Palliative Care in Selected Economies in Asia: Taiwan, Singapore and Hong Kong

Abstract

People are living longer nowadays. Medical advancement has helped to prolong lives and a lot of diseases are curable. However, patients with life-limiting and terminal illnesses still suffer. Palliative care is an approach to relieve pain and other distressing symptoms and gives psychological and spiritual support to patients, as well as their families. Patients who have received palliative care have a significant decrease in readmission rate and better quality of life. In Asia, Hong Kong, Singapore, Taiwan and South Korea are the developed economies once titled the “Four Asian Dragons”. They ranked differently in the 2015 Quality of Death (QOD) Index due to different development in end-of-life care. In this chapter, Taiwan, Singapore and Hong Kong, which ranked at number 6, 12 and 22, respectively, in the QOD Index, are selected to compare their resources on palliative services, advance directives (AD) policy and public awareness on palliative care. Taiwan has outperformed both Singapore and Hong Kong due to the government’s sufficient support in resources, diversified education opportunities to professionals and continuous efforts on improving legislations to protect patients’ autonomy. Singapore is following closely behind Taiwan’s progress in expanding palliative care services. Hong Kong is relatively lagging behind for failing to have comprehensive policies and legislation to increase public awareness and protect patients’ right on medical decisions. With the launched public consultation regarding AD legislation and expansion of end-of-life care, Hong Kong is targeting to follow closely with Singapore and Taiwan soon, and achieving a higher position in the QOD Index in the future. While dying in place is becoming an indicator of QOD, dying at home may not be suitable for every patient in terms of available resources at home and variation of patients’ needs. In parallel, rapid technology advancement facilitates the integration of palliative care and technology such as smartphone recording app and tracking bracelet. While keeping psychological and spiritual support as core components in palliative care, application of emerging technology to care and treatment could increase efficiency of care by conducting real-time assessment and preparation for more supportive services.