About the Project

A Singapore Bioethics Casebook, Volume II features 10 cases under the theme of Caring for Older People in an Ageing Society, developed in consultation with over 180 healthcare and social care professionals from 40 organisations serving the healthcare, rehabilitation and social care needs of older people living at home or in residential group care settings in Singapore. This enriches an earlier collection of 12 cases under the theme of Making Difficult Decisions with Patients and Families. The 12 cases in the first volume focused on the clinical context of decision-making, and were developed in collaboration with over 70 physicians and allied healthcare professionals to guide professionals in understanding key ethical challenges in the care of patients at the end of life and in other complex life-limiting circumstances. The cases in the second volume guide professional and non-professional caregivers and other readers in understanding care needs and care transitions for chronically-ill people in an ageing society.

Each case is supported by expert commentaries highlighting ethical issues and a perspective by a Singaporean healthcare or social care professional offering practical insight. Additional support is provided by informational backgrounders, a glossary of terms, and a teaching and learning guide.

A Note on the 2017 Website: Designed to be easy to use in formal and informal teaching and learning in clinical departments and broader care settings, users reviewing the website have found it to be simple to navigate, with case studies that can be printed in a single click, and a video for setting up ways of approaching ethics discussions with classes and clinical groups. This web-based resource is an open-access work, freely available to interested readers everywhere. Written in an accessible style that reaches out to professional and lay audiences, this team hopes that it may also serve as a platform for public, patient and policy education in healthcare and social care ethics.

The original website was designed and created in 2014 by Jacob Moses, a former Director of New Media at The Hastings Center. In the 2017 Website produced by Chee Soo Lian with designer Drake Lim, the 12 cases and commentaries in Making Difficult Decisions with Patients and Families have been updated, and linked to new and revised background essays and an updated topic list in the ‘Browse by Topic’ section. The 10 new cases reflecting healthcare and social care obligations in increasingly integrated care settings in Singapore have been skilfully incorporated to enhance the website’s continuity, functionality, and ease of navigation. The Teaching and Learning Guide has been enhanced in the 2017 edition of the Casebook to ensure that components that support teaching and learning (e.g. the ABC toolbox for ethical thinking) are user-friendly and presented in ways that reflect the different practice settings in which people teach and learn about health care and social care ethics. This includes, for example, leading a teaching session for colleagues, facilitating a group discussion with colleagues, or simply learning in one’s own time.

Nancy Berlinger drafted the case narratives, and Michael Dunn revised the Teaching and Learning guide for the 2017 edition. Several persons provided expert guidance and reviewed material on healthcare and long-term care financing, medical law, culture and communication in the Singapore healthcare and community care contexts, including Gerald Koh, Joanne Yoong, Andy Sim, Tracey E Chan, Chan Wing Cheong, Ng Wai Chong, Wong Loong Mun and Lee Lay Beng. The following individuals provided invaluable advice and knowledgeable contacts: Thomas Wee, Joseph Leong, Marcus Tan, Low Mui Lang, John Gee, Peh Kim Choo, Keith Lee, Neo Han Yee, Christopher Lien, Philip Yap and Noreen Chan.

We are grateful to the individuals who reviewed the case materials and commentaries and provided invaluable feedback, and particularly thank Matthew Chen and Owen Schaefer. We thank Theodora Kwok, Rosnizah Mohd Ali and Khoo Xuening for kind and detail-minded administrative assistance.

We thank the following institutions and teams consulted:

  • Agency for Integrated Care
  • Alexandra Health System
  • All Saints Home
  • AMKFSC Community Services
  • Ang Mo Kio – Thye Hua Kwan Hospital
  • Apex Harmony Lodge
  • Asian Women’s Welfare Association
  • Bright Hill Evergreen Home
  • Caregivers Alliance Limited
  • Centre For Seniors
  • Changi General Hospital (Transition Care)
  • Eastern Health Alliance
  • Institute of Mental Health
  • Jamiyah Nursing Home
  • Jurong Community Hospital
  • Jurong Health
  • Khoo Teck Puat Hospital
  • Lien Foundation
  • National Healthcare Group Polyclinics
  • National University Hospital (Palliative Care)
  • National University Hospital Residency Programme
  • National University Hospital (Transitional Care)
  • National University of Singapore Faculty of Law
  • NTUC Health
  • NTUC Health (Cluster Support)
  • Peacehaven Salvation Army Nursing Home
  • Peacehaven Salvation Army Bedok Multiservice Centre
  • Sathya Sai Social Service (4S)
  • Sengkang Health
  • Singapore Anglican Community Services
  • Singapore Christian Home
  • Singapore General Hospital
  • St Andrew’s Nursing Home
  • St Andrew’s Community Hospital
  • St Luke’s Hospital
  • St Luke’s Eldercare
  • Tan Tock Seng Hospital
  • Thye Hua Kwan Moral Charities
  • Transient Workers Count Too
  • Tsao Foundation Hua Mei Centre for Successful Ageing