One Way Ticket

Second childhood

Debating local laws prohibiting euthanasia and abortion is pointless in the era of medical tourism.


"What do you think about doctor-assisted suicide?" The relative who asked me the question is typically direct for Singapore, a nation known for its straight-talkers.

As the world ages and childcare costs balloon the previously ignored problems of a lingering death and unwanted (yet demographically insufficient) children are coming to the forefront of people's minds. Respected bureaus The Economist and the ABC are revisiting euthanasia.

After some fudging about safeguards, democracy, and ethics, I realised that although the topic is important to me in the sense of personal autonomy, none of what I said really matters. For example in Australia:

You live in Sydney, where physician assisted suicide is illegal. You are terminally ill and in unendurable pain. Or your internal life is so incapacitating it counts as a disability.

• Sydney to Zurich airfare: USD$1,050.
• Dignitas Full Service: USD$10,000.

Even at that price, (what I imagine to be) cheese, ice wine, and perhaps Tchaikovsky stacks up pretty well against spending your last years campaigning to change State law, or for an exception to be made in your case, all the while continuing to suffer.

Abortion is also subject to international jurisdictional arbitrage. That said, regulatory shopping can also be domestic.

You are 21 weeks pregnant in Perth and your situation has deteriorated to the point where becoming a parent or adoption are not options. Abortion in Western Australia is now off-limits to you. For as low as AUD$600 you can get return flights to Melbourne and a physician-assisted abortion. Medicare will also fund up to 85% of the procedure. In one part of Australia that is, but not another. How weird is that?

Some complain that extra-jurisdictional procedures must be resorted to, rather than celebrate the fact that they are available to those with savvy and savings. Indeed, even after these examples, the dinner party continued to debate advocating local laws be changed. The conversation was no longer about personal autonomy but wanting one's choices to be accepted by the community.

This illustrates to me the conceit of relativism: that it is not sufficient to be personally open-minded, but that society must be forced to liberalise. Compelling others to permit the rules we choose for ourselves is too close for comfort to the fundamentalist strong-arming that conservatives are often accused of.

But if we are going to use medical intervention to divorce ourselves so drastically from the natural biological processes of life, then we should care less about what society thinks, and just as little about leaving that society. Whatever the reason Mohammed had to commune with the mountain, at least he understood that he would have to go to it rather than have it come to him.

To the privileged, laws surrounding controversial procedures are fascinating but ultimately trivial. Knowledge of a global market allows me to think about physician-assisted euthanasia and abortion without worrying about it.