November 9, 2009 by admin
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From our Correspondent
Prime Minister Lee Hsien Loong said during a speech at Assisi
Hospice last night that terminally ill patients should not treat
death as a taboo subject.
He was speaking as the guest of honour at Assisi Hospice’s 40th
anniversary charity dinner. His wife, Ms Ho Ching, is the patron of
the hospice.
PM Lee urged them to discuss with their families and
doctors plans for dying with dignity and under the best possible
care.
He also said he felt more public education was needed about what
hospice and home palliative care can do to provide comfort for
patients in their last days.
With medical advances, people are living longer, but with
terminal illnesses, lives can be prolonged only up to a point when
‘more aggressive treatment will likely do more harm than good’, he
said.
Palliative care is a field of medicine that helps
terminally ill patients live the remaining days of their lives with
minimal pain and suffering. There are few specialist
palliative-care physicians in Singapore.
Singapore’s aging population will put more strain on its public
healthcare system which was rated one of the best in the world
by the World Health Organization.
Unlike Australia, Canada or the United Kingdom, palliative care
is not a recognized specialty in Singapore. The current palliative
care physicians are mostly geriatricians or internists whose
postgraduate training is in internal medicine.
The Ministry of Health (MOH) is recruiting and training more
doctors, nurses and social workers who can provide palliative care
which will also be introduced to nursing homes.
Earlier this year, Health Minister Khaw Boon Wan caused a furore
when he suggested that Singaporeans send their aged parents to live
in nursing homes in Johor Baru where medical expenses are lower. It
is not sure if there are any hospices in Johor Baru which can
accept Singapore patients in the future.
Tuesday, 4 November 2008, 12:54 pm | 774 views
Andrew Loh / Deputy
Editor
“We
need to overcome taboos about death and communicate better — both
among ourselves as well as between doctors and their
patients,” said Health Minister Khaw Boon Wan last month.
(See
here).
I agree with the minister.
More often than not, we would rather not talk about
death, or the possibility of our dying. It is indeed still quite a
taboo subject. It is a cultural thing, some say. Couple this with
our religious beliefs and it gets very personal, emotional and
spiritual as well.
Yet, looking at what the minister has said over the
last few years on the issue, I do believe that he is not just
looking, simply, to letting Singaporeans choose to die – whether it
is through the Advance Medical Directive or legalised
mercy-killing, to put it another way. Rather, Mr Khaw has obviously
adopted more of a holistic approach than just a simplistic one of
whether one should take one’s own life or allow another to do so on
one’s behalf.
The main point I believe he is trying to get across,
perhaps not very well so far, is one of dying with
dignity.
In this, there can be little argument or
disagreement with the principle. It is in the definition of the
word “dignity” itself, however, which is the bone of contention.
Some say that taking one’s own life is not dignified no matter how
it is achieved. That the act of suicide or assisted-suicide,
whether legal or illegal, through the AMD or legalised euthanasia,
is just plain wrong.
“We will go down a slippery slope”, is a phrase
used.
While I do agree that there are many – many – issues
involved, I am in agreement with Mr Khaw that we should be allowed
to “die with dignity”. And that, in my opinion, should be one of
the main points of this debate. In this respect, I am glad that the
minister is looking into palliative care and palliative medicine
and making these more easily-available. A pilot scheme to bring
such care to nursing homes will be implemented next
year.
More needs to be done, of course. Besides getting
doctors themselves to understand the AMD better, the bigger
challenge, I feel, is getting the average Singaporean (especially
the less-educated and literate) to know what the issues
are.
The one thing which we should not fail to address is
the notion, already in some people’s minds, that assisted-suicide
is directed at the “less-able” or that it is the less-literate and
less-educated who will be targeted for
“elimination”.
My hope is that the minister will not rush through
any changes in legislation but allow as much time as possible for
discussion, debate and feedback to take place.
Every life is precious. When the time arrives, and
each of us will face this, we will have to decide (if we are able
to) how we will die. Personally, to have the choice to decide how I
would die is a gift as not everyone gets to have this
choice.
Thus, if there were legislation in place which would
allow me to do this, to make this choice, and it gives me dignity
in my death, I welcome it.
But first, lets address the many issues involved for
the concerns are real and important.