ARTICLES
the decriminalisation of suicide in the Suicide Act 1961 set the basis to lobby for legalizing Physician-Assisted Suicide (PAS).
It also reinforces the patient’s clear intention to end his life as well as the desire to take control over the time and the manner of his death.33
It is argued that dying patients ought to have the option to seek PAS in order to minimise their suffering and honour their dignity.28 Following the advancements in modern medical technology, new ways have been developed to prolong life and delay death. However, this may not be a blessing. Instead of enriching a patient’s life meaningfully, these treatments sometimes serve to only prolong the physical existence of patients who are terminally ill.29 They experience mental and emotional torment despite the provision of palliative care that reduces their physical pain.30 Hence, these patients should have the freedom to seek PAS, in order to assert control over the time and way of their own deaths.
a. Comparison between Singapore and the UK
PAS involves a licensed physician prescribing the means of suicide. The patient can subsequently choose to adopt this prescription and end his life on his own accord. Another lethal means that is discussed in conjunction to PAS is voluntary active euthanasia (VAE), where the distinction lies in the physicians delivering the death instead of the patients themselves.31 Both forms of medical interventions involve a patient with a clear intention to die and a physician who intends to aid the patient in doing so. However, it is argued that PAS should be decriminalised. In PAS, the patient makes the final decision to perform the fatal act. This conserves the patient’s autonomy to have the freedom and the right to self-determination.32
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Academy of Law Journal 379, (2010), pp. 380-381. 28 ibid 29 E Jackson, “Death, Euthanasia and the Medical Profession” in Death Rites and Rights (B Brooks-Gordon et al eds) (Hart Publishing, 2007), pp 44-46. 30 T Cipriani, “Give Me Liberty and Give Me Death”,3 Journal of Law and Medicine, (1996) pp. 177-183. 31 Toh, Puay San and Stanley Yeo, ‘Decriminalising Physician-assisted Suicide in Singapore’ 22(1) Singapore Academy of Law Journal 379, (2010), pp. 382-385. 32 Antje Pedain, Assisted Suicide and Personal Autonomy, 61 Cambridge L.J. 511 (2002), pp. 512-513.
Abetment or assisting a complete suicide is a criminal offence in both Singapore and the UK. In Singapore, an individual abetting the suicide of another face prosecution under Section 30534 and 30635 of the Penal Code. The criminal culpability for abetting suicide is in line with that of homicide and causing death. Similarly, the UK prosecutes individuals who are involved in the suicide or attempted suicide of another under Section 2 of the Suicide Act 1961.36 In both jurisdictions, the individual who attempts suicide is not morally culpable.37 This is because the irrational act of attempting suicide indicates that the individual is under severe distress. In practice, these acts are rarely prosecuted even under the Singapore law, where attempted suicide is an offence. However, the abetter who voluntarily facilitates the suicidal conduct is morally culpable for ending the life of another,38 which justifies the consequent criminal charges for abetment. Physicians who are involved in PAS are not exempted from moral culpability as they have clear intention to cause death to the patient. In Singapore, Section 88 of the Penal Code39 provides that an act will not be construed as intending to cause death if done by consent in good faith for the benefit of a person. Despite operating under the consent of the patient and in good faith, the physician remains liable for the death due to their direct intentions to 33 ibid 34 Penal Code, Section 305. 35 Penal Code, Section 306. 36 Suicide Act 1961, Section 2. 37 Wilson, William, Criminal Law: Doctrine and Theory, Chapter 2 - Principles and Ideas Informing Decisions to Criminalise, Pearson Education UK, White Plains, (2003), pp. 37-39. 38 James Chalmers, Assisted Suicide: Jurisdiction and Discretion, 14 Edinburgh L. Rev. 295 (2010), pp. 296-298. 39 Penal Code, Section 88.