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      President's Forum

New Initiatives In Medical Ethics

The healthcare system in Singapore has undergone rapid changes in recent years. The year 1985 was the watershed with the introduction of Medisave scheme to finance inpatient healthcare and the restructuring of the National University Hospital. The decade following saw the redevelopment and restructuring of our major public hospitals and the exponential expansion of our private specialist sector.

With the tapering of the growth spurt and the recent slowdown in the demand for healthcare due to the regional economic crisis, it is timely to re-focus on our core institutions and ethical values. The revision of the Act governing the Singapore Medical Council (SMC), the setting up of the National Medical Ethics Committee (NMEC), the move by the Ministry to introduce clinical guidelines are all moves in this direction.

On the ethical front, SMA has forged consensus on the issues of medical advertisements and profit guarantees in the past two years. It has also released position papers on ethical issues. "The Medical Profession and the Pharmaceutical Industries" and "The Principles and Practice of In-clinic Dispensing" are some of the examples.

Riding on that momentum, we would like to announce two new initiatives – the SMA Ethics Award 1999 and the setting up of a Centre for Healthcare Ethics and Practice.

The SMA Ethics Award aims to encourage and develop wider interest in issues concerning medical ethics among medical practitioners and undergraduates. The essay-writing competition is open to two categories: one exclusively for medical undergraduates, and the other for non-medical students. The Award consists of a cash prize of S$1000 each and a certificate, to be presented to the winners at the next SMA Ethics Convention. The winning essays will be published in the Singapore Medical Journal. The focus of the 1999 Medical Ethics Essay is on any ethical aspect of the doctor-patient relationship in the Singaporean context. The submitted essays of between 1500 to 2000 words must reach the SMA by 30 June 1999. Details are found on page N9 of this issue.

SMA is also looking into the possibility of setting up a Centre for Healthcare Ethics and Practice. The Centre aims to be a vehicle to foster formal education and research. It would also serve as a think-tank for the healthcare profession in the area of ethics and practice. It hopes to complement and work with statutory bodies such as SMC, NMEC and other professional bodies, both in Singapore and overseas. It could also study the ethical and practice implications of the new healthcare financing tools such as Casemix and managed care.

There is now a greater interest in ethical matters. We are pleasantly surprised that more than 100 doctors have attended the short course on medical ethics held on Sunday morning on 15 November 1998. These two new initiatives would build upon that ground swell. K