Eon, a Greek goddess, asked Zeus to grant her lover Tithonus, a mortal, eternal life, forgetting to ask for perpetual youth to be granted as well, thus Tithonus was doomed to live forever, shrinking and getting weaker.

A bill entitled "Maintenance of Parents Act" was passed in the Singapore Parliament in November 1995. Citing a Singapore government's website, the act "allows Singapore residents aged 60 years and above - who are unable to provide for themselves - to claim maintenance from their children who are capable of supporting them, but are not doing so." This is in line with most Asians' Confucian values that children should support their parents in their old age. But in an aging society, where we are seeing more and more people living into their ninth decade or even beyond, we are beginning to see a disturbing new phenomenon.

As a medical doctor, I have seen patients who are in their 60s, with parents in their 90s who are sick also. The question these patients often asked me was: "How can I look after my parents when I myself am sick and am retired? Are my children supposed to support me and their grand-parents, that is, my parents, as well, when they have their young families to look after?"

Medical science, like Eon, has prolonged the lives of many and, also like Eon, has not thought of, nor prepared for the resulting social, economic and physical problems associated with living longer.

Recently, a Hong Kong media website featured the story of a young man called Ivan who donned a weighted suit, wore goggles that would dim his vision, and gloves that would hinder the movements of his fingers - all to make his daily life more difficult and similar to the disabilities elderly people have. He then checked himself into an old people's home to experience what it was like to be totally dependent on other people for even the simplest things in life, such as eating and going to the toilet. It was extremely demoralizing. He felt the dignity of life had gone. An experienced caregiver in a home for old people recalled that many residents there asked why they couldn't decide when to die.

The program also highlighted the difficulties of recruiting staff to those homes. So perhaps there should be programs for the proper training of caregivers in these institutions. Clearly more resources are needed, and the question must be asked how much of it should come from fee-charging and how much from government subvention. The latter is justified since it is no longer an individual problem but a pressing social issue.

While society should put more money into old peoples' home to enable those living there a more comfortable and dignified life, but more than that, perhaps society should have a more open discussion of life and death for people of advanced age and perhaps see the cycle of life and death with a more open mind - particularly mindful not only of an individual's sacred right to life, but to death with dignity as well.

What is society's attitude to those who want to die as a result of infirmity in general, and great stress and pain in particular? This question must also be asked if society has the right to prolong a person's acute suffering in such circumstances.

Euthanasia is not the answer as it is akin to murder, where the dying person has no choice. But what about assisted suicide, where the person, in full command of his mental faculties, has expressed a wish to die but can't do it himself? To date, I think Switzerland is the only country that has legalized assisted suicide, and the latest study shows more and more foreigners are going to that country for that reason - as their home countries do not allow it.

Even before we discuss assisted suicide, how many of our citizens know of the concept of Advanced Health Care Directive (AHCD)? As a first step, that concept could be made more generally known and legislation enacted to ensure its legality. What is AHCD? In laymen term, it is a document that allows you to provide a clear statement that in the event you are seriously ill and become unconscious whether you would like to be given all the life supporting system to prolong your survival. You can also choose to request relief from pain even if doing so hastens death. Singapore has allowed AHCD for many years already. The concept of assisted suicide should therefore be discussed in the context of providing the most ideal medical service, and not looked upon as a taboo topic. Death is very much part of the cycle of life. We should all live and die with dignity.

The author, a practising haematologist, migrated to Singapore from Hong Kong in 1984. He is also a principal mediator with the Singapore Mediation Centre.

(HK Edition 08/29/2014 page9)