Healthcare Decision Making for Children in Singapore: The Missing Chapter in Comparison with English Law

Abstract

In medical practice, Singaporean paediatricians regularly encounter ethical dilemmas concerning the medical treatment of children and adolescents. While such disputes tend to be resolved out of court, it is useful to understand the legal framework for decision making in hard cases. Unlike in England and Wales where there is an abundance of litigation in this area and the law is well established, Singapore has a dearth of case law and a few discrete statutes regarding consent to medical treatment by children. Local legal resources on this subject are limited, and the differences between Singaporean and English law are not always made clear in medical guidance. Therefore, this article provides a comparative roadmap and seeks to answer key questions in Singaporean law on healthcare decision making for children, such as: Who can make decisions on their behalf? When can children give or refuse consent to treatment on their own? What is the threshold for judicial intervention in disputes concerning children’s medical care? How should ‘best interests’ be determined? This article identifies gaps and proposes ways that Singaporean law can develop by drawing inspiration from English judgments while making adaptations to the local context. It outlines situations when it is appropriate for the courts to decide cases concerning children’s medical treatment, notwithstanding the preference for alternative dispute resolution in Singapore.