’s treshold of pain is different.

    If pain is used to argue for or against euthanasia, then it will be futile.

    My view is to allow a freedom for the patient to choose and for the doctor to choose yes or no. If there is a match, then perhaps in allowing euthanasia, compassion is better demonstrated and served ?

    Reply
  47. lobo76 7 May 2010

    lim,

    what is needed would be cryogenic stasis pods. We freeze the person as s/he is, and thaw them when a cure is found. These pods are fitted with solar panels and shot into orbit around Earth. Space is already cold, thus less power to keep it cold, and sunlight is unobstructed by clouds, thus maximizing power generation by the solar cells.

    The pods are also equipped with a small mass driver (powered by the solar cells) to shoot in the opposite direction (equal and opposite reaction), to nudge it out of orbit, when the relevant cure is found.
    *Chemical rockets (regular fuel rockets) have the problem of the fuel being frozen or leaked.

    THAT, is of course, science fiction.

    While science fiction regularly becomes fact as time passes, it usually take a very long time. it’s one thing to be concerned about what the future might bring, but don’t let it blind you to the present.

    The present, where a person is suffering.

    The present, where no palliative cure is working.

    would a doctor breach the responsibilities by reason of convenience and an easy way out?

    What is ‘easy’? Might it not be to fantasize about a cure in the (near) future, so that they have no need to challenge their Hippocratic oath?

    Reply
  48. Johnny Appleseed 7 May 2010

    With due respect Gemami and the others. This is ultimately a legal question and I dont see morality and ethics playing a dominant role here. A good way to begin this discussion is to look at what is the position of the law with regards to countries who have already approved euthanasia as a health care policy.

    Perhaps it would be better to rope in a legal expert to share how those countries are harmonizing those other issues with the law? Just my 2 cents.

    Reply
  49. gemami 7 May 2010

    Lobo76,
    -
    If you seriously seek to understand, then I think you ought to pay closer attention to details.
    -
    Very clever of you make my comments relevant to your guinea pig theory. Why do you think people like Madam Lim are guinea pigs? She is already suffering the disease and what better research subject other than her could there be? Seriously – truth be told.
    -
    People like you are degrading her suffering by making her feel that her sufferings are not worth it. People like me are telling her that her sufferings will bring joy to others of the future. Who then is the kinder?
    -
    Lobo76: [“Yours is the advancement of medical science regardless of cost?”].
    -
    This is your suggestion not mine. What do you mean by “regardless of cost”?. What cost does Madam Lim has to pay by giving medicinal science a chance? You are the one who is a liability, a cost to her by demanding the she be allowed to give up this chance.
    -
    I believe a lot has got to do with the hopelessness of the situation. You believe there is no cure for cancer and she will die waiting painfully, and therefore it is better for her to go.
    -
    There are others who believe that as long as she is alive, there is hope that a cure may be found tonight, tomorrow or the day after tomorrow. I would want her to be there to receive this cure. Who is the kinder?
    -
    It is why Palliative care is the only way forward at the moment. We have to do all we can to alleviate the pain and suffering of the patient.
    -
    Her desire to ‘end it’ is a natural reaction to suffering, even for those who are not terminally ill, like the many who have taken their own lives for a whole hosts of other reasons.

    Reply
  50. lobo76 7 May 2010

    Gemami,
    Why do you think people like Madam Lim are guinea pigs?

    I don’t. You do.
    In your very next sentence after this one, you implied as much.
    -
    People like you are degrading her suffering by making her feel that her sufferings are not worth it.

    Suffering is suffering. There is no worth it or not. Arbitrarily attaching a ‘value’ to it is easy for bystanders to do. In fact, by attaching a value to suffering, you made it possible to ‘degrade’ the suffering. Without a ‘value’, how would I even start to degrade it? So, it is not me who is degrading Mdm Lim’s suffering.. it is actually you.

    In a way, you are justifying terrorism (I know I am stretching a bit here). To me, suicide is suicide. An ending of life. Because suicide bombers attached a value to their death, they willingly go through with it, becoming martyrs for their ’cause’.
    -
    What cost does Madam Lim has to pay by giving medicinal science a chance?

    Suffering is a cost. Or were you thinking only in monetary terms?
    -
    I believe a lot has got to do with the hopelessness of the situation. You believe there is no cure for cancer and she will die waiting painfully, and therefore it is better for her to go.

    You believe correctly, as far as I am concerned, that is. The minor correction I would add, is that there is no cure in time. I haven’t heard of any breakthrough in medicine that is applicable overnight… or even over a year. My impression is that it usually takes a few years or decade.

    p.s TO ALL: html codes do work, at least for bold and italics.

    Reply