Advanced Medical Directive Act

From first sight, we can see that the AMD act and euthanasia are pretty much the same thing, so why is AMD allowed but not euthanasia? Upon further inspection, however, we can see the obvious differences between AMD and euthanasia, be it in definition, action, or ethics.

Let us first look at the definition of both AMD and euthanasia. AMD is a legal document that a patient signs before he is terminally ill and unable to do so. This document is to inform the doctor or hospital that should you become terminally ill or fall into a coma, that you do not want treatment that will only prolong your lifespan but will not cure the illness. As compared to that, euthanasia has a broader definition and there are many types of euthanasia that is present. Euthanasia basically is a way of ending a life peacefully and without pain, much like AMD where no further treatment to prolong life is wanted. Likewise, both AMD and voluntary euthanasia are very obviously voluntary.

However, there is a different form of euthanasia that is involuntary and it has been the focus of debate and controversy recently. Involuntary euthanasia is where an individual makes the decision of allowing life support to be taken away from a terminally ill patient and to allow him or her to die naturally. This is highly controversial as these individuals who claim to be proxies of the patient and have the right to decide for them might not actually have consent from the patient, and not have the authority to decide for them. In contrast, AMD would be a document that is signed before hand, much like the HOTA, so multiple proxies will not appear and claim authority.

Despite their obvious similarities, AMD is considered moral while euthanasia is considered unethical and not allowed in most countries. We can see that AMD is considered moral because the patient makes his own decision on whether he wants extra-ordinary treatment should he become terminally ill. However, since AMD and suicide are similar to euthanasia, why is euthanasia not allowed? Perhaps it is because that people consider it fine to decide that they do not want life support, but immoral that they participate actively in their own suicide.

Therefore, there needs to be certain measures put in place to ensure that the AMD is not abused and is free of loopholes. Current Singaporean laws state that it is an offense for someone other than the individual to force him or her to sign an AMD against his or her will. This is an important measure and will prevent the AMD from being abused such as having multiple proxies in involuntary euthanasia. Also, we need to ensure that AMD stays morally and politically correct, and the act must be well protected in order for people not to be able to find loopholes such as making decisions on behalf of the patient using a proxy.