Singapore is highly against active euthanasia and only made passive euthanasia possible with the signing of the Advance Medical Directive (AMD) after 9 years of contreversy. Presently, Singapore is promoting and raising the standards of palliative care to encourage patients to do away with the thought of euthanasia.
2. What laws or regulations have been instituted with regard to this issue?
An Advance Medical Directive (‘AMD’) is a document signed to instruct the doctor treating you (where you are terminally ill and unconscious or incapable of making a rational decision) that you do not want any artificial means of prolonging your life, such as the use of life-sustaining equipment (eg artificial respirator), where there is clearly no hope of finding a cure on either a temporary or permanent basis. The Act defines ‘extraordinary life-sustaining treatment’ as any medical procedure or measure which will only prolong the process of dying for terminally ill patients when death is imminent but excludes palliative care. Palliative care is the provision of reasonable medical procedures for relieving pain, suffering or discomfort and the reasonable provision of food and water.
One has to be 21 years and above and of sound mind, may obtain a prescribed AMD form at any polyclinic or private clinic. After completing the form, he must have it signed in the presence of two witnesses, one of whom must be a doctor. The other witness must be at least 21 years old and must not stand to gain upon your death (eg a beneficiary under your will or your policy of insurance or CPF monies). Both witnesses must be physically present to witness the signing of the AMD as well as to sign the AMD as witnesses. The doctor who signs as witness is responsible for ensuring that he is at least 21 years of age, of sound mind, and having made the AMD voluntarily and without inducement or compulsion, are informed of the nature and understand the consequence of making the AMD.
Three doctors, including the patient’s hospital doctor, must unanimously certify that the patient is terminally ill. Two of the doctors must be specialists. If the first panel of three doctors cannot reach a unanimous decision that the patient is terminally ill, the doctor-in-charge will review his diagnosis and may refer the matter to a second panel of three specialists, to be appointed by the Ministry of Health whose services will not be charged to the patient. If the second panel of specialists cannot agree unanimously that the patient is terminally ill, the AMD will not take effect.
A Lawyer is not required to make an AMD. However, since one of the witnesses has to be a doctor, one may be required to pay the doctor for services rendered. The AMD itself is free.
3. Do you agree with Singapore's position? Why or why not?
The Singaporean government does not allow the practice of euthanasia, but allows patients to sign an Advanced Medical Directive (AMD), thus giving consent to not want to continue life-sustaining treatment and be allowed to die. While this act of the government is undoubtedly in the best interest of society, it may not necessarily protect the patients’ welfare. The symptoms of dehydration, inclusive of delirium and paresthesia, entail extreme discomfort to the subject in question, and the process of dying may be a slow and painful one. In contrast, active euthanasia gives a quick and painless death to the patient, sparing him/her much suffering caused by passive euthanasia. Moreover, should the patient be in a persistent vegetative state and be unable to make such a decision, intimates would not be allowed to make the decision for him/her. The financial burden incurred from medical expenses could pose a problem for households lacking in wealth. By empowering family and close relatives to make the decision for the patient, the family would be absolved of a large amount of stress.
In conclusion, we disagree with Singapore’s position on euthanasia as the death it brings is neither quick nor painless, and the policy developed to deal with euthanasia is flawed and could have financial/emotional repercussions on the person’s immediate environment. The policy for euthanasia should be active euthanasia carried out on a case-by-case basis, with the primary intention being minimal suffering of the patient and family.
Edmund, Jonlim, Shiyuan
09SO6H
No comments:
Post a Comment