Who gets the last say in life – the law or love?

People often find themselves facing an unenviable number of choices when their days are numbered. The same is true when a loved one balances on the line between life and death. Family members tiptoe around the moral, ethical and perhaps even the legal issues that arise as an ugly question is posed: should the suffering continue if it can be prevented?

This question breaks the heart as loved ones lie on the narrow hospital bed, their eyes squeezed shut in pain, gasping for breath, feverish even in slumber.

Labelled taboo in most Chinese cultures, death is not discussed at home or in schools until it is too close for us to avoid. So often are we silenced during deathbed discussions that many are rendered helpless when the doctors ask whether to continue life-sustaining treatment.

Meaning “good death” in Greek and translated to “safe, peaceful death” in Chinese, euthanasia is the process that intentionally ends a patient’s life in order to cut short the pain and relieve severe suffering. The practice is categorised into voluntary, non-voluntary and involuntary euthanasia; only the first – carried out with the patient’s consent – is legal in some countries such as the Netherlands, Belgium, Luxembourg, Switzerland, as well as in several states in the United States. While non-voluntary euthanasia is illegal, as it takes the life of a patient who is unable to give consent, involuntary euthanasia is regarded as murder.

Digging deeper, these types of assisted deaths can also be divided into passive and active euthanasia. Passive euthanasia involves the withholding of treatment that is crucial to continue living, while active euthanasia usually calls for the administration of lethal substances.

Despite anti-euthanasia groups arguing for the sanctity and miracle of life, taking one’s life voluntarily is a decision that deserves respect from outsiders. The decision is not made in haste nor without prolonged debate. We all understand that this is the path of no return.

The terms associated with euthanasia and also its taboos are vague. Patients on their deathbed are subjected to “hospice palliative care” in Taiwan, which the Hospice Palliative Care Act states is the “mitigatory and supportive medical care given to relieve terminally ill patients in physical, mental and spiritual pain ... to improve their quality of life”.

Yet, who is to determine the quality of life but the patient himself? Who can ensure that the patient is truly relieved of the various types of pain when he is conscious but unable to speak?

Palliative care also contradicts the concept of “life sustaining treatment (LST)” as it is defined in law. LST “maintains the vital signs of patients with terminal illnesses to extend the process of dying without actually curing the patient,” and is administered with the consent of the patient or a close relative.

It would be best for the patients to make their own choices, but when the relatives’ decision for LST is made just because they are unwilling to let go, the well-being of the patient is not what is being prioritised. To put it crudely, the living struggle with their affections and selfishness.

According to the American Hospital Association, some patients die when the pain-easing medication they are taking stops their breathing. These can be regarded as planned deaths. For many who practice medicine, it is an open secret that pain-relieving medication may also shorten a person’s life. There are people who have chosen to use the pain reliever morphine to end the suffering of their loved ones.

So in the end, the fate of the person at death’s door is caught on the fine line between life and eternal sleep. The living tug as hard as they can until some decide they cannot take it any more – then comes the stage of “letting go”, when you want to end things once and for all. You decide to thrust death at them, not just to end their suffering but also your own.

How do you choose when there is no right answer? How do you give up when you are not ready?

However unwilling you may be to loosen your grasp, the well-being of the patient should be the first priority in mind.