Abstract
Bioethics in Singapore may be construed as comprising three key systems: clinical, research, and academic. This chapter provides an analytical overview of each of these systems, beginning with a brief description of the healthcare infrastructure. In the past decade or so, systemic factors and a policy initiative have contributed to important changes in the ethical governance of medical practice and biomedical research, as well as in medical education, through three major actors operating in each of the systems: the Ministry of Health (MOH), the Bioethics Advisory Committee (BAC), and the Centre for Biomedical Ethics (CBmE, at the National University of Singapore). MOH was responsible for establishing a system comprising hospital or clinical ethics committees to consider and address ethical issues in clinical practice. It has also implemented a variety of policies directed at meeting existing and emergent healthcare and public health needs and concerns. Some of the policies discussed in this chapter include those relating to reproductive medicine, infectious diseases, organ transplantation, palliative care, care for the elderly, and mental health. Working collaboratively with MOH, BAC has been instrumental in setting up a research ethics governance framework, primarily administered through institutional review boards (IRBs). It has also promulgated ethical guidelines for research relating to human pluripotent cells, genetics, human tissue, and personal information. Since its establishment, CBmE has supported both MOH and BAC by its research and expertise and has developed training programs for ethics committees and IRBs. Its scholarship has been important in establishing Singapore as a center for the ethical conduct of (bio-) medical practice and research. The collaborative work of the MOH, BAC, and CBmE has come to define a major aspect of bioethics in Singapore.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Biggs, H. (2010). Healthcare research ethics and law: Regulation, review and responsibility. London/New York: Routledge.
Campbell, A. V., Chin, J., & Voo, T.-C. (2009). Ethics and attitudes. In J. A. Dent & R. M. Harden (Eds.), A practical guide for medical teachers (pp. 274–280). New York: Elsevier.
Campbell, A. V., Chin, J., & Voo, T.-C. (2010). The clinician-researcher: A servant of two masters? In J. M. Elliott, W.-L. C. Ho, & S. S. N. Lim (Eds.), Bioethics in Singapore: The ethical microcosm (pp. 89–108). Singapore: World Scientific.
Chong, S.-A. (2007). Mental health in Singapore: A quiet revolution? Annals Academy of Medicine, 36(10), 795–796.
Evans, J. H. (2006). Between technocracy and democratic legitimation: A proposed compromise position for common morality public bioethics. Journal of Medicine and Philosophy, 31, 213–234.
Harrington, S. E., & Smith, T. J. (2008). The role of the chemotherapy at the end of life: “When is enough, enough?”. Journal of the American Medical Association, 299(22), 2667–2678.
Health Promotion Board. (2012). Press Release: A New Chapter for Tobacco Control in Singapore, 21 March 2012
Hedgecoe, A. (2010). Bioethics and the reinforcement of socio-technical expectations. Social Studies of Science, 40(2), 163–186.
Ho, W.-L. C., Capps, B., & Voo, T. C. (2010). Stem cell science and its public: The case of Singapore. East Asian Science, Technology and Society: An International Journal, 4(2010), 7–29.
Kaan, T. (2010). At the beginning of life. Singapore Academy of Law Journal, 22, 883–918.
Kleinert, S. (2010). Singapore statement: A global agreement on responsible research conduct. The Lancet, 376(9747), 1125–1127.
Krimsky, S. (2006). The ethical and legal foundations of scientific “Conflict of interest”. In T. Lemmens & D. R. Waring (Eds.), Law and ethics in biomedical research: regulation, conflict of interest, and liability (pp. 63–81). Toronto: University of Toronto Press.
Law Yuen Han. (2012). Public Health in Pre-War Singapore: The development of hospital services and medical education. In L-P. Bu, D. H. Stapleton, & K-C.Yip (Eds.), Science, public health, and the state in modern Asia (pp. 33–50). New York: Routledge.
Lien Centre for Palliative Care, Duke-NUS Graduate Medical School (Coordinating Body), Report on the National Strategy for Palliative Care, 4 October 2011
Lim, C. A.-C. (2010). Life and death: A decade of biomedical law making 2000–2010. Singapore Academy of Law Journal, 22, 850–881. at 860–861.
Lum, S. (2012). Doctors gave liposuction patient too much sedative: Coroner. The Straits Times, 5 January 2012.
Ministry of Community Development, Youth and Sports, Protecting Children in Singapore, October 2005
Office of Public Guardian, Code of Practice: Mental Capacity Act 2008. Singapore: Ministry of Community Development, Youth and Sports, 2008.
Pang, M. (2012). MOH accepts national palliative care strategy report, The Straits Times, 5 January 2012.
Stirrat, G. M., Johnston, C., Gillon, R., Boyd, K., on behalf of the Medical Education Working Group of the Institute of Medical Ethics and associated signatories. (2010). Medical ethics and law for doctors of tomorrow: the 1998 Consensus Statement updated, Journal of Medical Ethics 2010; 36:55–60
Tan, J. O.-A., & Chin, J. J.-L. (2011). What doctors say about care of the dying. Singapore: The Lien Foundation.
Traditional Chinese Medicine Practitioners Board. (2006). Ethical code and ethical guidelines for TCM practitioners, March 2006.
W-lC, H. (2010). Safeguarding the integrity of scientific research – build a Maison à Colombage. Singapore Academy of Law Journal, 22, 994–1022.
Singapore Statutes and Regulations
Singapore Statutes and Regulations. (1985a). Medical (Therapy, Education and Research) Act, Cap 175, Rev Ed.
Singapore Statutes and Regulations. (1985b). Termination of Pregnancy Act, Cap 324, Rev Ed.
Singapore Statutes and Regulations. (1997). Advance Medical Directives Act, Cap 4A, Rev Ed.
Singapore Statutes and Regulations. (1999a). Civil Law Act, Cap 43, Rev Ed.
Singapore Statutes and Regulations. (1999b). Private Hospitals and Medical Clinics Act, Cap 248, Rev Ed.
Singapore Statutes and Regulations. (2000). Medicines (Clinical Trials) Regulations RG 3, Rev Ed.
Singapore Statutes and Regulations. (2001a). Children and Young Persons Act, Cap 38, Rev Ed
Singapore Statutes and Regulations. (2001b). Traditional Chinese Medicine Practitioners Act, Cap 333A, Rev Ed.
Singapore Statutes and Regulations. (2003a). Infectious Diseases Amendment Bill 2003, Bill No. 10/2003
Singapore Statutes and Regulations. (2003b). Infectious Diseases Act, Cap 137.
Singapore Statutes and Regulations. (2004a). Medical Registration Act, Cap 174, Rev Ed.
Singapore Statutes and Regulations. (2004b). Human Cloning and Other Prohibited Practices Act, Cap 131B, Rev Ed.
Singapore Statutes and Regulations. (2004c). Human Organ Transplant Regulations No. S 213, Rev Ed.
Singapore Statutes and Regulations. (2005). Human Organ Transplantation Act, Cap 131A, Rev Ed.
Singapore Statutes and Regulations. (2008a). Infectious Diseases (Amendment) Bill No. 5/2008.
Singapore Statutes and Regulations. (2008b). National Registry of Diseases Act, Cap 201B, Rev Ed.
Singapore Statutes and Regulations. (2010). Mental Capacity Act, Cap 177A, Rev Ed.
Singapore Statutes and Regulations. (2011). Tobacco (Control of Advertisements and Sale) Act, Cap 309, Rev Ed.
Legal Cases
Gillick v West Norfolk & Wisbech Area Health Authority & Another. (1985). 3 All ER 402.
Lim Poh Eng v Public Prosecutor. (1999). 2 SLR 116.
Wang Chin Sing v Public Prosecutor. (2009). 1 SLR 870.
Lim Mey Lee Susan v Singapore Medical Council. (2011). SGHC 133.
Huang Danmin v Traditional Chinese Medicine Practitioners Board. (2010). 3 SLR 1108.
Bioethics Advisory Committee
Bioethics Advisory Committee. (2002a). Ethical, legal and social issues in human stem cell research, reproductive and therapeutic cloning, June 2002.
Bioethics Advisory Committee. (2002b). Human tissue research, November 2002.
Bioethics Advisory Committee. (2004). Research involving human subjects: Guidelines for IRBs. Singapore: Bioethics Advisory Committee, November 2004.
Bioethics Advisory Committee. (2005). Genetic testing and genetic research, November 2005.
Bioethics Advisory Committee. (2007). Personal information in biomedical research, May 2007.
Bioethics Advisory Committee. (2008). Donation of human eggs for research, November 2008.
Bioethics Advisory Committee. (2010). Human-animal combinations in stem cell research, September 2010.
Ministry of Health
Ministry of Health. (1999). Singapore guideline for good clinical practice, September 1999.
Ministry of Health. (2006a). Directive 1A/2006: BAC recommendations for biomedical research, 18 January 2006.
Ministry of Health. (2006b). Directives for private healthcare institutions providing assisted reproduction services: Regulation 4 of the private hospitals and medical clinics regulations (Cap 248, Reg 1), March 2006.
Ministry of Health. (2007a). Clinical practice guidelines (Dementia).
Ministry of Health. (2007b). Operational Guidelines for Institutional Review Boards. Singapore: Ministry of health (Biomedical Research Regulation Division), December 2007.
Ministry of Health. (2009a). Code of ethical practice in human biomedical research. Singapore: Ministry of Health, April 2009.
Ministry of Health. (2009b). Licensing Terms and Conditions on Hospital Ethics Committee, 10 September 2009.
Ministry of Health. (2009c). Guidelines for ethical living donor organ transplantation.
Ministry of Health. (2010a). Healthy minds, healthy communities: National Mental Health Blueprint 2007–2011, December 2010.
Ministry of Health. (2010b)., Medifund for HIV patients, 15 January 2010.
Ministry of Health. (2011a). Update on the HIV/AIDS situation in Singapore 2010, 11 May 2011.
Ministry of Health. (2011b). HIV Update for World AIDS Day 2011, 28 November 2011.
Ministry of Health. (2011c). Clinical Practice Guidelines 4/2011 (Schizophrenia).
Ministry of Health. (2011d). Clinical Practice Guidelines 5/2011 (Bipolar Disorder).
Ministry of Health. (2011e). Clinical Practice Guidelines 6/2011 (Depression).
Ministry of Health. (2012a). More affordable intermediate and long-term care services to help Singaporeans Age-in-place, 20 February 2012.
Ministry of Health. (2012b). COS Speech for Minister Of State for Health – Community Health: Working with and through the Community for Better Health Outcomes.
National Medical Ethics Committee (Ministry of Health)
National Medical Ethics Committee (Ministry of Health). (1997). Ethical guidelines on research involving human subjects. Ministry of Health: Singapore, August
National Medical Ethics Committee (Ministry of Health). (2010). Guide for Healthcare Professionals on the Ethical Handling of Communication in Advance Care Planning, September 2010
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media Dordrecht
About this entry
Cite this entry
Ho, C.W.L., Chin, J.J.L., Campbell, A.V. (2014). Singapore. In: ten Have, H., Gordijn, B. (eds) Handbook of Global Bioethics. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2512-6_48
Download citation
DOI: https://doi.org/10.1007/978-94-007-2512-6_48
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-2511-9
Online ISBN: 978-94-007-2512-6
eBook Packages: Humanities, Social Sciences and Law