Eight years ago, when odd-job labourer Lim Kian Huat, then 46, smothered his 49-year-old sister to death with a pillow, he was sentenced to jail for a year. She had been suffering from colon cancer for years and had begged him to end her life. In Singapore, a person caught for attempted suicide can be jailed for up to a year. Assisting a suicide is a serious crime and carries severe penalties, including a mandatory jail term. Sometimes, a doctor would perform a death-causing act, usually a lethal injection, after determining that the patient indeed intends to end his life. This is known as euthanasia. It is still not legal in many countries although calls for legalising euthanasia have been growing louder in recent years.
This article discusses the case for euthanasia, presenting economic considerations and the individual’s right to choose as key reasons. It then outlines the arguments that opposers to euthanasia put up. While it is tougher to make a compelling case, they contend that legalizing euthanasia destroys respect for human life and the mystery of life and death. They also point out that allowing euthanasia usually leads to the slippery slope of abuse and threatens the morals of future generations. The conclusion weighs the merits of both camps and makes a reasoned judgement on the issue of whether society should allow euthanasia. 2. Arguments For Euthanasia
1. Economic Considerations
As medical costs soar and the large baby boomer generation ages, putting pressure on already-strained health-care and welfare systems worldwide, governments have been forced to ask if it makes economic sense to allow euthanasia. A study published in the New England Journal of Medicine in October pointed out that allowing legal euthanasia for terminally ill patients could cut American health-care costs by US$627 million (S$940 million) per year. Recent extraordinary medical advances are prolonging both life and the process of dying – and adding quite substantive medical costs to society.
By 2030, one in four people in Europe will be 65 or older. In the US, it will be one in five, similar to Singapore. The population trends indicate that there will be less and less economically productive people to support the burgeoning medical bills for more and more dependent senior citizens. Meanwhile, the fight to legalise euthanasia is gathering force as more senior citizens challenge the laws. Luxembourg, despite being largely Roman Catholic, approved a law in February 2008 allowing euthanasia. In November 2008, the American state of Washington approved a law allowing physician-assisted suicide, where terminally ill people can be prescribed lethal medication. It is the second American state to do so, after Oregon in 1997. 2.2 Right to Choose
Euthanasia advocates base their arguments on respect for individual autonomy and the failure of palliative care to relieve all suffering. Locally, an example of a pro-euthanasia advocate is medical doctor George Wong, 76, who wrote in to The Straits Times forum page last month arguing that euthanasia for the terminally ill should be allowed. He brought up the case of his late father who suffered from stomach cancer and pleaded repeatedly with his doctor to let him die comfortably and peacefully. His doctor refused. ‘He was not harming anyone by his wish. Why should the law not allow it?’ asked Dr Wong. Elsewhere in Britain, in September 2008, 23-year-old Daniel James, paralysed by a rugby injury, made the journey to Switzerland to kill himself after three suicide attempts had failed.
His parents, who accompanied him, were investigated by the British police. Though suicide is not illegal under British law, aiding or abetting suicide is. ‘I have had a good life. Now I want to have a good death.’ Mr Donald Flounders, 78, is an Australian who had made a trip to Mexico in February to buy the drug pentobarbital for himself and a friend. He suffers from mesothelioma, a rare and deadly form of cancer usually linked to exposure to asbestos. It is clear that baby boomers, who are used to having their way, are not going to sit by and wait for doctors to tell them when and how they can die. Instead, they would want to determine the manner, time and place of their death. 3. Arguments Opposing Euthanasia
1. Tough to make a compelling case
While the case for euthanasia is too easily made, the case against it is tougher to make. ‘Heart-wrenching individual cases of very difficult deaths make dramatic and compelling newspaper stories and TV footage,’ says Professor Margaret Somerville, a bioethicist who heads the Centre for Medicine, Ethics and Law at McGill University in Montreal, Canada. ‘But the arguments against euthanasia, based on the harm that it would do to individuals and society in both the present and the future, are very much more difficult to present visually.’ Despite having researched euthanasia for three decades and having written a book on it, entitled “Death Talk: The Case Against Euthanasia And Physician-assisted Suicide”, she admits she still struggles to make a compelling case against legalising euthanasia. Usually, those who oppose euthanasia embed their arguments in a moral context but without resorting to religion. 3.2 Upholding respect for human life
Legalising euthanasia would damage important societal values and symbols that uphold respect for human life. It overturns the prohibition on intentional killing – which is the cornerstone of law and human relationships, emphasising our basic equality. In a secular, pluralistic society, the two institutions of medicine and law are responsible for maintaining the value of and respect for human life. Euthanasia would seriously damage their capacity to do so. She is insistent that physicians’ absolute repugnance towards killing people is necessary to maintain people’s and society’s trust in them. Health-care professionals need a clear line that powerfully proves to them, their patients, and society that they do not inflict death. Both their patients and the public need to know with absolute certainty, and be able to trust that this is the case. Anything that would blur the line, damage that trust, or make them less sensitive to their primary obligations to protect life is unacceptable. Legalising euthanasia would do all of these things. Opposers also argue that legalizing euthanasia is not about the right to die. ‘It is about the right to kill,’ pointed out one Singaporean, a Catholic, Mr Desmond Liew. ‘It is wrong for one human to intentionally kill another, except in self-defence,’ said the 55-year-old businessman. 3.3 Holding sacred the mystery of life and death
Every society debating the consequences of euthanasia must realise that making it legal would fundamentally change the way we understand ourselves, human life and its meaning. In modern societies, there are two views of human life and, as a consequence, of death. One is that human beings are simply gene machines. People who hold this view feel that people past their ‘best before’ date should be checked out as quickly, cheaply and efficiently as possible. This group tends to favour euthanasia. The contending view sees a mystery in human death, because it also sees a mystery in human life. Such a view does not require any belief in the supernatural or religion. Euthanasia, unfortunately, converts the ‘mystery’ of death to the ‘problem’ of death, for which a technological solution must be sought. A lethal injection is a very efficient, fast solution to the problem of death but it is antithetical to the mystery of death. Normalising euthanasia would destroy a sense of the unfathomable mystery of life and seriously damage our human spirit and our capacity to find meaning in life. 3.4 A slippery slope towards abuse of euthanasia
Legalising euthanasia would be the first step on a ‘slippery slope’ towards abuse of the practice. This usually cannot be prevented. The Netherlands serves as an example. Originally, euthanasia was only available to dying adults with suffering that could not be relieved, who were competent to give informed consent and who repeatedly requested euthanasia. Later, the law was extended to include disabled newborns. The Dutch example shows that once euthanasia is legalised, its availability expands. One risk that euthanasia opposers often bring up is that of involuntary or forced euthanasia. In Holland, which legalised euthanasia in 2002, studies show that at least 500 people are put to death every year without their explicit consent. Most of them are old people with dementia or who are too sick to object.
3.5 A Danger to future generations
Sanctioning euthanasia would set a precedent that would present serious dangers to future generations. Just as our actions could destroy their physical environment, likewise, we could destroy the moral environment for our future generations. If we want to protect individuals and society, uphold the fundamental value of respect for life, and promote, rather than destroy, our capacities and opportunities to search for meaning in life, we must reject euthanasia. [The conclusion is left out.]
Sections extracted and adapted from:
Davie, Sandra. (2009 December 13). Right to die… or right to kill?, The Straits Times, Saturday Special Report. Davie, Sandra. (2009 December 13). Tough to make a compelling case, The Straits Times, Saturday Special Report.
Write out an evaluative conclusion for this article. Consider the following pointers: Which camp are you more persuaded by?
What reasons do you have for agreeing/disagreeing with the arguments presented? What long term consequences are there? What might the government do?