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A Descriptive Study of the Demography, Symptomology, Management and Outcome of the First 300 Patients Admitted to an Independent Hospice in Singapore

Modern society views death as an aberration which has to be postponed and, if possible, prevented at all cost. Death is just unacceptable and...

Experience with a Nine-step Policy Dealing with Requests for Medically Inappropriate Interventions for Cancer

Although great strides have been made in treating cancers, a significant number of patients still reach the point at which no curative treatment is...

9th Chapter of Surgeons’ Lecture: The Orthopaedic Surgeon: Historical Perspective, Ethical Considerations and the Future

The legacy of caring and humanitarianism has been the mission of the medical profession since the founding of Singapore by Sir Stamford Raffles in...

Design of Phase I and II Clinical Trials in Oncology and Ethical Issues Involved

Drug development is costly and time-consuming in terms of economic, patient and research resources. An integrated effort involving academia, industry, and regulatory authorities is...

Evaluating Drugs from Cradle to Grave—Evolving Systems for a Complex Activity

Are medicines dangerous chemicals or life enhancing agents? The answer is ‘Both of those things, often at the same time, and worse in the...

The Practice of Foregoing Life Support in the Critically Ill “Old Old”: A Singapore Perspective

Studies on the foregoing of life support (FLS) in North America, Europe and Australia have shown diversity in terms of the incidence, decision-making process...

End-of-life Care: Challenges and Obligations in Setting Limits to Life-sustaining Therapy

A patient with recurrent stroke disease and severe pneumonia did not respond to the previous courses of antibiotics. The medical team decided to switch...

5th College of Physicians Lecture – A Physician’s Odyssey: Recollections and Reflections

Allow me to thank you Mr President and your Council for asking me to deliver the 5th College of Physicians Lecture. Your President has...

Pathological Pulmonary Hernia in a Patient With Metastatic Breast Cancer

Pulmonary hernia is a rare and uncommon clinical entity that has been defined as a protrusion of pleural membranes or lung parenchyma through the...

Internationally, it is Time to Bridge the Gap between Primary and Secondary Healthcare Services for the Dying

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...

Characteristics of unplanned hospitalisations among cancer patients in Singapore

Cancer is a pervasive global problem with growing healthcare utilisation and costs.1-3 This situation is similar in Singapore where cancer incidence is on the...

Opioid Use amongst Cancer Patients at the End of Life

Opioid use in terminally ill cancer patients at the end of life has been a source of concern amongst many for fear of its...

Maternal and Fetal Best Interests in Day-to-Day Obstetrics

When we discuss maternal and fetal best interests in an ethical context, we have to deliberate on the morality of healthcare, including the morality...

The Ethics of Responding to a Novel Pandemic

“A man without ethics is a wild beast loosed upon this world.” -Albert Camus (1957 Nobel Prize for Literature) As the microscopic ‘wild beasts’ of infectious...

An Approach to the Ethical Evaluation of Innovative Surgical Procedures

Innovative surgery is perhaps best defined as “a novel procedure, a significant modification of a standard technique, a new application of or a new...

Telemedicine for palliative care: Current and future challenges

Dear Editor, We read with interest the article published in the June 2021 issue of the Annals titled “Use of telemedicine in healthcare during COVID-19...

How do English-speaking Cancer Patients Conceptualise Personhood?

Understanding the way personhood or “what makes you, you” is conceptualised is pivotal to the practice of medicine. Conceptions of personhood determine the moral...

Nation-Wide Observational Study of Cardiac Arrests Occurring in Nursing Homes and Nursing Facilities in Singapore

Out-of-hospital cardiac arrest (OHCA) is a significant public health problem in Singapore and from around the world. Between 2010–12, local OHCA patients with a...