Singapore

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.