Dear Editor, Mok et al. gave hope for cautious optimism for the acceptance of telemedicine for palliative care—which will be referred to as “telepalliative care” in this article—during the COVID-19 pandemic.1 Properly organised, telepalliative care can save time, provide flexibility, improve access for patients2,3 and possibly reduce the need for...

The origins of withholding medical support are found in ancient times. More than two millennia ago, Hippocrates (460 to 361 BC) stated that the role of medicine was “to do away with the suffering of the sick, to lessen the violence of their diseases, and to refuse to treat...

In the last decade, many countries have experienced alarming transformation in their demographic patterns, with the elderly population emerging as the fastest growing segment of the population. Owing to their generally poorer health status in terms of chronic illnesses and long-term disability, the elderly consume a disproportionate amount of...

Stroke is the fourth principal cause of death in Singapore, and the leading cause of long-term disability amongst developed countries. Due to the spiralling increase in healthcare expenditure in recent years, many countries have implemented cost-containing measures in healthcare financing. This article is available only as a PDF. Please click...

A syndrome of total functional dependence, poor mobility, lack of meaningful communication and incontinence of bowels and bladder appears to be the final common pathway for many neurodegenerative conditions such as the dementias, Parkinson’s disease (PD) and motor neurone disease (MND). In the United States, the National Hospice Organisation...

Health-related quality of life (QOL) is recognised as an important aspect of patient care. In oncology studies, it may stand as the primary end-point. Most QOL instruments are developed in English, although about one-fifth of the world’s population is ethnic Chinese. This article is available only as a PDF. Please...

With the introduction of block budget for acute care hospitals, cost containment is an important issue for all secondary and tertiary hospitals. Though health care cost was rising at a rate of 31.2% between the year 2002 and 2003, it is important to keep the cost of health care...

Around two-thirds of people with incurable diseases in economically developed countries wish to die at home, but less than one third succeed in doing so. Developing primary care-based services for the dying in the community is essential to reach and serve the whole population, and to provide care where...

Opioid use in terminally ill cancer patients at the end of life has been a source of concern amongst many for fear of its perceived life shortening effects, despite evidence to the contrary. This fear has, in fact, contributed to the reluctance in utilising these drugs to provide adequate...

Decisions regarding potential surgery for metastatic disease are influenced by estimates of patient survival. For example, patients with long life expectancy may be appropriately treated with extensive resection and durable reconstruction to provide long lasting function and mobility; in contrast, a patient with a very short life expectancy may...

Persisting disabilities from stroke lead to partial or total dependence for up to two-thirds of survivors. To improve mobility and to enable the recommencement of self-care activities, rehabilitation is essential. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

A hiccup is a result of an involuntary, intermittent spasmodic contraction of the diaphragm and the inspiratory intercostal muscles, resulting in a sudden inspiration and ends with an abrupt closure of the glottis. This article is available only as a PDF. Please click on “Download PDF” on top to view...

End-stage renal disease (ESRD) is reaching epidemic proportions and is increasingly a public health issue due to the cost of providing care to these patients. There are many kidney disease databases and registries tracking and studying trends in the epidemiology and care of ESRD patients. This article is available only...

Understanding the way personhood or “what makes you, you” is conceptualised is pivotal to the practice of medicine. Conceptions of personhood determine the moral and legal status of an individual, is central to the protection of rights and privileges and is pivotal to the maintenance of the distinctiveness of...

The management of schizophrenia has advanced considerably since the term was first coined in 1911, with Kraepelin’s early pessimism tempered by more recent evidence examining outcome. The discovery of antipsychotics represented a major breakthrough in the treatment of schizophrenia, while more recently we have witnessed promising initiatives such as...