Advance Medical Directive Act

The Advance Medical Directive Act (ADMA) is an act which allows a person to make an Advance Medical Directive (AMD) that should he become terminally ill, he does not want doctors to use extraordinary life-sustaining treatment to be prolong his life. But is this not similar to euthanasia, a crime in Singapore? In such a major decision, is it open to abuse? Is it even justified? I will attempt to answer those questions.
Euthanasia is the act of ending a human life in a painless manner. This entails the use of unnatural means to hasten the process of death i.e. using lethal drugs. It can also be done either by the patients themselves or if they are incapacitated, others can decide for them. The ADM however, can be made only by the patient. It also takes effect only during terminal illness. Also, there are very strict requirements as to what constitutes terminal illness, namely it has to be diagnosed by a panel of three doctors, two of them being specialists, who must all agree.
This can be justified as should a person is already terminally ill, prolonging his life will just prolong his suffering. In addition, some of the medications may be causing even more pain. An example would be giving chemotherapy to a terminally ill cancer patient. While it may prolong his life, the chemotherapy has many side effects.
Note that this is different from euthanasia, in which the person speeds up his death. I feel that this should not be allowed since speeding up your death is tantamount to suicide. A person may feel he is unable to live with the pain but that is a matter for counseling to help him overcome this, not taking the easy way out and simply killing himself.
In order to prevent abuse, patients who are suffering from intense pain etc. should not be allowed to authorise this. This is because they may be so desperate to relieve their pain that they may consent to extreme measures to do so. They may also be susceptible to persuasion by family members unwilling to pay the costs of life support. Of course, this may lead to a situation where a patient who had no prior knowledge of the ADMA learns of it after becoming terminally ill, wants to apply but cannot due to the proposed restriction. Thus, high risk patients could be advised about this beforehand so they will have time to think about it and will not be in the abovementioned conundrum.
Another way to prevent abuse would be to get the government to partly sponsor such treatment. Surely such an important decision regarding a person’s life should not have to be influenced by money. Thus, the government can review this on a case by case basis and decide how much it should subsidise.
In my opinion, the AMDA is justified since it is simply allowing for a natural death, rather than euthanasia, which I feel is simply suicide.