Cutting Loss

By TAN Kee Wee
(MediaCorp 938LIVE’s Money Talks, Friday, 12 October 2012, 7.55 am, and Saturday, 13 October 8.35 am)

When our investments go wrong, one solution is to cut loss. Instinctively, we carry this cut-loss solution into other aspects of our lives.

Currently, there is a heart-breaking drama happening in New York. It involves a 28-year old Korean American woman by the name of Ms Grace LEE Sung-Eun.

A year ago, she was a Manager for Bank of America in New York. She was training for the famous New York marathon and had everything going for her.

Then doctors told her that she had brain cancer. Last month, while undergoing treatment, a seizure left her paralysed from the neck down. Today, Ms Lee communicates mainly by blinking her eyes.

However, Ms Lee is still conscious. A fortnight ago, she told doctors to remove the ventilator keeping her alive. Two court rulings supported her decision. Essentially, Ms Lee chose the cut-loss solution.

Then things became complicated. Her family members were against her wish to die for religious reason. They rallied support to stop doctors from switching off the ventilator.

Legally speaking, Ms Lee has the upper hand. Last Saturday, in the middle of the faceoff, Ms Lee suddenly changed her mind and now wants to remain on life support. We may never know what changed Ms Lee’s mind.

In cases like this, there are many other considerations. Let’s focus on two others. The first one is the quality of life. For the patient, being bed-ridden is torture. So the patient wants to go. For the loved ones, death is painful so they refuse to let the patient go.

The second consideration is financial. It can be costly to keep a patient on life support. For the patient, he or she might not want to impose this financial burden on others. For the loved ones, it is not easy to withhold measures just to save money.

So we have a typical case whereby what the patient desires goes against what the loved ones desire. It is more complicated when the patient is unconscious. Many of us could face this situation one day.

One way to lessen the complications is to prepare an Advanced Medical Directive, or AMD, when we are conscious. This gives clear instructions on how we want our final days to be when we are unconscious. This takes care of the first consideration of what kind of life a patient wants.

It also helps to sort out the second consideration of money. If the AMD favors life support, the bills could soar. It costs at least $1,000 a day in ICU in Singapore hospitals. But if the AMD does not favor life support, the costs are lower.

This is when hospice and palliative care units step in. They are specialized medical units that take care of patients in their last days. Usually, most patients require just regular home visits from a specialist doctor. This service is usually free.

Some patients require 24/7 care in hospice wards. This would cost $300 a day. But most patients don’t pay anyway because of donations and government assistance.

Hospice care isn’t just about saving money. The underlying aim is to improve the quality of the patients’ last days. Basically, hospice care can address our two considerations.

Many say that adopting a cut-loss solution makes us better investors. Likewise, many say that if we are prepared for our last days, we will live better lives.

This Saturday is World Hospice and Palliative Care Day. Perhaps we could review the cut-loss solution for our own lives.