Mr Seah Yam Meng suggests that there is a difference between euthanasia and suicide in his letter, as he cites suicide as a "grisly alternative" to euthanasia (View euthanasia in a positive light; Nov 1).

What the public must understand, however, is that euthanasia is, like physician-assisted suicide, also a form of suicide. The only difference is that in the former, doctors administer lethal drugs to end a life while, in the latter, the patient does it himself.

For many reasons, legalising euthanasia is fraught with the potential for abuse (Too many variables to legalise euthanasia, by Mr Cheng Choon Fei; Oct 29).

In the Netherlands, medically assisted suicide is accepted in cases of depression. Once euthanasia is legalised, why should it be confined to those with physical rather than mental suffering? The law abets the depressed to commit suicide.

Should euthanasia be limited to those with terminal illness? Some of those who seek to end their lives may not be terminally ill but, for example, may be paralysed.

Should euthanasia be limited to the cognitively intact? What of those with dementia?

Legalising euthanasia opens up an avenue for the elderly, who seek not to "be a burden" to their families, to request death.

While those seeking to legalise euthanasia are motivated by compassion, it can be seen that, practically, legalising euthanasia is problematic.

Euthanasia is not the only means to end suffering.

Palliative care is a win-win solution which, in the vast majority of cases, is able to "kill suffering without killing the patient".

Palliative care refers to medical care and support at the end of a person's life, which helps to relieve symptoms and bring comfort to the patient and family in the patient's last days. This is increasingly becoming recognised as preferable to life-prolonging intervention in cases when a condition is beyond cure.

Care continues, but goals of care are shifted to maximising the quality of life in the patient's last days and facilitating closure at the end of life. No unnecessary, uncomfortable or futile medical procedures are done. Palliative care allows for "death with dignity".

It may be argued that dignity is not dependent on the appearance of the patient, however emaciated, or the function of the patient, however dependent, but on the presence of those who provide loving care for the patient.

This is in abundance in the hospices or homes of patients on palliative care.

Joanna Chan Shi-En (Dr)