PUBLISHED : Thursday, 18 December, 2008, 12:00am
UPDATED : Thursday, 18 December, 2008, 12:00am

Opponents say it is murder; supporters say it ends unbearable pain: Euthanasia is again in the spotlight with two high-profile cases in Britain - one a promising young rugby player and the other a retired professor, who both chose to terminate their lives in the same euthanasia clinic in Switzerland.

Twenty three-year-old Daniel James, a university student and former national rugby team player, had made repeated wishes to die after a rugby training accident left him paralysed from the neck down. He persuaded his parents to bring him to Switzerland in September this year.

Craig Ewert, 59 suffered from an untreatable motor neuron disease that would eventually leave him completely paralysed. He allowed his last hours to be filmed, and they were screened as a documentary - The Right to Die? - in Britain last week.

Their deaths echoed the situation of Hong Kong's 39-year-old Tang Siu-pun, or Bun Tsai, who has been paralysed from neck down after an accident 17 years ago. He appealed to then chief executive Tung Chee-wah to support euthanasia in 2004, and last year published a memoir about his life, reiterating his call for legal euthanasia in Hong Kong.

Euthanasia - 'good death' in ancient Greek - is highly controversial, and only a few countries, such as Switzerland, Belgium and the Netherlands, have legalised it.

Switzerland is alone in allowing it to be offered to foreign nationals. Opponents of Swiss law say the result is 'death tourism' - a stream of seriously ill people and their families, paying as much as #5,000 (HK$58,000) to visit Switzerland and end their own lives.

In the past year, Switzerland assisted more than 700 deaths - most of them from Germany and Britain. One of the major arguments for euthanasia is everybody has the right to choose what to do with their lives, even if their decisions are not considered wise. Every adult has the right, for example, to decide what kind of medical treatment they receive, no matter what doctors advise. From this point of view, euthanasia is entirely a personal choice, and prohibiting the choice is, therefore, a breach of their human rights.

Quality of life is also central to the debate. Despite all the advancements of medicine, there are still many cases in which doctors cannot improve a patient's condition.

In his appeal letter, Bun Tsai described how he had spent 12 years in a hospital bed, relying on others to take care of him - feeding, washing and using the toilet. He said wished he could take control of his life and die with dignity.

However, religious communities stand firm against euthanasia, insisting it is immoral and no different from murder. Legalising euthanasia is a subtle admission of inequality - that some lives are inferior to others, and that it is justified to terminate them.

According to the argument, hardship and suffering are a part of life, and there are shining examples of people achieving great things in the face of extreme adversity. Disabled Australian missionary Nick Vujicic, who visited Hong Kong last month to share his story of a life without limbs with thousands, is one of them. Another moral issue is legalising euthanasia might put pressure on sufferers of debilitating diseases, making them feel they are obliged to die to relieve the financial burden their illness imposes on their families. There is also concern some sufferers might be misinformed about their condition, and kill themselves too soon.

The role of the medical professions is especially sensitive. It is a conflict of interest to assist patients to end their lives, particularly when it comes to the issue of advising patients about euthanasia. Some fear any legislation might lead to doctors and families abusing their powers on patients who cannot express their will.

In The Right to Die?, Craig Ewert died a death of his own choosing, listening to Beethoven's Ninth Symphony, to end unbearable suffering. His death will likely encourage those in similar situations to follow the same path, making the euthanasia debate even more fiercely contested, with no easy solution in sight.


1. Compare the rights of terminally ill patients in Hong Kong to those in Switzerland.

2. A doctor's oath is to preserve life, is there a time when this oath is unsuitable?