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Life and death

Some of this century's greatest developments have undoubtedly been in medical technology. Machines can now take over when the heart ceases to beat; and people can often be kept 'alive' when even the brain has ceased to function.

These are great technological advances, but they have also created new and onerous ethical problems. Modern medicine can often extend life when all reason says that the quality of that life is so poor, death would be preferred.

Perhaps it is not surprising that so many Hong Kong's doctors are in favour of certain forms of euthanasia. Those who have witnessed the appalling quality of life of some patients can clearly see that a merciful release from suffering is the humane option. Nor is it difficult for the public to imagine similar circumstances.

And yet it is too simple to conclude that euthanasia should therefore be legalised. The issue is one of immense legal and moral complexity.

Clear guidelines that set out when a terminally ill patient is not to be resuscitated are one thing; but to go a step further and legislate for actively assisting in ending someone's life is riddled with danger, if only from a legal point of view. And, morally, euthanasia challenges all tenets of medical training.

Advocates of mercy killing take the view that a doctor driven by compassion should have the backing of the law. But who is wise enough to set the legal or ethical parameters for such an act? It is perhaps easy to cite clear-cut examples when euthanasia would seem appropriate and humane. Fully-aware patients, who have consulted with family, had counselling and expert medical advice, and whose dreadful quality of life will never improve, may well have the right to demand professional help to end their lives. But life and death decisions are rarely quite so straightforward.

Inevitably, that means the burden remains in medical hands. But, until the issue of euthanasia has been debated freely and thoroughly, and provided doctors are not required to 'officiously keep alive', they are the best people to trust to reach such difficult and irrevocable decisions.

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