Advance Medical Directive Act - a form of euthanasia?

 

An Advance Medical Directive Act is a legal document that one signs in advance to inform the doctor treating him that in the event he becomes terminally ill and unconscious, one would not want any extraordinary life-sustaining treatment to prolong one’s life. Definitely, this can be seen as a form of euthanasia, also known as “mercy killing”. While euthanasia is carried out to alleviate physical and mental suffering, this Advance Medical Directive Act can as an easy release from the suffering of being a vegetable, dead to the world but still breathing. However,

The horrible part about choosing the easy way out of suffering is that while one does need to undergo such anguish and torment be it emotional, mental or physical, it is extremely selfish to our loved ones. What about them? The emotional pain that we cause them will be so great, and the knowledge that we value the relief of the pain over being with them would hurt them even more. Furthermore, who are we to play God and decide when we want to leave this Earth? Euthanasia being mercy killing, and is still a form of killing; and killing ourselves equates to suicide which is murder. The killing can be for a good intention but killing ourselves is still a form of murder, which is the greatest possible sin.

Worse of all, this Advance Medical Directive Act and euthanasia both are equally horrifying in causing the dehumanisation of man and the desacrilisation of life. The sacredness of human life becomes viewed as mere sentimentalism, and expediency takes priority. Life becomes just a commodity, and can be thrown away when the going gets rough. The problem about opening the door to this form of assisted suicide is that more reasons will surface as to ending one’s life. First came euthanasia which gave the reason that physical and emotional pain was enough to warrant a merciful ending of one’s life, then came this Act which states that we have a right to end our lives if we are dead to this world. If this continues, perhaps next time there could be an Act stating that all people who recently lost a loved one could kill themselves also if they wish to.

In my opinion, unless the cost of life-sustaining treatment would be too much to bear for one’s family, nobody should even be given the option of signing this act to end their lives. Just as euthanasia is banned in all but four countries in the world, this Advanced Medical Direct Act should definitely also be banned by all countries. The decision to turn off the life-support machine should be made by the family, when after observing that there is no chance of every recovering for the person, then should they make the decision, and not leave the decision him.

Swine Flu

 

               Swine flu can be seen as a repeat of the SARS virus that swept the earth in 2003, hitting hardest in Asia and despite all the desperate measures taken by governments of various countries. Viruses are harder to control than terrorists, as even with quarantine of infected people, and use of vaccines, viruses can never be totally contained, as it is far too easy for these microscopic pathogens to slip through our safeguards and stopgap measures. However, though SARS took away thousands of lives, swine flu will not do the same, because of numerous reasons. Not only are we more prepared, united and hygiene conscious than the last encounter with a deadly virus, but the governments across the world are also more experienced in measures they take to contain the spread of this virus, also known as H1N1.

               As of today (28-5-09), there have been less than a hundred deaths caused by H1N1, but it is mostly in North America, where the virus originated from. However, as long as other countries keep up with measures such as quarantining citizens who travel to “hot-spots” of H1N1, such as Mexico, there would be a infinitesimally small chance of the virus spreading, even if one of her citizens is infected.  The only reason why Mexico has so many cases and deaths is because by the time measures were taken, the disease was already spread around the country, and it would be impossible to quarantine every possible person in the country.

               Another measure taken by the governments which I find effective is stocking up on flu vaccines, as if a mass pandemic breaks out, everybody can be quickly treated, averting a possible tragedy. The bright side about this virus is that as long as prompt treatment is sought, it is not potent, unlike SARS. Therefore, as long as everybody is alert to themselves showing symptoms of swine flu and seek immediate medical attention, and as long as the doctors treat all possible cases of swine flu seriously, the vaccines will hopefully not need to be used at all.

               However, is being over cautious good? The Mexican government was outraged over the way their citizens were treated by the Hong Kong authorities. As the saying goes “once bitten, twice shy”, so the Hong Kongers quarantined all Mexican tourists and treated them poorly, but one could hardly blame Hong Kong from being over-suspicious, looking at the number of deaths Hong Kong incurred at the hands of SARS. Also, many Mexicans were repatriated from China for fear of them being carriers of the swine flu virus. Thus, while being cautious, some countries end up being rude and causing unnecessary tension with other states.

               Also, swine flu poses as a double whammy to countries still reeling and trying to recover from the recent financial crisis. Not only are millions going to be spent on stepping up health-care measures and stocking up on vaccines, but the tourism industry is going to be dealt a sucker-punch. Countless flights to Mexico have been cancelled, be it for tours, business meetings or other events such as exchange programmes, and this greatly reduces Mexico’s revenue which already took a hit along with the United States in the financial crisis.

               Nevertheless, as long as the human race stays united, there is cause for hope and we will definitely triumph over this disease.  

HOTA

The recent amendments to the Human Organ Transplant Act resulted in an uproar in Singapore, with the major change being that unless one opted out of this scheme, once declared “brain-dead”, his organs would be harvested to give others. I have been thinking this issue over, and while it appears at the surface that this seems like a “win-win” situation, that one can do a good deed with organs no longer needed, and lives be saved, looking deeper into this issue reveals certain problems that are not obvious at first.

Firstly is the issue of ignorance. Not everybody in Singapore is literate, and among the literate, not everybody is well-informed. What if somebody is personally giving up his organs while he is still living, but is not aware of the amendment to this Act? Would not it be a terrible injustice to violate his rights as a human being? True, he is ignorant, but that is no reason to take away his organs. This could be as stupid as the government making a 100% tax policy, and you will get the normal tax rate only if you opt out of this scheme. Why make this scheme in the first place, where it would only inconvenience people who are well-informed, and do a grave injustice to people who are more ignorant?

Singapore has not done enough to make her citizens aware of the amendments to this Human Organs Transport Act, almost as if she is hoping to keep it silent. Perhaps keeping silent after drafting this Act is easier than launching campaigns to educate people about the merits of donating their organs after they are brain-dead or dead. Furthermore, why are the organs belonging to the state in the first place? Should not it be the right of the deceased or the “brain-deceased” family to decide if the organs should go to the state, or for other purposes. After these organs are harvested, what type of person does the family have to bury or cremate? An person without kidneys, livers, hearts and corneas?  Surely, this is too harsh a price for simply being ignorant. If people are ignorant, it is the duty of the state to educate them about this, and let the family and the person himself make the choice whether to sign the form, and not to OPT OUT of the form.

Also, what if the person certified “brain-dead” could eventually wake up at some point later on? While the chance is slim, it would be worth the long wait to the family. Without his organs, he is definitely and 100% dead. Miracles do happen and it is not uncommon for people in comas to wake up later on in their life. Doctors can never be truly sure that somebody is “brain-dead” and that he is ripe for harvesting. Foregoing consent and harvesting somebody’s organs is as good as foregoing consent and raping him, or foregoing consent and murdering him. Well the state may have the right to our property; it should not and will not have the rights to the body and organs of us citizens. We should have a right in deciding whether we want to keep our organs to accompany us into the ground or the flames. True, it may be selfish but it is for us to decide, and not the state.

The solution to this problem is probably to take the easiest and most effective way out. The scheme should be to let people “sign up” to donate their organs, based on their own goodwill and kindness, and not to let them “not sign out”, based on their ignorance. If the government truly wants people to donate their organs, they should step up on campaigns to inform Singaporeans about the merits of doing so, and not by resorting to such schemes.

National Service

National Service- How can this be amended or improved further to alleviate the problem of dodging?

               Despite all the propaganda about National Service being a glamorous and macho way of showing one’s devotion and loyalty to our homeland, many young men would rather skip National Service, if possible. While this rite of passage may be deemed by young boys to be cool, the older we grow, the more we feel that our two years spent in National Service is a total waste of time. With modern values, and as due to higher standards of living, why should spoilt young men waste time and energy on something that does not benefit them? The pay is meagre, the training extremely intensive, the hours long. Thus, many young men choose to ‘dodge’ National Service by staying overseas and not coming back to serve National Service.

               This problem of dodging has led the government to mete out stiffer punishments for draft dodgers, as ‘If we (the government) don’t come down hard on those who default, it would undermine the dedication and commitment shown by those who have gone through NS.” While the government is right in this punishment of dodgers as this is only fair to those who had to go through the full two years of National Service, maybe sometimes the ‘stick’ is not the only approach to solving such problems. One possible drawback would be that to avoid the harsh punishments, dodgers might never dare to return to Singapore. Sometimes, some of the young men who skip National Service may in their later years, voluntarily return to Singapore in remorse over their actions, but even stiffer punishments would further discourage this group of people from returning to Singapore.

               Thus, I advocate amending the very root of the problem – National Service itself. You could hardly blame young men with bright prospects for placing their career and studies over National Service. Furthermore, with globalization, the new world order is now less about geographical borders and absolute national loyalties, and more about global movements of people and talent. National Service either chases away talent who refuse to come back for fear of being punished, or put these talents through 2 years of mundane training for a war which might never come in the next century, wasting precious hours that could go a long way to maximise the potential of these talents, which also benefits Singapore which relies on a knowledge-based economy.

               However, it would also be unrealistic for elitism to decide who goes through the two years of living hell and who does not. Where do you draw the line between talent and average people? Will people who failed at studies in their teens never be successful in their later life? What if Bill Gates went through National Service? Would Microsoft still exist, and would computers be as advanced as today? There would definitely be public out-cry against this elitism and people who do not make the cut may out of anger at the system; decide to skip National Service also. It is terribly unfair to see fellow countrymen being able to skip the two hard years that one underwent, so it would be understandable that people who went through National Service expect others to do the same.

Another solution is for the appeal system, which could be on a case-by-case basis. If one wants to skip or rather, postpone National Service because of issues pertaining to furthering studies, then perhaps if he does seem serious and is not skipping National Service for other reasons, then perhaps permission could be granted. Such cases will have to be dealt with care, as like I said, it is hard to draw the line. To prevent public grievance, National Service should remain as it is, and the stricter laws should stay. It is impossible to please everyone, but it is possible to please the majority.  

Are IRs a boon or bane to Singapore?

               In 2 more years, Singapore’s hotly debate integrated resorts should be up and running. Before I make my stand, I think that it is more important to define the topic, rather than foolishly misinterpret it and distort its meaning.  Since this proposal burst forth in 2003, many discussions or debates have been centered around mostly on are casinos a boon or bane to Singapore, while the term IR is ignored. True, a IR without a casino is not a proper IR, but we have to remember that an integrated resort comprises of many amenities, such as theme parks, cinemas, hotels, shopping malls, exhibition and convention spaces, theatres and even museums. To forget about this wide range of other facilities and just focus on the casino itself would be misleading.

               While the building of two integrated resorts will pose many problems to Singaporeans, we have to look into the long term. In globalization, with many countries opening up to the world, spending billions of dollars to reinvent, repackage and revamp themselves, complacency could very well result in the elimination of Singapore’s status as a vibrant city. London and Hong Kong have already begun giving themselves a face-lift, and are full of drive and energy just like Singapore. Both cities have been looking into casinos, with Hong Kong seeking to compete with Macao by building a casino, after their successful launch of Disneyland. We are not the only global city that is developed in just Asia alone, with Seoul, Tokyo, Beijing and Hong Kong proving themselves to be vibrant and cosmopolitan cities.

               Thus, in this rat race, only the strong survive. Unless we find ways to continually keep up with this relentless pace of improvement, we will be bypassed and left behind many other countries. Already, Singapore has lost ground in tourism over the past years. We need something other than the Singapore Flyer and F1 among our newest additions to tourist attractions. Already, we have not been blessed with beautiful scenery unlike many large countries and we need manmade attractions to resist tourists flocking to the new and rising powers such as China and India. Thus, the main case for the integrated resort is this very point. In short, the economic merits to Singapore that these integrated resorts bring could revive and revise Singapore’s global image and whether we get eliminated in this race could depend on this.

               The sentiment of most Singaporeans is that the integrated resort is a bane to Singapore. While the other amenities are harmless, unless people want to bring up the issue of shopaholics or theme park addicts, the main bone of contention is irrefutably the casinos.  In every country, just as there will be murderers and thieves, there will be gambling addicts. What better way for these addicts to sate this insatiable appetite then to just take a bus down to the casinos conveniently situated in Singapore itself? Many other problems come with gambling, such as breakdown of family, spouse and children abuse, loansharks, money laundering or even thefts. True, this problems are by no means trivial, but if these gamblers are that hardcore, they would already be gambling in Macau or nearby countries. Why not let them spend their money here? The government has already made a regulation whereby families can ban a family member or themselves from entering the casinos, to counteract this threat.

               The casinos will not actually make gamblers, but would rather convert gamblers. Gambling is not altogether illegal in Singapore, with illegal and legal forms of gambling, such as mahjong, horse racing, betting on soccer, Toto and 4D, to name a few. Thus, speaking of the casinos as if Singapore has no other forms of gambling can distort the actual picture. Furthermore, the government has taken measures to provide a better safety net against these gamblers. Firstly, a high entrance fee will be charged, so the casinos will be catered more to the tourists than locals. Thus, casual gamblers will be deterred. Furthermore, the casinos will not be allowed to extend credit to locals, thus it is harder for us Singaporeans to lose more than we can afford.

               With these safety measures, I am sure that the integrated resorts will help to boost Singapore’s image and tourist numbers, and at the same time safeguard its citizens effectively.