General Purpose

: To persuade

Specific Purpose

: To persuade my audience to think positively about euthanasia.

Central Idea

: Euthanasia has caused controversies especially in this

religious country , we should change the
the perception towards the issue.

Introduction
I.

Euthanasia is not something unheard of in Malaysia.

II.

It is one of the most controversial topics in this century after cloning and genetic
engineering.

III.

Euthanasia or mercy killing can be define as the act or practice of killing or

permitting the death of hopelessly sick or injured individuals in a relatively
painless way for reasons of mercy.

IV.

Euthanasia is not yet legal in Malaysia and religion is the main reason why people
are against it.

V.

According to Dato Prof Alex Delilkan, Senior Consultant of Anaesthetist Kuala

Lumpur in article by Asma Md Arif, Vaishnavi Jeyasingam and Lucy Chan
stated that Euthanasia might never accepted in Malaysia as this is a multiracial
and multirelegious country which most of Malaysian are God fearing people.

VI.

Many of them claimed that ending a terminally ill persons suffering is simply
giving room to certain groups to play God.

VII.

In the majority of countries euthanasia or assisted suicide is against the law.

VIII.

According to the National Health Service (NHS) UK in Medical News Today it is

illegal to help somebody kill themselves, regardless of circumstances.

IX. Assisted suicide or voluntary euthanasia carries a maximum sentence of 14 years in

prison in the UK.
X. Today I would like to open your mind about the true concept of euthanasia and
persuade to think positively on why euthanasia should be legal in Malaysia.

(Transition: Lets start with knowing briefly about the types of Euthanasia)

Body
1.1 There are several types of Euthanasia and we should know deeper all these different
types of euthanasia before jumping into disagreement.
1.1 In an article by The Medical News Today by Christian Nordqvist, there are
four types of euthanasia and the first one is voluntary euthanasia.
1.1.1

It is conducted with consent which means the termination of life which

proceeds in responds of a competent person.

1.1.2

Since 2009 voluntary euthanasia has been legal in Belgium,

Luxembourg, The Netherlands, Switzerland, and the states of Oregon
(USA) and Washington (USA).

1.2

Next is involuntary euthanasia, where a person is killed against their expressed

wishes.
1.2.1

This is often done to the patients who does not request on the aid of
dying especially those with massive brain damage and probably will
never recover consciousness.

1.3 Passive euthanasia is ending a person life by altering some form of support and
let the God takes the course.
1.4 Active euthanasia is the most controversial one.
1.4.1

It is where a person deliberately intervenes to end someones life for

example, by injecting them with a large dose of sedatives.

1.4.2

This is usually due to the patient does not want a horrible death in
future because of their current advancing disease.

(Transition: So what is the reason we should legalized euthanasia)

2.0 Euthanasia should be legalized to consider the economic factor.
2.0.1

Many times they do not have enough money to pay for the needed
medical care not knowing if the patient is going to get any better. .

2.0.2

In a way, we are just spending time and money on a situation that wont
get better.

2.0.3

Imagine, they are in great suffering and we are paying to make it longer.

2.1 For example of someone who has been in a life support system for a long term,
their families would then not be burdened by the hefty medical bills and the
emotional strain of care giving.
2.2 Due to financial short comings, some patient cannot afford to pay those expensive
hospital bills and thus, view mercy-killing as their last resort
2.2.1 Then why we should pay for medical care when you know your condition is
not going to get better anyway?

(Transition: How to change the Malaysians perspective about euthanasia?)

3.0 Religion is main the reason why Malaysian are against euthanasia and it is
challenging to change their view towards it.
3.0.1

According to a survey conducted by Department of Anaesthesiology of

University of Malaya Medical Centre, 67.91% of 399 respondents are
against the practice of euthanasia.

3.0.2

Thus they must be educated thoroughly about euthanasia to change their

view.

3.0.3

Andrew Khoo, a high court lawyer in The Star article on February 2015
said that euthanasia should be part and parcel of Malaysian legal practice,

and we have to prepare the public through education, just like how we
educate people right now about organ donation.
3.0.4

Dr. Rahim Affandi from Jabatan Fiqh and Usul of University of Malaya in
Euthanasia in Malaysia:Opinion and Controversies article stated that Islam
is flexible and tolerate with modernization.

3.1 It is true that ending ones life can be considered as murder.

3.1.2 However they are times where Islam permitted euthanasia for instance when the
patients himself is in vegetative state for a long time and only depend on support
machine.
3.1.3 The influence of religion is very strong among Muslims because the
implementation of law and fatwa institution which protect the Muslims from
being exposed to such situation.
3.1.4 Nevertheless, with influences of Western civilization, I am very sure the
Muslims might consider euthanasia without considering what the religion has to
say about it.

Conclusion
I.

Many people still find it difficult to find the difference between euthanasia and
suicide.

II.

If somehow euthanasia is legalized in Malaysia, the medical professionals need a

proper guidelines on dealing with this issue as opinion on euthanasia may be
varies among individuals.

III.

Nevertheless, with the increasing of awareness and acceptance among the public,
the doctors might face more euthanasia request in future.

IV.

I personally believe that if a terminally ill patients life holds nothing but suffering,
then it should be an acceptable option to help them die as long as the conditions is
met , and sufficient permission is given.

References

Asma Md Arif, Vaishnavi Jeyasingam and Lucy Chan (2002). Euthanasia in

Malaysia:Opinion and Controversies. Retrieved from
http://jummec.um.edu.my/filebank/published_article/JUMMEC%202002%207(2)92-99.pdf
The Economist (June 2015). Doctor Assisting Dying: The Right To Die. Retreived from
http://www.economist.com/news/leaders/21656182-doctors-should-be-allowed-helpsuffering-and-terminally-ill-die-when-they-choose
Matthew Hayes. (Nov 2014). Right to Die: Should Euthanasia and Assisted Suicide Be
Legal? Panampost. Retrieved from https://panampost.com/editor/2014/11/26/right-to-dieshould-euthanasia-and-assisted-suicide
Christian Nordqvist (April 2016). Euthanasia and Assisted Suicide. Medical News Today.
Retreived from http://www.medicalnewstoday.com/articles/182951.php
Tan Yi Liang and L. Suganya. (February 2015). Euthanasia and living wills in Malaysia - two
sides of the coin. The Star. Retrieved from
http://www.thestar.com.my/news/nation/2015/02/26/euthanasia-and-living-wills-in-malaysia/

THE STAR
Thursday, 26 February 2015 | MYT 7:40 AM

Euthanasia and living wills in

Malaysia - two sides of the coin
BY TAN YI LIANGANDL. SUGANYA

PETALING JAYA: A 75-year old man lies on a bed he hasn't left in over five years. He
wants to get up and walk around in the garden with his grandchildren - but his cancer-ravaged
body is just too weak.
He is unable to even sit up without gasping for air, relying on caregivers to change his diapers
and pyjamas before there are drenched through with urine. His caregivers have to turn him
every few hours to prevent bed sores.
Day-in, day-out he takes heavy doses of medication that leave him barely lucid. Most of the
people he grew up are dead and buried, and at this stage of his existence there is no quality of
life, no recovery for his terminal illness.
Simply a long drawn-out painful death
There are no other alternatives, for a patient must endure this suffering for as long as the body
keeps breathing. At least as far as Malaysia is concerned.
Growing legislative action
On Feb 6, Canada joined the ranks of nations like Switzerland, Belgium, Luxembourg and
the Netherlands in legalising physician-assisted suicide, or euthanasia.
Multiple sclerosis patient Gloria Taylor, 89, won the right to terminate her life.
Canadas Supreme Court ruled; by leaving people like Ms. Taylor to endure intolerable
suffering, it impinges on their security of person."
Ms Taylor incidentally died of natural causes before the euthanasia could be implemented.
Its very unlikely however that we could see such legislation in Malaysia. In fact the strength
of religious belief preclude rational discussion of the topic.
If the sentiments of the immediate past president of the Malaysian Medical Association

(MMA), Datuk Dr. NKS Tharmaseelan are anything to go by, it will be a long time before
euthanasia of any form, let alone physician-assisted euthanasia is legalised in Malaysia.
"I personally feel nobody has a right to take a life when he cannot create one. Miracles do
happen, what may be considered incurable today may become curable in the near or distant
future. We should realise that medical science is still an imperfect and incomplete science,"
said Tharmaseelan in an email to The Star Online.
Addressing passive euthanasia, such as the removal of life support, Tharmaseelan added
measures such as withholding life support measures in a brain-dead patient who is already
dependent on a life support system may be justified after considering social and religious
sensitivities and taking into confidence the next of kin.
The High Court lawyer Andrew Khoo has a different view.
"As a matter of principle, a person must have the right to terminate their own life, this is a
fundamental principle of the right to life. The question is whether society is ready to accept
that," said Khoo, who serves as Bar Council Human Rights Committee chair but emphasises
that he is speaking in a personal capacity.
He pointed out that currently suicide is an offence in Malaysia under the Penal Code.
"If there are compelling medical reasons for assisted suicide, then I would agree with the
concept," said Khoo.
"What constitutes quality of life has to be established, but will it be objective or subjective
criteria. Quality of life has to go to life and death issues, it cannot simply be about quality of
life, it has to be quality of life in comparison to something that is life-threatening," said Khoo.
Cultural objections
One point that Khoo and Tharmaseelan agree on is that Malaysia seemed to not be ready for
legalizing euthanasia.

"In nearly all Western countries a significantly higher proportion of people are for euthanasia
but in Asian Countries and culture it is taboo. In a democracy, it is the wishes of the majority
also taking into account religious, cultural and traditional beliefs. Legislation should reflect
the will of the people," said Tharmaseelan.
"Many Malaysians still believe in a Creator and the sanctity of life given by that Creator. I
can well see religious institutions stepping in to say this is not allowed as the sanctity of life
is being removed by tampering with creation. And as the state feels duty-bound to uphold
Islamic values, they will not allow this," added Khoo.

Tharmaseelan also pointed out there were other, more personal hurdles that have to be
overcome if euthanasia can be allowed, such as the mental competence of the patient desiring
euthanasia.
"Euthanasia is only voluntary if the patient has a lucid understanding of available options
and consequences. Determining or defining competence is not straightforward," said
Tharmaseelan.
"Patients may also feel that the burden - financially, emotionally, mentally - on their family is
overwhelming. Even if the costs of treatment are provided by the state, there is a risk hospital
personnel may have an economic incentive to encourage consent to euthanasia."
Living wills
But how about advanced directives, or "living wills" - written documents where patients
express their desires or consent for further medical procedures should they become mentally
incapacitated?
Khoo feels this is a concept that needs to be examined to see how it can be introduced in a
legally-binding manner in Malaysia.
He pointed out that the tension with living wills is between respecting the wishes of the
patient when that patient can no longer express their view or opinion and whether there are
overriding medical circumstances.
Khoo said that if a living will was legally recognised, it would mean that the law recognises
the right of a person to decide for themselves and to give effect to their decisions regarding
their treatment.
"Now a doctor can choose to respect the desires of the person, but if a person is brought to a
doctor, how can they verify the wishes of the patient when they are voiced by a third party,"
added Khoo.
He added that he feels living wills should become part and parcel of Malaysian legal practice,
as there is no way for Malaysians to draw one up at this point.
"I certainly think it should be part and parcel of Malaysian legal practice, and we have to
prepare the public through education, just like how we educate people right now about organ
donation. We need to educate people about the decisions that can be made which will be
legally binding," said Khoo.

Pain / Anesthetics

Euthanasia and Assisted Suicide

MEDICAL NEWS TODAY| Written by Christian Nordqvist
Last updated: Fri 8 April 2016
359SHARE22

Euthanasia, also known as assisted suicide, physician-assisted suicide (dying), doctor-assisted

dying (suicide), and more loosely termed mercy killing, means to take a deliberate action
with the express intention of ending a life to relieve intractable (persistent, unstoppable)
suffering.
Some interpret euthanasia as the practice of ending a life in a painless manner. Many disagree
with this interpretation, because it needs to include a reference to intractable suffering.
In the majority of countries euthanasia or assisted suicide is against the law. According to the
National Health Service (NHS), UK, it is illegal to help somebody kill themselves, regardless
of circumstances. Assisted suicide, or voluntary euthanasia carries a maximum sentence of 14
years in prison in the UK. In the USA the law varies in some states (see further down).
Euthanasia classifications
There are two main classifications of euthanasia:
Voluntary euthanasia - this is euthanasia conducted with consent. Since 2009 voluntary
euthanasia has been legal in Belgium, Luxembourg, The Netherlands, Switzerland, and the
states of Oregon (USA) and Washington (USA).
Involuntary euthanasia - euthanasia is conducted without consent. The decision is made by
another person because the patient is incapable to doing so himself/herself.
There are two procedural classifications of euthanasia:
Passive euthanasia - this is when life-sustaining treatments are withheld. The definition of
passive euthanasia is often not clear cut. For example, if a doctor prescribes increasing doses
of opioid analgesia (strong painkilling medications) which may eventually be toxic for the
patient, some may argue whether passive euthanasia is taking place - in most cases, the
doctor's measure is seen as a passive one. Many claim that the term is wrong, because
euthanasia has not taken place, because there is no intention to take life.
Active euthanasia - lethal substances or forces are used to end the patient's life. Active
euthanasia includes life-ending actions conducted by the patient or somebody else.

Active euthanasia is a much more controversial subject than passive euthanasia. Individuals
are torn by religious, moral, ethical and compassionate arguments surrounding the issue.
Euthanasia has been a very controversial and emotive topic for a long time.
The term assisted suicide has several different interpretations. Perhaps the most widely used
and accepted is "the intentional hastening of death by a terminally ill patient with assistance
from a doctor, relative, or another person."
Some people will insist that something along the lines of "in order relieve intractable
(persistent, unstoppable) suffering" needs to be added to the meaning, while others insist that
"terminally ill patient" already includes that meaning.
Medical definitions of euthanasia
According to MediLexicon's medical dictionary:
Euthanasia is:
"A quiet, painless death." or
"The intentional putting to death of a person with an incurable or painful disease intended as
an act of mercy."
Active euthanasia is:
"A mode of ending life in which the intent is to cause the patient's death in a single act (also
called mercy killing)."
Passive euthanasia is:
"A mode of ending life in which a physician is given an option not to prescribe futile
treatments for the hopelessly ill patient."
Options for terminal patients or those with intractable suffering and pain
Patients with a terminal or serious and progressive illness in most developed countries have
several options, including:
Palliative care
The World Health Organization (WHO) defines palliative care as:
"An approach that improves the quality of life of patients and their families facing the
problems associated with life-threatening illness, through the prevention and relief of
suffering by means of early identification and impeccable assessment and treatment of pain
and other problems, physical, psychosocial and spiritual".
One goal of palliative care is for the patients and families to accept dying as a normal
process. It seeks to provide relief from pain and uncomfortable symptoms while integrating
psychological and spiritual features of patient care. Palliative care strives to offer a support

system to help patients live their remaining time as actively as they can and to help families
bereave and deal with the illness of a loved one.
Since pain is the most visible sign of distress among patients receiving palliative care,
affecting about 70% of cancerpatients and 65% of patients dying from non-malignant
diseases, opioids are a very common treatment option.
These medicines form part of well-established treatment plans for managing pain as well as
several other symptoms that patients encounter. Often, opioids are chosen during palliative
care in spite of the side effects such as drowsiness, nausea, vomiting, and constipation.
Some type of palliative care is given to about 1.2 million Americans and 45,000 new patients
each year in England, Wales, and Northern Ireland. About 90% of these patients have cancer,
while the remaining patients have heart disease, stroke, motor neuron disease, or multiple
sclerosis. The providers of the palliative care include in-patient care, hospital support
services, community care, day care and outpatient care.
Refusing treatment
In the USA, UK and many other countries a patient can refuse treatment that is recommended
by a doctor or some other health care professional, as long as they have been properly
informed and are of sound mind. In the UK, the Mental Health Act 1983 excludes children
and people under the age of 18 years.
According to the Department of Health, UK, nobody can give consent on behalf of an
incompetent adult, such as one who is in a coma. Nevertheless, doctors take into account the
best interests of the patient when deciding on treatment options. A patient's best interests are
based on:
What the patient wanted when he/she was competent
The patient's general state of health
The patient's spiritual and religious welfare.
An example in the UK
The doctor may decide the best option for a patient who is declared as clinically brain dead is
to switch of the life-support machines; equipment without which the patient will die. The
doctor in charge will talk to the patient's family. However, the final decision is the doctor's,
and strict criteria must be met.
A living will (advance directive)
This is a legally binding document which anybody may draw up in advance if they are
concerned that perhaps they will be unable to expresses their wishes at a later date. In the
advance directive the individual states what they want to happen if they become too ill to be
able to refuse or consent to medical treatment.

Right to Die: Should Euthanasia and

Assisted Suicide Be Legal?
PANAMPOST NOV 26, 2014, 10:22 AM

All Individuals Have the Right to Die with Dignity

By Matthew Hayes
For the last years of her life, my grandmother did not want to live. She suffered from
advanced heart disease and renal failure. After battling a bacteria infection acquired during
surgery, she was left weak and confused a shell of the woman she had been.
She couldnt take care of herself. Leaving the house became dangerous. Hosting Sunday
dinners, a tradition she held for nearly 50 years, became too much. All the things that made
life enjoyable were quickly being taken away from her. And she did not want to live.
We talked often about her desire to die. Life was not worth living, she told me, without
autonomy. She wanted to die happy and with some dignity left. But we lived in New York
State, where physician-assisted suicide is not an option. She could not end her life on her own
terms, so instead she suffered: a crippling stroke; massive blood loss after an angiogram;
dialysis; constant hospitalization; and mistreatment by staff. Month after month, she sank
further into despair.
On the morning of May 21, 2011, we received a call from the hospital: the end was near.
When we arrived, she laid in a hospital bed, unconscious, face clenched up in pain. She was
surrounded by family and friends, but could not say her goodbyes. Death took her slowly,
agonizingly, until finally she let out her last breath. After nearly two years, her suffering was
finally over.
This story is not unique. Its the story of countless terminally ill patients who want to end
their lives with dignity. Why should we force people to endure such physical and emotional
pain? Is there a better way?
In 1997, Oregon passed the Death with Dignity Act, allowing terminally ill patients the right
to end their lives through the use of physician-prescribed lethal medications. Once received,
individuals may choose when, if ever, to take them.
Since then, 1,173 patients have elected to participate in the program. Of them, 65 percent
have chosen to die. Today, assisted suicide is legal in four US states and three countries.
While this is a great start, it is not enough. Doctors everywhere should be free to offer
euthanasia for terminal illnesses.
This is not to say aid-in-death should be left unchecked. Laws should be narrow and specific.
Regulatory systems should be in place to thwart involuntary euthanasia and assess for
psychiatric illnesses. Practices and medications should be routinely updated to reflect new
information.

Despite these efforts, we must remember that no system is infallible, and there will always be
unintended consequences. These risks alone do not warrant inaction, however. If they did, we
would have no governments, no legal systems, and no health care of any kind. It is not the
existence of risk but how we respond to it that determines our outcomes. By acknowledging
the risk involved, and letting it guide our policymaking, we can better protect patients,
families, and physicians.
US Supreme Court Justice William Brennan said, An ignoble end steeped in decay is
abhorrent. A quiet, proud death, bodily integrity still intact, is a matter of extreme
confidence. In a perfect world, end-of-life care would involve no suffering. Individuals
would live to the end of their days happy and satisfied.
But that is not the world we live in. Individuals, like my grandmother, suffer terrible fates, to
the anguish of their families and themselves. While we should strive for this standard of care,
no one should be categorically denied the right to a quiet, proud death.

UNIVERSITI TEKNOLOGI MARA

FACULTY OF HOTEL & TOURISM MANAGEMENT
ELC 590
ENGLISH FOR ORAL PRESENTATION
OUTLINE FOR PERSUASIVE SPEECH
TITLE
EUTHANASIA SHOULD BE LEGALIZED IN
MALAYSIA
PREPARED BY
NURUL NAZIHA BT M. NASHARUDIN (2016651934)
GROUP
HM2406C
DATE OF SUBMISSION
7TH DECEMBER 2016