Although great strides have been made in treating cancers, a significant number of patients still reach the point at which no curative treatment is available. Physicians then face the difficult task of informing patients that, although palliation is always possible, cure is not. This article is available only as a...

The legacy of caring and humanitarianism has been the mission of the medical profession since the founding of Singapore by Sir Stamford Raffles in 1819. To this small fishing village in the Riau Archipelago on the southern tip of the Malay Peninsula came traders and entrepreneurs from China, India...

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 needed to ensure novel, effective therapies continue to be approved for clinical use. This article is available only as a PDF. Please click on “Download PDF”...

Placebo-trials on HIV-infected pregnant women in developing countries like Thailand and Uganda have provoked recent controversy. Such experiments aim to find a treatment that will cut the rate of vertical transmission more efficiently than existing ‘gold standard’ treatments like zidovudine. This article is available only as a PDF. Please click...

Are medicines dangerous chemicals or life enhancing agents? The answer is ‘Both of those things, often at the same time, and worse in the wrong hands’. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

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 and outcome. However, they have not specifically looked into such practice in the elderly. This article is available only as a PDF. Please click on “Download...

In the 1960s, some hospitals in the US set up special committees to review decisions regarding abortions, renal dialysis and human experimentation. As many of the decisions centred on the ethics of autonomy, rationing, or consent, these early ad hoc groups can be considered the forerunners of our present-day...

Dementia is an age-prevalent chronic degenerative disease that causes gradual and progressive deterioration of a patient’s cognitive abilities. With Singapore’s rapidly ageing population, the prevalence of dementia has been rising inevitably and steadily. This article is available only as a PDF. Please click on “Download PDF” on top to view...

For the past 25 years, professionalisation, industrialisation, large-scale infusions of technology into the healthcare system and consumerism, to name a few factors, have definitely contributed to changes in the healthcare environment. At the same time, society has moved from modernity to post-modernity with the adoption of pluralism, relativism and...

Allow me to thank you Mr President and your Council for asking me to deliver the 5th College of Physicians Lecture. Your President has suggested that with over 50 years of association with Medicine, the title be “In the Service of the Medical Profession”. This article is available only as...

Ms T was a single, 41-year-old Chinese female who had been diagnosed with schizoaffective disorder at the age of 21. Her illness was characterised by frequent relapses and admissions to hospital; the longest admission was for more than a year when she was 27 years old. This article is available...

“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 diseases are loosed upon this world with an ever increasing frequency in recent years, there is a corresponding need for us to come up with...

Innovative surgery is perhaps best defined as “a novel procedure, a significant modification of a standard technique, a new application of or a new indication for an established technique, or an alternative combination of an established technique with another therapeutic modality that is developed and tested for the first...

The concept of medical futility has been present since antiquity, and traditionally marked the shift in the primary goal of care to providing physical and emotional comfort. Only by following the declaration of futility could interventions be designed to relieve distress and pain for the patient, and bringing a...