Forum: Time to discuss what dignity at the end of life means
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After witnessing someone I deeply cared about die from advanced cancer, I found myself asking: What does dignity at the end of life really mean? And who should decide?
Singapore rightly invests in palliative care, hospice services and pain management. These services have brought comfort and compassion to patients and families. Healthcare professionals do remarkable work in helping people live as well as they can, for as long as they can.
Yet, watching someone approach the final stage of a terminal illness also reveals the limits of medicine.
Some patients become bed-bound, struggle to communicate, or endure symptoms that cannot be completely relieved. Families witness the gradual decline, often feeling helpless while waiting for the inevitable.
Singapore allows mentally competent individuals to refuse certain life-sustaining treatments through established legal and medical frameworks. In doing so, it recognises that people should have some say over how they are cared for when death is near.
This raises a difficult question.
If we accept that a person may choose not to prolong the dying process, should we also be willing to have a broader conversation about how much autonomy a mentally competent person should have when death is medically inevitable?
This is not an argument against palliative care. Nor is it a dismissal of the many ethical concerns surrounding assisted dying. Questions about protecting vulnerable persons, preventing coercion and safeguarding against abuse deserve serious consideration.
This is not a call to immediately legalise euthanasia.
Rather, it is a call to have an honest conversation about what dignity means at the end of life. For some, dignity means living for as long as possible with all available support. For others, dignity may mean retaining some control over how their final chapter unfolds.
As medical science continues to advance and Singapore’s population ages, more families will face these personal decisions. They should not shy away from discussing them simply because they are uncomfortable.
Regardless of where one stands, perhaps the question worth asking is not only how we help people live well, but also how we honour their values when life draws to a close.
Yeow Beng Zhen
