I believe AMD (see description at the bottom), if we follow the principles, is acceptable because:
The modern medical technology through a panel of doctors can tell us when one's major organs have stopped functioning and it is up to the Health Care Proxy (the sick or his/her family members) to decide if they would like to use extraordinary medical treatment to prolong life or to let the patient die naturally with support by some pallative medicines while waiting.
Some clues may be useful in making such decisions: the age and the length/the history of the sickness, the immensity of pain/suffering, the quality of life that the patient given by the extraordinary machines/drugs.
I remembered, an old lady who has survived on an artificial heart for about 20 years. After getting her third artificial heart, finally the artificial heart also failed. Soon, her lung also failed and was filled with water when it stopped pumping. She was in ICU for almost two weeks suffered from pneumonia. Apart from the ventilator, for the past few days of her life, the medical team had to make a hole in her throat and insert a plastic tube to enhance some function. She kept asking people to take away the plastic tube as she felt very uncomfortable and couldn't talk at all with the tube. Isn't it better for the last few days of her life, if she can enjoy talking to her children or perhaps went home and died in a familiar and loving environment surrounded by her loved ones instead of struggling with the plactic tube?
Another case, an 80 yr old lady, has been having liver problems for few decades. And finally she collapsed. She was rushed to hospital and we could tell, this time was different. After two days in ICU, her family decided to move her back to normal room where she has more freedom to interact with her loved ones and friends. Initially, like many of us, none of us will be gladly saying to God, "I am ready to die". (Even Jesus has to struggle and to overcome that stage both in Gethsemane and in golgotha before He finally commit His Spirit to God.) I told her family, just lead her to trust and surrender to God, this will help her to die/rest in peace rather than forcing her to fight for life. When the bell tolls, who can run away?? So, it's better to prepare than to deny.
We need the spirit of discernment to make the decision for the sake of the patient without ignoring God's sovereignty. He alone has the final say of all lives. Be aware that we may not risk the life of the patient for medical experiement/interest only. There is no one valid answer that can solve all the problems. We can't avoid this dillema of 'situational ethic' and have to deal with it case by case to tell if this is Euthanasia in disguise or AMD. That's why, the spirit of discernment is important. When human brains and hearts fail to lead, the Spirit is still in control. We may be too brainy and good in calculation and speculation OR too emotional burnt by our passion and compassion, therefore can't see the reality well. I believe, the Spirit will provide the balance when the brain and the heart fail to judge. That's why prayer is needed.
Very often, in normal condition, we don't cherish our loved ones. Only when they get sick, we become panic and stricken by guilt, we try our best to prove our love to them by giving them the best treatments we can afford. I wonder if such attempt may in fact is an attempt to cure our own guilt, if not to satisfy our possessive desire. After all, we are all selfish-fallen-creatures. It's difficult for us to love someone for her/his sake. We are not ready to face separation and unwilling to surrender our loved ones to others, not even to God. Isn't it beautiful, if it works the other way? Cherish every moment we have with our loved ones so when the bell tolls, though it is painful to face separation, the memory which they leave behind will live forever.
Advance Medical Directive Act
Introduction to AMD ActAn Advance Medical Directive (AMD) is a legal document that you sign in advance to inform the doctor treating you (in the event you become terminally ill and unconscious) that you do not want any extraordinary life-sustaining treatment 1 to be used to prolong your life.
Making an AMD is a voluntary decision. It is entirely up to you whether you wish to make one. In fact, it is a criminal offence for any person to force you to make one against your will.
New advances in medical knowledge and technology create new choices for both patients and health care providers. Some of these choices raise new ethical and legal issues.
One issue is that modern medical technology can technically prolong life in the final stages of a terminal illness2. However, it cannot stop the dying process. In such situations, further medical intervention would be medically ineffective, and a decision has to be made whether to withdraw such futile medical intervention. Some terminally ill persons who are unable to express their wishes at that time, may want to be spared further suffering and be allowed to die naturally, in peace and with dignity.
The law in Singapore allows Singaporeans who wish to make an advance medical directive to do so. The AMD Act was passed in Parliament in May 1996.
1 "Extraordinary life-sustaining treatment" is any medical treatment which serves only to prolong the process of dying for terminally ill patients but does not cure the illness. An example is the respirator that is connected to a patient to assist him/her to breathe. It serves only to artificially prolong the life of a terminally ill patient.
2 "Terminal illness" is defined in the Act as an incurable condition caused by injury or disease from which there is no reasonable prospect of a temporary or permanent recovery. For such a condition, death is imminent even if extraordinary life-sustaining measures were used. These measures would only serve to postpone the moment of death for the patient.
- It acknolwedges the sovereignty of God, only HE has the final say. It doesn't impose anything to end one's life.
- Death is not the end of everything, but it's the beginning of the eternal life. The deadline has been set. Sometimes grace period may be given, but, this period is for us to finish all our bussinesses well. I'm not so sure if we can count the extraordinary medical attempts as God's grace period when death indeed may be the greatest cure for the patient to release him/her from the suffering. So, it may be better to observe the deadline that God has given to us. We don't know when, but we need to be ready to meet God anytime and be answerable to Him for the life and talents He has entrusted to us.
- I believe if God's willing, miracle may happen when we put our trust in God, not because we apply special treatments.
The modern medical technology through a panel of doctors can tell us when one's major organs have stopped functioning and it is up to the Health Care Proxy (the sick or his/her family members) to decide if they would like to use extraordinary medical treatment to prolong life or to let the patient die naturally with support by some pallative medicines while waiting.
Some clues may be useful in making such decisions: the age and the length/the history of the sickness, the immensity of pain/suffering, the quality of life that the patient given by the extraordinary machines/drugs.
I remembered, an old lady who has survived on an artificial heart for about 20 years. After getting her third artificial heart, finally the artificial heart also failed. Soon, her lung also failed and was filled with water when it stopped pumping. She was in ICU for almost two weeks suffered from pneumonia. Apart from the ventilator, for the past few days of her life, the medical team had to make a hole in her throat and insert a plastic tube to enhance some function. She kept asking people to take away the plastic tube as she felt very uncomfortable and couldn't talk at all with the tube. Isn't it better for the last few days of her life, if she can enjoy talking to her children or perhaps went home and died in a familiar and loving environment surrounded by her loved ones instead of struggling with the plactic tube?
Another case, an 80 yr old lady, has been having liver problems for few decades. And finally she collapsed. She was rushed to hospital and we could tell, this time was different. After two days in ICU, her family decided to move her back to normal room where she has more freedom to interact with her loved ones and friends. Initially, like many of us, none of us will be gladly saying to God, "I am ready to die". (Even Jesus has to struggle and to overcome that stage both in Gethsemane and in golgotha before He finally commit His Spirit to God.) I told her family, just lead her to trust and surrender to God, this will help her to die/rest in peace rather than forcing her to fight for life. When the bell tolls, who can run away?? So, it's better to prepare than to deny.
We need the spirit of discernment to make the decision for the sake of the patient without ignoring God's sovereignty. He alone has the final say of all lives. Be aware that we may not risk the life of the patient for medical experiement/interest only. There is no one valid answer that can solve all the problems. We can't avoid this dillema of 'situational ethic' and have to deal with it case by case to tell if this is Euthanasia in disguise or AMD. That's why, the spirit of discernment is important. When human brains and hearts fail to lead, the Spirit is still in control. We may be too brainy and good in calculation and speculation OR too emotional burnt by our passion and compassion, therefore can't see the reality well. I believe, the Spirit will provide the balance when the brain and the heart fail to judge. That's why prayer is needed.
Very often, in normal condition, we don't cherish our loved ones. Only when they get sick, we become panic and stricken by guilt, we try our best to prove our love to them by giving them the best treatments we can afford. I wonder if such attempt may in fact is an attempt to cure our own guilt, if not to satisfy our possessive desire. After all, we are all selfish-fallen-creatures. It's difficult for us to love someone for her/his sake. We are not ready to face separation and unwilling to surrender our loved ones to others, not even to God. Isn't it beautiful, if it works the other way? Cherish every moment we have with our loved ones so when the bell tolls, though it is painful to face separation, the memory which they leave behind will live forever.
Advance Medical Directive Act
Introduction to AMD ActAn Advance Medical Directive (AMD) is a legal document that you sign in advance to inform the doctor treating you (in the event you become terminally ill and unconscious) that you do not want any extraordinary life-sustaining treatment 1 to be used to prolong your life.
Making an AMD is a voluntary decision. It is entirely up to you whether you wish to make one. In fact, it is a criminal offence for any person to force you to make one against your will.
New advances in medical knowledge and technology create new choices for both patients and health care providers. Some of these choices raise new ethical and legal issues.
One issue is that modern medical technology can technically prolong life in the final stages of a terminal illness2. However, it cannot stop the dying process. In such situations, further medical intervention would be medically ineffective, and a decision has to be made whether to withdraw such futile medical intervention. Some terminally ill persons who are unable to express their wishes at that time, may want to be spared further suffering and be allowed to die naturally, in peace and with dignity.
The law in Singapore allows Singaporeans who wish to make an advance medical directive to do so. The AMD Act was passed in Parliament in May 1996.
1 "Extraordinary life-sustaining treatment" is any medical treatment which serves only to prolong the process of dying for terminally ill patients but does not cure the illness. An example is the respirator that is connected to a patient to assist him/her to breathe. It serves only to artificially prolong the life of a terminally ill patient.
2 "Terminal illness" is defined in the Act as an incurable condition caused by injury or disease from which there is no reasonable prospect of a temporary or permanent recovery. For such a condition, death is imminent even if extraordinary life-sustaining measures were used. These measures would only serve to postpone the moment of death for the patient.
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