Medicine and morality

PUBLISHED : Saturday, 28 April, 2001, 12:00am
UPDATED : Saturday, 28 April, 2001, 12:00am

Modern medicine has the ability to prolong life even when there is no chance of recovery. This has led to hospitals having special wards for patients in a vegetative state, and geriatric homes filled with people who no longer know who or where they are.

And people with terminal illnesses, who cannot bear further suffering, often ask to be allowed to die.

This raises ethical and moral questions on a level of global debate. Holland has become the first nation to legalise euthanasia, with the support of 90 per cent of the population. But that law is for people of sound mind who are subjected to 'irremediable and unbearable suffering'. They must have requested a lethal injection voluntarily, persistently and independently. It makes no provision for dementia, a looming scourge as longevity increases to the point where, according to a report based on United Nations statistics, the growth in the 60-plus population will be three times the overall rate between now and 2005.

Every aspect of this problem affects Hong Kong but discussion so far has been low-key, at least among the general public. It may be different in medical circles, because a report from City University confirms that doctors are frequently called upon to take positions on the subject. Six of 10 say they support 'mercy killing', as do 60 per cent of the public.

Seventy-four per cent of doctors have been asked by patients or relatives to withhold treatment and let nature take its course. And 30 per cent were requested to assist patients to die. For most medical practitioners, there are no easy answers to this dilemma. Doctors are trained to preserve life and it can go against their conscience to do otherwise, no matter how desperate the case.

Ceasing treatment is a less onerous decision. There is general acceptance that: 'thou shalt not kill, but needst not strive, officiously, to keep alive'. In the United States, the old or terminally ill can make a 'living will', asking that treatment stop when they are beyond help. But when patients in unendurable agony beg to be released from life, what then?

Before a decision is taken in the SAR, there must be a community consensus. Wednesday's debate in the Legislative Council will attempt to put this topic on a wider agenda. It cannot be delayed indefinitely.