SINGAPORE: As Singapore grapples with the realities of a rapidly ageing population and as debate over euthanasia and physician-assisted suicide gains interest across online forums and social media platforms, a local doctor is arguing that medicine should not evolve into what he describes as a “killing profession.”
In a lengthy post circulating on Facebook, Dr Vincent Chia, a physician and bioethicist, argues against euthanasia and frames the issue as one that strikes at the very identity of medicine.
At the heart of his argument is the idea that euthanasia contradicts the fundamental purpose of the medical profession. Doctors, he writes, are entrusted with specialised knowledge and authority over vulnerable patients, a responsibility that is “ordered towards healing wherever possible” and compassionate care when cure is no longer an option. Allowing physicians to intentionally end life, he argues, would alter that role “in kind, not merely in degree.”
Dr Chia points to longstanding opposition from major professional bodies, including the World Medical Association and the American Medical Association, which have maintained that euthanasia is incompatible with the physician’s role as healer. He also notes that within the United States, opposition among medical and surgical societies continues to outweigh neutral positions on the issue.
Beyond professional identity, Dr Chia raises concerns about public trust. While acknowledging that empirical evidence on trust is mixed, he argues that trust is not merely a measurable sentiment but something embedded in the ethical foundations of the profession. Drawing a clear boundary between caring for the dying and actively ending life, he says, is essential to preserving that trust.
Another key strand of his argument centres on the physician’s duty not to abandon patients. Rather than responding to suffering with lethal intervention, Dr Chia says doctors should intensify efforts in palliative care by addressing not just physical pain but also psychological, social, and spiritual distress. He highlights that globally, only a fraction of patients who require palliative care actually receive it, suggesting that euthanasia risks becoming a substitute for gaps in care.
Dr Chia also questions the nature of suffering that leads patients to request assisted death. Citing data from Oregon, he notes that concerns such as loss of autonomy, dignity, and the ability to enjoy life are among the most frequently reported reasons. These, he argues, are complex and multidimensional issues that should be addressed through holistic care rather than by ending life.
He further warns of what he describes as the “medicalisation of suicide,” pointing to concerns raised by the International Association for Suicide Prevention about the potential overlap between suicide and assisted dying. For a profession that is otherwise committed to preventing suicide, Dr Chia argues, endorsing physician-assisted death creates a fundamental contradiction.
Issues of vulnerability and inequality also feature prominently in his critique. The inherent power imbalance between doctor and patient, he says, means that requests for euthanasia may be influenced by factors such as social isolation, fear of being a burden, or inadequate support systems. In such contexts, he argues, the choice to die may not be entirely free.
Looking at jurisdictions where euthanasia is legal, Dr Chia cites figures from Canada, the Netherlands, and Belgium to argue that once introduced, the practice tends to expand. While he stops short of claiming this proves abuse, he says it demonstrates how assisted dying can shift from an exceptional measure to a more routine part of medical practice.
He also highlights the impact on doctors themselves, noting that even organisations that have adopted neutral positions, such as the British Medical Association, continue to call for strict opt-in systems and protections for conscientious objection. Such safeguards, he argues, reflect the extent to which assisted dying remains disruptive to the traditional practice of medicine.
In the Singapore context, Dr Chia stresses the importance of maintaining a clear ethical distinction between allowing natural death and actively causing it. He points to the country’s Advance Medical Directive framework, which explicitly rejects euthanasia while permitting the withdrawal of futile treatment and emphasising palliative care.
Ultimately, Dr Chia contends that euthanasia risks undermining the identity of medicine, eroding trust, and exposing vulnerable patients to pressures that cannot be fully mitigated by law.
“Humane medicine must be able to say two things at once,” he writes, asserting that no patient should be left to suffer needlessly, and that the physician’s role is to care for patients through suffering, not to end their lives.
Read his post in full HERE.
