Singapore

Treatment cannot be forced on unwilling

Why can't the authorities or health professionals authorise treatment on unwilling persons suffering from serious conditions?

In Singapore, patient autonomy is upheld by law.

There is a precedent in the case of Madam LP in 2006. A Singaporean woman suffering from diabetic gangrene refused to amputate her diseased leg until she went comatose in Mount Alvernia Hospital.

Doctors petitioned the court in the first of such a case here.

Justice Choo Han Teck ruled that the adult patient "was entitled to give or withhold consent to any medical treatment and doctors are obliged to respect that person's decision".

Why can't Mr Lim's sister give permission on his behalf, for his best interests?

In Madam LP's case, Justice Choo ruled that "No one else, however close by reason of kinship or friendship, was legally entitled to make that (medical) decision for the patient."

He also added: "The best interests of the family are not to be confused with the best interests of the patient."

But family members can apply to be appointed as deputies and make decisions of the patient under the Mental Capacity Act (MCA).

This applies only when the patient lacks the mental capacity "to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain."

But in Mr Lim's case, he has not been diagnosed with any mental condition and hence, the MCA does not apply.

Is it not enough that social workers already suspect that Mr Lim is also suffering from a mental illness?

To be deemed as mentally incapable, Mr Lim must be properly diagnosed by a certified mental health professional.

But to do so, he must give consent and cooperate with the assessment, which he has not done.

This is despite joint efforts from Care Corner Seniors Services (CCSS), National Healthcare Group and Institute of Mental Health, says CCSS' group director Grace Lee.