Increased access to subsidised end-of-life care helps ease seniors' concerns

The rise in suicide rates among Singaporeans above the age of 60 is deeply disconcerting.

While it is frequently assumed that intractable pain and financial woes are the chief motivating factors, it is premature to arrive at such conclusions (Consider legalising euthanasia, by Mr Seah Yam Meng; Aug 1).

Palliative care has rapidly progressed in the past decade to include specialist-led services spanning hospitals, daycare centres and home care.

Access to palliative care is now commonplace in Singapore.

Medical advancement has also enabled physicians to effectively alleviate pain and other distressing symptoms in the vast majority of patients at the end-of-life stage.

Over the years, there has been an increase in Medisave withdrawal limits and increased subsidies for end-of-life care. These help to alleviate the financial concerns of the elderly facing terminal illnesses.

Not all elderly people who attempt suicide suffer from terminal illnesses.

There needs to be a comprehensive evaluation to identify specific unmet needs that compel the elderly to hasten death.

Significant risk factors include undiagnosed depression, social isolation, loneliness as well as progressive functional disabilities from chronic, but not necessarily life-limiting, illnesses.

Resolving these issues requires proactive advocacy for holistic programmes that empower our elderly to lead active and fulfilling lives.

Public spaces can also be reinvented to promote inclusivity for people with cognitive and physical disabilities.

Greater efforts to promote societal literacy regarding mental wellness in older adults will be crucial to identifying the vulnerable elderly, as well as in enhancing their early access to professional help.

In contrast, euthanasia provides a cold and overly convenient end to what is essentially a deeply humanistic issue - how to enable the elderly to age and die in a graceful and dignified manner.

Legalising euthanasia will inadvertently lead society down a steep and slippery moral slope, as is seen in the Netherlands.

There, approved indications for medically assisted deaths extend to include people with dementia, people with psychiatric conditions, young people from the age of 12 and, more recently, elderly folk who express a non-specific tiredness for living.

The elderly among us should be cared for and supported.

For our society to evolve in a wise and compassionate manner, suicide - self-inflicted or medically-assisted - must remain an unnecessary end.

Neo Han Yee (Dr)

Ong Eng Koon (Dr)

Ethics Advisory Committee

Singapore Hospice Council

A version of this article appeared in the print edition of The Straits Times on August 06, 2018, with the headline 'Increased access to subsidised end-of-life care helps ease seniors' concerns'. Print Edition | Subscribe