Should euthanasia be legalised in Singapore?

Euthanasia, as a concept, is easy enough to understand. It is the choice of a terminally ill person – often in physical and psychological pain – to end his life with the assistance of a medical professional. The word is of ancient Greek origin and literally means “the good death”. What is less easy to understand are the moral, ethical, social and economic quandaries that legalising euthanasia can create. This essay shall examine both sides of the euthanasia debate to demonstrate the legalising euthanasia in Singapore is not only the practical, but also the moral choice to make.

Opponents of legalising euthanasia tend to cite four main arguments to build their case. Chief amongst these arguments is the idea that life is absolutely sacred and cannot be violated. The premise of this argument is that life is the most basic and fundamental of all rights. IT is the basis on which all other rights operate. After all, one cannot have the right to freedom of speech, for instance, if one is not alive. This, it is argued, is the reason life must be placed on a pedestal above all other rights – even the right to choose one’s death. Further, life is not perceived to be a creation of Man. It is often perceived as a “gift” from Providence. If we are to approach the concept of life from a non-atheist point of view (as most Singaporeans do) then life is not the property of an individual but rather, is a divine gift. Hence, the individual has no right to take his own life, as it never was his to begin with – it is the property of a diving being. Thus, on a secular as well as religious level, the right to life can be seen as sacred and therefore inviolable, leading us to the necessary conclusion that euthanasia should not be legalised.

The second argument often cited by opponents to euthanasia is that the pain and agony of a terminally ill patient is not so great that is warrants the act of him committing assisted suicide. The suggestion of this argument is that modern palliative care is effective enough o mute the physical suffering of the sick individual. Drugs such as morphine or medically prescribed heroin can go a very long way to dulling pain and allowing a terminally ill person to live his final days in relative comfort. In a developed country such as Singapore, access to these drugs and the medical facilities required to administer them is far from impossible. Hence, if the tools to reduce pain are available, why should we take the risk of legalising an immoral act on the basis of that avoidable pain? As this essay will go on to show later, opponents to euthanasia may be overestimating the efficacy of palliative care as well as ignoring the psychological dimension to being terminally ill.

The third argument often put forth against euthanasia is that there exists an immense propensity for abuse. The basis of this argument is that the terminally ill are extremely vulnerable. Their illness prevents them from exercising their full range of mental facilities and the physical pain that they are in prevents them form guarding against the possibility of being manipulated. While we do not wish to think ill of the patient’s family, Singapore cannot afford to take the risk that family members will push the idea of euthanasia onto the sick patient. Especially in this time of economic crisis (with unemployment expected to rise in the coming year), desperate family members might be very keen to rid themselves of a financial burden or to gain access to their inheritance. Even if the family is not manipulative, the terminally ill individual might himself feel bad about the burden he has created for his family and might choose to die on this basis rather than out of a genuine desire to end his life. This argument concludes that the risk that euthanasia might be abused is too great to warrant legalising it in the first place.

The final argument against euthanasia is centred on doctors. The premise of this argument is that doctors have sworn the Hippocratic Oath – which explicitly states that doctors should “do no harm” to the patients that they are caring for. All Singaporean doctors must swear to uphold this oath before they are allowed to practise in Singapore. If the Hippocratic Oath compels doctors to “do no harm”, legalising euthanasia would compromise the ethics and integrity of the medical profession and hence should not be allowed. This essay, however, will go on to argue later that this is a narrow misreading of the Hippocratic Oath and is not in line with the spirit of that same oath.

As this essay will go on to show, the arguments brought by euthanasia’s opponents either present problems that can be overcome or are simply erroneous. Proponents of euthanasia often support this case with three lead arguments: first, the idea t hat the right to life is wholly the property of the individual who is living that life and hence he has the right to relinquish his property. The premise of this argument is that for every right, there exists a converse. We are endowed with the right to speech, but we also have the right not to speak. We have the right to freedom of movement, but also the right to stay where we are. Inherent in every right is the option not to exercise that right. This principle is something Singapore subscribes to when we advocate that rights like the freedom of speech should be exercised judiciously. Singapore accepts that there are scenarios where individuals should choose not to exercise their rights. If the converse exists for all other rights, why does it not exist for the right to life? Simply saying that the right to life is more important than other rights does not negate the basic nature as a right that can have a converse. The philosophically consistent stance to take is that (like all other rights), the right to life does have its converse – the right to death. Further, in absence of proof of the existence of a divine being, it can only be assumed that the individual is the owner of his life. He exercises all bodily functions associated with his life and is, often, the sole determinant of what path his life should take. If the individual owns his life (and we cannot prove otherwise) and the right to life comes with the choice not to live one’s life (and this is the case), then euthanasia should be legalised as the individual has a right to his death if he so desires.

The second argument to be made is that there can be no arbitrary distinction drawn between the right to life (or life itself) and the quality of that life. The premise of this argument is that life can only have meaning if one has access to the full schema of rights that allows one to participate in meaningful activities that one enjoys. A terminally ill patient is in the final days of his life is often bedridden and has lost any and all control of his body. He effectively can have no access to higher order rights like the right to speak as he is physically incapable of exercising those rights. Opponents of euthanasia are prolonging a life for the sake of prolonging life. In fact, they demean and oversimplify life by suggesting that quality of life has nothing to do with whether one should choose to live or not. If one believes one’s life is no longer meaningful, then one should be able to decide to end it.

While palliative care can reduce pain somewhat, opponents often grossly overstate the effectiveness of this care. Cancer patients on morphine drips have been known to wake up in the middle of the night screaming because despite the medication, the pain is still unbearable. On compassionate grounds, euthanasia should be legalised. Even if we are able to accept that palliative care can be effective, what sort of life does that lead to? A patient who is pumped full of drugs often spends his final days passed out – unable to clean himself or have control over his basic bodily functions. Effective palliative care has the potential to rob individuals of their agency and their dignity. On the grounds of protecting human dignity, euthanasia should be legalised. Doctors, in fact, can be participants in the euthanasia process. In carrying out euthanasia, doctors are relieving their patients of immense physical and mental trauma. That is certainly doing “no harm”. The quality of life cannot be divided from life itself.

The final criticism of euthanasia is that abuse may occur. This can be avoided through effective policy making. The Netherlands legalises euthanasia but compels all patients to go for psychiatric tests and patient counselling before they make that decision to ensure that they are of sound mind and that they are making this decision on their own. Given Singapore’s medical resources, such a policy could be implemented here.

Euthanasia could be legalised as criticism against it is unfounded and there exists moral, legal and ethical arguments in support of it.