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SINGAPORE: More measures are in the pipeline to help Singaporeans die with dignity. The Ministry of Health said the number of hospice beds in Singapore is expected to grow by about 20 per cent in the next five to seven years.
The ministry added that resources and expenditure will have to rise in tandem as the aging population grows and guidelines will be put in place for end-of-life care.
As the Health Ministry said Singapore is under-performing when it comes to care for the dying, it has announced several initiatives to address this.
Among them is a pilot scheme next year to bring end-of-life planning into nursing homes.
This will include guidelines on providing patients and families with care options in advance instead of leaving it to the last.
Health Minister Khaw Boon Wan, said: “Underlying these initiatives is the need for us to have more "die-logues", about death and not sweep it under the carpet. We need to overcome taboos about death and communicate better - both among ourselves as well as between doctors and their patients.”
More doctors and nurses will also be trained in palliative medicine while hospice services will receive more funding.
Each year, the Health Ministry provides about S$5 million worth of funding for inpatient hospice and home hospice services. Mr Khaw said this figure will rise as the aging population grows.
Last year, 4,400 patients received such government subsidies.
One legislation that certainly needs better communication is the Advance Medical Directive (AMD).
Implemented 11 years ago, it allows a person to declare that he or she does not wish to receive external life-sustaining treatment in the event of terminal illness.
Mr Khaw said his ministry has been unduly squeamish in the promotion of the AMD, resulting in a low uptake of fewer than 10,000 people.
Going forward, the ministry will promote it more actively, and make the process of signing the AMD less complicated by providing a multilingual registration form in easy-to-understand language.
Currently, some doctors shy away from acting as witnesses to patients signing this document because they don't fully understand the implications of the AMD.
Mr Khaw said he might make legislative changes to do away with the need for witnesses to be doctors.
And while declining life-support may soon be more common, the jury is still out over medically assisted suicides, which are currently legal in three countries.
Mr Khaw said: "I do not know if Singaporeans are ready for euthanasia. But I do know that ageing will throw up many more human stories of agony and suffering."
Experts said that with the right palliative care system in place, few would consider euthanasia. - CNA/vm
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