Best interests determination within the Singapore context

Area of Science:

• Medical Sociology
• Cultural Anthropology
• Bioethics

Background:

• Familialism, emphasizing family-centric care and filial piety, significantly influences Singaporean healthcare.
• This cultural mindset often prioritizes collective family decisions over individual autonomy in care provision.
• The traditional physician-led model faces challenges due to complex psychosocial, political, and cultural factors in Singapore.

Purpose of the Study:

• To investigate the challenges of familialism and physician-led care in Singapore.
• To propose an alternative decision-making process for end-of-life care.
• To align care practices with the patient-centered ethos of palliative care.

Main Methods:

• Critical analysis of existing care provision models in Singapore.
• Exploration of psychosocial, political, and cultural influences on healthcare decisions.
• Development of a multidisciplinary team approach framework.

Main Results:

• The study identifies limitations in applying purely familial or physician-led models in complex Singaporean contexts.
• A multidisciplinary, multiprofessional approach is presented as a viable alternative.
• This approach is deemed more congruent with palliative care principles.

Conclusions:

• A shift towards a multidisciplinary team approach is recommended for Singaporean end-of-life care.
• This model better supports holistic, coherent, and sensitive palliative care.
• It offers a more inclusive and patient-centered alternative to prevailing practices.