The Right to Die in Singapore

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 services.

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 dilemmas."

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 building.

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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.

Correction: The 13 May seminar is not being hosted by the National Arts Council. Exit International, organizer of the seminar, has booked a function room in the Drama Centre, a theatre managed by the Council, which is only renting out the premises to the organiser.