Session 1: Medical Advice: Implementing Hii v Ooi
The landmark decision Hii Chii Kok v Ooi Peng Jin London Lucien and Another has greatly shifted the legal standard for medical advice in Singapore. Previously, what information needed to be disclosed depended on what reasonable medical professionals would deem pertinent. Now, Singapore’s Supreme Court has endorsed a modified version of the Montgomery-standard, where disclosure depends on what a reasonable patient would find material, or what the doctor knows is important to that particular patient. Notably, the SMC’s Ethical Code and Ethical Guidelines recently endorsed a similar position. This session will reflect on Singapore’s shift towards a more patient-centric position in providing medical advice.
Session 2: Innovative Interventions
The line between medical care and research are becoming increasingly blurred, especially as patients become increasingly aware of the latest healthcare innovations. When standard of care is failing, they or their physicians may turn to unproven interventions. At the same time, we need to guard against desperation interfering with sound decision-making. This session will look at cases involving referrals for ‘compassionate use’ of unproven, experimental interventions, where there must be a balance between empowering patients and avoiding exploitation of their vulnerability.
Session 3: Foreign Workers
Singapore has a large foreign worker population, one that helps sustain its growth and quality of life. When such workers fall sick, healthcare professionals may face particular dilemmas surrounding consent and standards of care. For example, workers on work passes may rely on their employers to coordinate care and communicate their situation, but the employers are conflicted: they are liable for medical expenses exceeding the insurance cap. This session will emphasise the need for healthcare professionals to respect boundaries and the norms of informed consent when treating foreign workers, while being cognizant of the realities of the patient’s situation that may legitimately affect care decisions.
Session 4: Frailty and Chronic Care
As Singapore’s population ages, an increase in frailty and chronic care is inevitable. Such patients are in a precarious position: they are greatly dependent upon health professionals and may have limited physical autonomy. In light of this vulnerability, clinical ethics committees have a role to play in ensuring proper care and respect in cases involving the chronic care of frail and dependent patients. This session will discuss the particular challenges of chronic care, and the ways professionals can address and overcome those challenges.