Work Cut Out?

I have been gotten numerous feedback since my article "Some Lives Are Not Worth Living?" was posted on The Online Citizen. For those of you who have supported the intent of the article, I want to say, "thank you". Here, I aim to address some of the questions, as well as some of the aspersions cast by some other readers of the article.

Am I Pro-PAP?
It is true that some of my articles seem to favor some of the policies and programmes of PAP and that I have questioned some remarks of the opposition politician. But does that automatically make me pro PAP? Elsewhere, I questioned the policies and programmes of the PAP government. Now, does that make me anti-PAP? Let me state categorically, "I am not pro or anti PAP! Neither am I pro or anti opposition parties! I am merely PRO-SINGAPOREAN!"

Am I Religious?
It all depends what your definition is of religious. If by religious you mean someone who follows a set of patterns, formulas, rituals, traditions, dogmas or doctrines of established religions, then I most certainly am not religious. But if by religious, you mean someone who is devoted follower God, then, I most certainly am religious. You see, although I am a passionate follower of Christ Jesus, I do not go to church, I do not celebrate special days (I celebrate everyday) and I do not observe any rituals or traditions of any form of Christianity. I would like to classify myself as being non-religious. In fact, when someone asked me what my religion was recently in a government agency, I declared that I have no religion. But it seems that even if you do not follow religion, religion seems to follow you. And now to answer the question, "does my body belong to myself?" It most certainly does! But I choose to worship God by offering my body as a living sacrifice, holy and pleasing to Him. But that is my choice! Not something that I would compel upon everyone. I have many relatives who are Hindus, friends who are Muslims (in fact during the past fasting month for Muslims, I broke fast at a mosque with some of my Muslim friends), Christians, Catholics, Buddhist, Taoists, Atheists and even free-thinkers. I do not force my views on them. My lifestyle is very often my witness.

Who is Rita Marker of International Anti-Euthanasia Task Force?
Instead of writing away an organisation because it does not have an actual address, it helps to ask "why?" and "who are the people involved in such organisations?" The International Anti-Euthanasia Task Force has been in operation for over 20 years. Why do they list a PO Box address instead of an actual address for their organisation? There are specific security measures that activists are encouraged to implement at their offices, clinics, homes, and on the road, because violent and harassing activity is often directed towards individual activists, and even their families. To protect themselves, various personal security measures must be implemented. It's unfortunate to have to divert time and resources to prevent unjustified attacks, but putting at least some personal security measures into place will decrease the risk of becoming a target. It may also help ease the stress of living and working in what some call a "war zone". Such security measure includes;

• Get an unlisted phone number, a call display device, and a post office box. Never give your home address to anyone, other than to people you're inviting over.
• Get your address out of databases, including car and health insurance agencies, telephone services, libraries, voters' lists, your bank, cable company, credit card companies, and any others you can think of.
  

But who is the main person behind Anti-Euthanasia Task Force? It is Rita Marker. Rita has been the executive director of the organisation since it began in 1987. She is a practicing attorney and was profiled in the American Medical Association's American Medical News. Her full profile can be found here. Not everyone who has flashy web pages are credible and not all with web pages that can be designed by a "12-year old" are credulous.

And what about NRC Handelsblad? It is a respected Dutch Newspaper and it did report the "humanitarian termination". Maybe one cannot find the article because it is written in the Dutch language. But the articles pertaining to humanitarian terminations written by Margaret Oostvenn "Ik kan me goed voorstellen dat artsen stervenshulp niet melden" can NRC Handelsblad dated April 1, 2001. The English translation of the article can be found here.

What about the question of the fiscal deficit in Netherlands?
One can be quite deceived one looks at the current fiscal deficits of Netherlands. It pays to look at the economy of Netherlands before the law on euthanasia, which was advocated by the party D66 was legalised in the Netherlands on April 1, 2002. The economy of the Netherlands was booming from the years 1996 - 2000, with GDP growth averaging 3.7% annually. But the year 2001 saw a drastic slowdown and the economy came to a virtual standstill in the year 2002. The fiscal deficit in the year 2002 was 1.6%, which jumped top 3.3% in the year 2003. The health care expenditure per capita in the Netherlands had jumped from $755 in the year 1980, to an estimated $2909 in the year 2003. In 2003, the newly elected government of a coalition of parties including D66 cut back on healthcare spending by 1.5 million euros and the standard of medical care available to the broad public suffered. If the budget seems well-managed by the year 2008, it is because of various cost-cutting measures by the Dutch government including trying to bring under control the ballooning healthcare costs for its aging population. An USA Today article suggests that most at risk by these cost-cutting measures are "pensioners, the elderly, single parents and non-native households".

The government of Singapore which spends merely 3.7% of its GDP on healthcare, may find investments in development of palliative care and pain management much more costly, and may adopt the culture of euthanasia as the easy way out to manage the escalating healthcare costs for the aging population of Singapore. You see I am also a minarchist and libertarian at heart, who who does not stoop to name-calling and who believes in the individual freedom to express oneself. But everyone is entitled to their own style of expressing their opinions.

Some Lives Are Not Worth Living

"Do we allow euthanasia or assisted dying?" asks the Health Minister, Mr Khaw Boon Wan when he spoke on challenges in the healthcare sector recently at at the Institution of Engineers' annual dinner and dance. A Straits Times article reports that, "End-of-life issues are expected to be on his ministry's agenda next year". So what direction would the government take in addressing this problem?

Euthanasia or the so-called "right to die" is not a future problem but a problem of the present. It is happening now and is becoming increasingly embraced by governments, courts and the media.

There is anecdotal evidence that elderly people in the Netherlands where euthanasia is legalized, are now afraid to check into hospitals, for fear that they will be killed. According to Rita Marker of the International Anti-Euthanasia Task Force, euthanasia now accounts for 15% of the deaths in the Netherlands. And according to the Dutch newspaper NRC Handelsblad, "humanitarian terminations" by doctors occur at the rate of ten thousand per year in the Netherlands.

Economics indeed plays an important role in motivating Netherland's culture of euthanasia. Faced with bloated fiscal deficits the state is rationing the use of new technologies. Moreover Holland which do not use prices to allocate heath care, have taken the economic incentives for extending life away from physicians. And because extending the lives of ill old people can be costly, the economic incentives run in the opposite direction in this state. In these budget-balancing times, the doctors at public nursing homes and hospitals are under severe pressures to keep costs down. There is of course an economic value to the state in promoting euthanasia as it brings in the suicide tourist dollars, from all over the world.

It is highly probable that the government of Singapore who rates the worth of the individual Singaporean by his economic value, will move towards legalising euthanasia, citing the same reasons. But if that happens, what does it say about our society, when we say that we will stop caring for a person because he is "unproductive" or "surplus"? I do not believe that the value of a human life can be measured by how productive he is at work or how much he can be to pay in taxes. We must engage in economic to live; but this is not why we live. The purpose of economics is to sustain human life; the purpose of human life is not to sustain economics. A crippled person, a mentally retarded person, or an old person is no less valuable than a young and healthy person. The fact that they contribute less to the economy has nothing to do with their value as human beings.

Do we really have a "right to die"? Many people now speak of such a thing without properly understanding the terminology. A "right" is a moral claim. We do not have a claim on death. Rather, death has a claim on us! A few years ago Governor Richard Lamm of Colorado said that the "terminally ill elderly have a duty to die and get out of the way". ("Elderlys' Duty to Die", New York Times, 29 March 1984) It is very easy to transition from discussing "a right to die" to "a duty to die".

Purposely seeking the death of a patient is contrary to the Hippocratic Oath that a physician swears to abide by. But as Singapore Health Minister is not medically trained he has not taken the Hippocratic Oath. As such, I am sure this oath will not be a hurdle too large for him to cross if he comes to it, while he tries to rationalise euthanasia.

Chasing that Illusive Singapore Dream

Peter faces difficult choices. Peter who is a diabetic with a heart condition, barely makes enough money to pay the rent on the 3-Room HDB house that he is renting from a friend of his son, pay for transportation costs and to put food on the table for his family of five.

It is a constant struggle even though Peter works as an Administrative Assistant in Singapore Press Holdings and his wife works as an Administrative Assistant in a secondary school. Together, they bring home $1800 after CPF and loan deductions. Of this, they spend $1200 as rent, $400 for transportation costs and are left with a mere $200 to buy provisions and to put food on the table. Peter often have to scrimp to pay for the medicine he has to take for his diabetic condition. The medicine costs about $250, but he can only deduct $150 from Medisave and has to pay the remaining $100 in cash. Peter has 3 children, a son 22 doing his national service and two daughters aged 13 and 10 still in school.

His problems started in 2005, when he fractured his leg in a motorbike accident. His employers of ten years had to retrench him. As he was not able to service the mortgage loan that he had taken from the bank, he had to sell his 5-Room flat at a loss of $18,000. As his household income is above $1500, he is not able to rent a flat from HDB. He did not have sufficient COV to buy another flat from the open market. He went for help to his MP. After an appeal from his MP, HDB referred him to EM Services, who rented him a 3-Room flat at $1300 per month, which was later reduced upon appeal by his MP to $850. This September, EM Services refused to allow him rent any longer as he had expired his contracted duration of occupancy. When he reached out to some social service agencies, he was advised that they could help by arranging for his children to stay in a shelter but Peter declined this 'help' as it would mean effectively breaking up his family. It was at this point that his son's friend provided a temporary solution for his predicament.

“My son's friend allowed me to rent his house for 3 months. It was very kind of him. But what will I do after the 3 months?” asks Peter. “The government should help Singaporeans like me. But nobody wants to hear my story”, laments Peter.

Peter's story is but just one example that a new classification of 'needy' exists in Singapore. Just like Peter, a substantial number of families in Singapore, with dual income are struggling to make ends meet. We are in the midst of a sociological change where a new class of poor is created. Many families, are in the workforce, many even with dual income; but it is a form of indentured. These people are the emerging faces of the new poor in Singapore. Singapore was built on the belief that “if you work hard, you can make it”. But the ladder to a better life for some hardworking families seems to have been shut down.

Sarah a 36 year old who works as an attendant in a home for the aged says, “the work is emotionally fulfilling. I feel like I am serving my parents who are no more. But it is financially frustrating.” Her husband works as a taxi-driver and together they have a combined income of about $2300. Their HDB flat was repossessed by the banks for non-payment, and now most of their income goes towards renting a 4-Room HDB flat. “I have 3 children and my husbands parents stay with us, so we have to rent a bigger house. After paying $1800 for the rental of the house, I am left with very little for food and other necessities. And during festival seasons, it is even more pressing as my children expect us to buy new clothes and gifts like the other children. I think I am a failure as a parent.”

The runaway prices of HDB houses have made home ownership out of reach for this “new poor”. Home prices have risen faster than wages and salaries for low-to-moderate-income families. While many jobs are still being created, the higher paying jobs are still illusive to the “new poor”, who often lack a diploma or a degree. These people who hold jobs such as administrative assistants, taxi-drivers, laboratory technicians, hawkers and teaching assistants, seem to be chasing an illusive Singapore Dream for a better life.

The unedited version of the write-up in The Online Citizen: Chasing that elusive Singapore Dream