Tuesday, April 21, 2009

The Right to Die in Singapore

From a proud tower in the town/Death looks gigantically down/On
the island republic
Singapore may have not a reputation for opening its doors to
outspoken activists but in an intriguing move, next month it
will host a seminar by one of the world’s most controversial
speakers, Philip Nitschke, the Australian campaigner for
voluntary euthanasia and assisted suicide known, like Dr Jack
Kevorkian in the United States, as "Dr Death".
What makes the visit of the renowned pro-euthanasia campaigner
even more surprising is the legal status of suicide in
Singapore, where attempting to take your own life remains a
criminal offence. Those who have slashed their wrists or taken
an overdose but failed to kill themselves are routinely
handcuffed to their beds when they are brought into hospital by
the police. Assisting a suicide is considered an even more
serious crime, with a mandatory jail term for anyone found
guilty of such an offence.
Nitschke has played a key role in driving the global debate
about voluntary euthanasia and in 1996 he became the first ever
doctor to administer a fully-legal, voluntary lethal injection
under the right-to-die law in Australia’s Northern Territories.
His campaign group, Exit International, regularly holds seminars
around the world in which it discusses voluntary euthanasia and
tells over 50s and the seriously ill how they can end their
lives in a reliable, painless and cost-effective manner.
However, his vigorous advocacy for euthanasia has earned him
many critics, who oppose assisted suicide on moral, religious or
social grounds.
With an irony not lost on Nitschke himself, he will be welcomed
in Singapore, a state that places strict limits on public
discourse, just weeks after he was turned away by the Oxford
Union, the famous university debating society that likes to
think of itself as the "last bastion of free speech in the
Western world".
"We get repeated requests for information from Singapore so we
think it would be reasonable to see what the interest really
is," Nitschke told Asia Sentinel from his base in Darwin. "We’re
unclear about the reaction but we’ll see how things go."
The Singaporean government argues that it is necessary to place
restrictions on freedom of speech when it comes to sensitive
political and religious issues in order to prevent outbreaks of
social disorder. The fact that the government is willing to
allow in someone such as Nitschke, whose views have prompted
furious opposition from religious groups in the past, is
indicative of its desire to push forward the debate about end of
life issues in a nation that has one of the world’s most
rapidly-ageing populations.
By 2030, one in five Singaporeans will be over 65, up from 1 in
12 today, according to the Ministry of Community, Development,
Youth and Sports’ latest report on the ageing population. This
graying of Singapore, which is being driven by a low birth rate
and ever-increasing life expectancy, will put even greater
pressure on the island’s already-stretched healthcare and social
Singapore has also been flirting with ways to increase the
number of organ donors for those with failing kidneys or other
organs. As Asia Sentinel reported in January, the government has
decided to legalize the payment of compensation to organ donors,
who can be reimbursed for their medical expenses and loss of
earnings. Although the figure has yet to be finalized, the sum
could be at least S$50,000 (US$33,179.69 after Singapore’s most
recent devaluation).
In a widely reported speech last year, health minister Khaw Boon
Wan called for an open public discussion about the end of life
issues including palliative care and the right to a "good
death". While not openly endorsing euthanasia, he said that he
had been moved by accounts of terminally ill people who wanted
the right to end their lives.
"I do not know if Singaporeans are ready for euthanasia," he
explained. "But I do know that aging will throw up many more
human stories of agony and suffering. All societies will have to
prepare for longer life spans and the many dilemmas that they
will have to confront. We must seek a humane way out of such
In light of these comments, it becomes easier to understand why
Singapore is welcoming Nitschke with such open arms. His
seminar, which will take place on May 13, is being hosted by the
National Arts Council, in the ultra-modern National Library
Nitschke says that while there is a chance that the event will
fall apart because he still needs to obtain a public
entertainment license, he is hopeful that there will be no
hitches. He is mindful of the legal climate surrounding suicide
in Singapore and concedes that he will be modifying his usual
program as a result.
"We'll be taking a great deal of notice of the legal situation
and we won't be presenting the same sort of material as we do in
the UK, for example," he says. "We’ll mostly be talking about
the advantages and disadvantages of moving toward legislation
for providing legal assistance to die."
Nitschke says he will not be running his workshop on how to
commit suicide painlessly, although he will happily direct
Singaporeans to such information, which is widely available on
the Exit International website and elsewhere on the internet, if
they ask.
"I would imagine that there'll be private discussions with
people who want to know how to end their lives and I’d point
them in the right direction without necessarily sitting down and
saying this is what you do," he explains.
The main aim of his trip is to generate support for the
establishment of a branch of Exit International in Singapore.
"We’d like to see a branch of our organization set up in
Singapore and I’ll be interested in talking to people who want
to help us do that," he says.
Although the right-to-die law in the Northern Territories was
overturned after just a few months, a number of other
jurisdictions - including Belgium, Luxembourg, the Netherlands,
Switzerland and the US states of Oregon and Washington - have
since enacted similar legislation.
Nitschke is hopeful that he can persuade more governments to
bring in right-to-die laws, which he believes are much needed.
"There’s an awful lot of tragedy going on around us," he adds.
"I see people every day caught up in medical nightmares who are
desperate for help. But people are fearful to provide that help
because of the legal climate we all find ourselves operating in."
He thinks it is an "inevitability" that right-to-die laws will
eventually become commonplace around the world and that it is a
question of "when not if". Judging by the government’s unusually
open-minded approach, perhaps Singapore will be next.
Asia Sentinel

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