Healthcare decision-making at the end of life in South-East Asia: Ethical and legal perspectives

Patients, families and healthcare professionals often face ethically challenging choices at the end of life, and some of those choices may have been shaped by the law. Making healthcare decisions in the context of critical illnesses and end of life is challenging and can affect patients in many ways. As medical technologies have advanced, and with populations rapidly ageing in many countries, these challenges have become more acute. So, this thesis is about healthcare decision-making, especially at the end of life. The focus is on South-East Asia, and particularly Singapore, and attends to perspectives, and investigates and considers patient, family and recent legal developments for what should be good practice in this area.

The focus of Part I of this thesis is on the experience of healthcare decision-making in Singapore and South-East Asia more generally, where there are particular considerations including cultural, religious, and societal norms, and where death and dying are not usually discussed because they are taboo subjects. The laws, legal judgments and policy considerations in Singapore as they affect healthcare decision-making, and their consequential impact on medical practice will be the focus of Part II of this thesis. We conclude with a General Discussion in the final chapter that focuses on the key aspects of this thesis.