Advance Medical Directive

An interesting interview with a doctor who has signed an Advance Medical Directive. It's basically Singapore's form of legalised euthanasia, although you can be sure that Health Minister Khaw Boon Wan wouldn't like to hear the E word being used in this context.

Oct 30, 2006
Terminally ill? Doctor has 'no intention of lingering'
Dr Lee Wei Ling, director of the National Neuroscience Institute, tells The Straits Times why she was among the first to sign the Advance Medical Directive

Why did you sign the AMD?
I was among the first to submit the Advance Medical Directive (AMD) - which allows a patient to state in advance that he does not want to be sustained artificially should he become terminally ill and unconscious.

I have also convinced my parents to do so.

In case you didn't know, Wei Ling's parents are Mr and Mrs Lee Kuan Yew.

When I say I will carry on until I cannot carry on any more, I have no intention of lingering.

I have cheated death many times, and I came to a decision long ago that enabled me to remain optimistic day to day while hearing the ticking of the clock.

How have your life experiences shaped your decision?
As an avid hiker, I have had many hiking near misses. My medical and surgical near misses have been even more dramatic. I plan 10 years ahead knowing full well that I might not make it to tomorrow.

Everybody has a clock ticking. Some hear it and are bothered; others like me hear it and remind ourselves not to leave undone things we want to do, for there may be no tomorrow.

Others don't hear it and are not bothered until tragedy strikes them or someone close to them.

Some people feel that this topic is too morbid to address. What are your views?

We have no control over our birth, who we are born to, when we are born, where we are born.

But death is sometimes within our control.

My philosophy is that I control my own life, not someone else, not society, and to a certain extent not even disease or fate.

Knowing I have control gives me confidence to face tomorrow or the next moment.

This is not morbid thinking. I am not depressed or suicidal.

But like a chess player, I have to think several steps ahead.

I take what comes, knowing it is not entirely within my control but not entirely out of my control either.

My dad, like Dr Lee Wei Ling, also signed an AMD years ago. My dad has told me not to tell my mum. My mum doesn't read my blog, so I guess it's ok for me to mention it here. :P

I've never seen Dr Lee Wei Ling but I've been told that she is quite obese. I've also learned that she had had a heart attack (or was it a stroke?), which is a little surprising, because she was quite young - not yet 45, I do believe - when that happened.

I respect her philosophy -

"My philosophy is that I control my own life, not someone else, not society, and to a certain extent not even disease or fate"

... but I wonder how well she manages to execute it. I mean, she was fat, and she had a heart attack (or stroke) in her early 40s, and she's a doctor. It seems that she didn't really have enough control over her life, to manage her body weight and other risk factors relating to cardiac infarction. She probably ate too much, exercised too little and worked too hard.

This post isn't meant to put down Lee Wei Ling in any way - think of it more as a reflection of general human weakness. Very often, we all do know what's best for ourselves. Whether we get around to doing it is another question altogether.


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UPDATE (25 Nov 06): Major oops by Mr Wang! I've received word, from the doctor herself, that she isn't or wasn't fat, she is very fit & athletic and she didn't have a heart attack. She had a transient ischemic attack caused by a surgical complication which caused her platlets to rise to a very high level. Thus her condition had nothing to do with high cholesterol or atherosclerosis (in other words, it wasn't caused by an unhealthy diet or a lack of exercise).


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