Responding to Calls to Legalise Euthanasia and Physician-Assisted Suicide in Singapore

Responding to Calls to Legalise Euthanasia and Physician-Assisted Suicide in Singapore

Proponents of physician-assisted suicide and euthanasia (PAS/E) assert that mentally competent terminally ill patients experiencing ‘intractable’ physical and/or existential suffering with no means of alleviating this suffering should be afforded the right to end their lives at a time and place of their choosing. A significant obstacle to legalising PAS/E has been the slippery slope argument that posits that gradual abuse of PAS/E is inevitable, leaving vulnerable patient groups of patients susceptible to its use. To distance this practice from the slippery slope, proponents of PAS/E proffer the concept of “Medical Aid-In-Dying” (MAID) that boasts of strict criteria for its use and forward evidence that its use in Oregon and the Netherlands has revealed no evidence of vulnerable patients being coerced into having PAS/E. This paper assesses the position and the assertions brought by proponents for the legalization of MAID in Singapore using an evidenced based socioculturally sensitive approach to contextualise these arguments. Socioculturally, prevailing Confucianinspired family-centric practices hinders informed consent and creates coercive influences upon the decisionmaking process that will hinder effective consent for MAID whilst clinical evidence highlights inherent inaccuracies within determinations of prognosis and intractability that compromise legitimate application of MAID. This paper highlights the need for socioculturally sensitive, evidenced-based evaluation of all extrapolated data to consider the impact of prevailing mores and laws upon its application within the local scene. Singapore’s culture, clinical practice and laws do not support use of MAID locally.