The doctor-patient relationship: A survey of attitudes and practices of doctors in Singapore

Bioethics

Volumn 14, Issue 1, 2000, Pages 58-76

  Chan, David ^a   Goh, Lee Gan ^a  

^a NATIONAL UNIVERSITY OF SINGAPORE   (Singapore)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; DOCTOR PATIENT RELATION; HUMAN; INFORMED CONSENT; MEDICAL DECISION MAKING; MEDICAL PRACTICE; PHYSICIAN ATTITUDE; SINGAPORE;

EMPIRICAL APPROACH; PROFESSIONAL PATIENT RELATIONSHIP;

ATTITUDE OF HEALTH PERSONNEL; CONFIDENTIALITY; DATA COLLECTION; DECISION MAKING; ETHICS, MEDICAL; HUMANS; INFORMED CONSENT; PATERNALISM; PATIENT PARTICIPATION; PERSONAL AUTONOMY; PHYSICIAN-PATIENT RELATIONS; PHYSICIANS; QUESTIONNAIRES; SINGAPORE; SOCIAL VALUES; TRUTH DISCLOSURE;

EID: 0343852118     PISSN: 02699702     EISSN: None     Source Type: Journal    
DOI: 10.1111/1467-8519.00180     Document Type: Article

References (20)

1. Gary B. Weiss, 'Paternalism Modernised', Journal of Medical Ethics, 1985, 11: 184-187; Robert M. Veatch, 'Models for Ethical Medicine in a Revolutionary Age', The, Hastings Center Report, 1972, 2: 5-7. Balint J. & Shelton W., 'Regaining the Initiative: Forging a New Model of the Patient-Physician Relationship', Journal of the American Medical Association, 1996, 275(11): 887-91, propose a patient-alliance based on mutual education of the physician and patient about health and illness, values and persons, social responsibility, beneficence, trust and a degree of paternalism.
2. Gary B. Weiss, 'Paternalism Modernised', Journal of Medical Ethics, 1985, 11: 184-187; Robert M. Veatch, 'Models for Ethical Medicine in a Revolutionary Age', The, Hastings Center Report, 1972, 2: 5-7. Balint J. & Shelton W., 'Regaining the Initiative: Forging a New Model of the Patient-Physician Relationship', Journal of the American Medical Association, 1996, 275(11): 887-91, propose a patient-alliance based on mutual education of the physician and patient about health and illness, values and persons, social responsibility, beneficence, trust and a degree of paternalism.
3. Gary B. Weiss, 'Paternalism Modernised', Journal of Medical Ethics, 1985, 11: 184-187; Robert M. Veatch, 'Models for Ethical Medicine in a Revolutionary Age', The, Hastings Center Report, 1972, 2: 5-7. Balint J. & Shelton W., 'Regaining the Initiative: Forging a New Model of the Patient-Physician Relationship', Journal of the American Medical Association, 1996, 275(11): 887-91, propose a patient-alliance based on mutual education of the physician and patient about health and illness, values and persons, social responsibility, beneficence, trust and a degree of paternalism.
4. Guo Z., 'Chinese Confucian Culture and the Medical Ethical Tradition', Journal of Medical Ethics, 1995, 21: 239-46.
5. Nor have we found any reports of a similar survey done in Western countries. We hope that the publication of this paper may lead to comparable data being produced in other countries.
6. Tom L. Beauchamp & James F. Childress, Principles of Biomedical Ethics, 4th edition (New York: Oxford University Press, 1994); R. Gillon, 'Medical Ethics: Four Principles plus Attention to Scope', British Medical Journal, 1994, 309: 184-8.
7. Tom L. Beauchamp & James F. Childress, Principles of Biomedical Ethics, 4th edition (New York: Oxford University Press, 1994); R. Gillon, 'Medical Ethics: Four Principles plus Attention to Scope', British Medical Journal, 1994, 309: 184-8.
8. We also asked some questions to gauge the doctors' satisfaction level and perceptions about the profession and its future in Singapore. These fall outside the scope of this report.
9. A further 1,653 were excluded from the sampling frame because their discipline was undefined in the gazette list.
10. Respondents to this question were permitted to choose more than one option. Percentages are calculated based on total number of respondents in each category.
11. See footnote 7 above.
12. The percentage of Christians among doctors is much higher than the percentage of below 20% among the general population of multi-racial and multi-religious Singapore.
13. In Singapore, the immediate family is contrasted with the extended family, and refers to the nuclear family consisting of parents and their children who live together as a household. In some cases, grandparents who live within a 3-generation household may also count as immediate family members, although in practice, doctors are unlikely to consider them as such unless more immediate family members such as parents, siblings, or adult children are unavailable. Grandparents, aunts, uncles, and siblings who do not stay together are relatives who count as part of the extended family, but not the immediate family.
14. The number of complaints made to the SMC against doctors in recent years, taken in relation to the number of practising doctors, are as follows (Year/Complaints/No, of Doctors): 7997/57/4912; 1996/66/4661; 1995/36/ 4495; 1994/54/4201; and 1993/60/4156. Over this five year period, there were on average 12.2 complaints per thousand doctors per year. [Source: 1997 Annual Report of the Singapore Medical Council (Singapore: SMC, 1998)]
15. E.g., Harrison's Principles of Internal Medicine, 14th edition, ed. T.R. Harrison & A.S. Fauci (New York: McGraw-Hill, 1998); Clinical Medicine: A Textbook for Medical Students and Doctors, 4th edition, ed. Parveen Kumar & Michael Clark (Edinburgh : W.B. Saunders, 1998).
16. E.g., Harrison's Principles of Internal Medicine, 14th edition, ed. T.R. Harrison & A.S. Fauci (New York: McGraw-Hill, 1998); Clinical Medicine: A Textbook for Medical Students and Doctors, 4th edition, ed. Parveen Kumar & Michael Clark (Edinburgh : W.B. Saunders, 1998).
17. E.g., American College of Physicians, 'Ethics Manual, 4th edition', Annals of Internal Medicine, 1998, 128(7): 576-94; British Medical Association, Philosophy & Practice of Medical Ethics, 1986; Journal Of Medical Ethics. The authors of this report are themselves working on the first medical ethics source-book designed for the local context in Singapore.
18. E.g., American College of Physicians, 'Ethics Manual, 4th edition', Annals of Internal Medicine, 1998, 128(7): 576-94; British Medical Association, Philosophy & Practice of Medical Ethics, 1986; Journal Of Medical Ethics. The authors of this report are themselves working on the first medical ethics source-book designed for the local context in Singapore.
19. E.g., American College of Physicians, 'Ethics Manual, 4th edition', Annals of Internal Medicine, 1998, 128(7): 576-94; British Medical Association, Philosophy & Practice of Medical Ethics, 1986; Journal Of Medical Ethics. The authors of this report are themselves working on the first medical ethics source-book designed for the local context in Singapore.
20. This paper is based on research funded by an Academic Research Grant from the National University of Singapore. Thanks are also due to Chan Sze Ling for her contribution as Research Assistant, and to those involved in gathering data for our survey, especially our unpaid volunteer, Agnes Tan. In addition, we wish to thank the editors of this journal for their helpful comments and suggestions.