chapter  10
31 Pages

Decriminalising physican-assisted suicide in Singapore

ByPUAY SAN TOH AND STANLEY YEO

Every human being must confront death at some point in their lives. Through the advances in modern medical technology, ways have been found to prolong life and delay death. However, this does not necessarily result in human lives being enriched in a full and meaningful manner because, in some cases, it merely lengthens the physical or biological existence of a person. Many people do not fear death as much as they fear the ‘tragic figure’ (Cheang, 1977: 266) they may become before death. In order to minimise their suffering and to honour their dignity, these people should be afforded more control over the timing and manner of their deaths. In Singapore, the Advance Medical Directive Act gives Singaporeans some

control over their deaths by allowing a person of sound mind to sign an advance medical directive (AMD) declaring that he or she does not wish to receive extraordinary life-sustaining treatment in the event of terminal illness. As our ageing population1 grows, more measures need to be put in place to deal with end-of-life issues. Recently, Health Minister Khaw Boon Wan expressed that ‘ageing will throw up many more human stories of agony and suffering’ (Forss, 2008).2 The minister’s remarks have spawned a public debate over whether voluntary active euthanasia (VAE) should be legalised (Basu, 2008a, 2008b; Chung, 2008; Ee, 2008; Yeo and Mohan, 2008). The Ministry of Health has announced plans to make the process of signing the AMD less complicated and to expand palliative care systems in Singapore. Importantly, however, it is observed that although optimum palliative care might minimise physical pain, it cannot remove the strong sense of helplessness and mental or emotional anguish that some patients experience as a result of the progressive deterioration of their bodies (Jackson, 2007). This chapter argues that the options available to dying patients need to be

increased. In the event that palliative care is unable to meet a patient’s need of having his or her physical, mental or emotional health attended to adequately, the patient ought to have another option – physician-assisted suicide (PAS). While a patient has made the decision to end his or her life, he or she may not have the knowledge or means to do so in a painless and dignified manner and

would require help. Assistance from physicians is more desirable than that from laypersons due to the former’s medical training and access to drugs and equipment. Such assistance would also provide the patient with information about his or her prognosis and options, together with psychological support (Cipriani, 1995-6).3