A casebook that deals with the everyday ethical challenges of caring for the elderly is now online and available to anyone.
The open-access casebook is the second volume produced by the National University of Singapore (NUS) Yong Loo Lin School of Medicine's Centre for Biomedical Ethics, and was inspired by observations of one of the authors of the "moral distress" faced by medical professionals in end-of-life care while she was doing research for a report in 2011.
"Part of the solution was to come up with a resource that was free and open-access, to help healthcare professionals think through and reflect about their practices of care," said NUS Yong Loo Lin School of Medicine Associate Professor Jacqueline Chin, who developed the book with three other scholars.
The 10 case studies in Singapore Bioethics Casebook, Caring For Older People In An Ageing Society are about fictionalised characters, whose stories are based on real-life cases encountered by healthcare and community-care professionals.
For instance, one is of an ageing caregiver who worries about care for her mentally ill son. Another is of a hawker who is concerned about the safety of an old man he often sees alone at the hawker centre, but is unsure if he should intervene.
The cases are followed by commentaries from public-health experts and local healthcare and social-care professionals on how to make ethical decisions. There is also information on healthcare laws, among other things.
Prof Chin edited the book with Dr Michael Gusmano and Dr Nancy Berlinger from The Hastings Centre in the United States and Dr Michael Dunn from the Ethox Centre in Britain. They spoke to more than 180 professionals, including nurses, therapists and social workers, between July 2015 and May this year.
The case studies were then discussed with medical professionals to ensure they reflected actual challenges faced by the elderly and their caregivers.
According to the Department of Statistics, the proportion of Singapore residents aged 65 and above increased to 12.4 per cent last year, from 8.4 per cent in 2006.
"The signal importance of the Singapore casebook as a contribution to bioethics is its focus on the home and community contexts that are invisible to most healthcare professionals, but are where most people experience ageing and caregiving," said Dr Berlinger, a research scholar on healthcare ethics.
The authors are exploring plans to integrate the casebook into education for medical and social-work professionals.
Ms Doris Low, director of community relations at the non-profit organisation Tsao Foundation, welcomed it. "The Tsao Foundation is pleased to have been part of the publication as it's very useful for clinical training and it also leads the general reader to a more considered, multi-dimensional perspective of the lives of older persons and how we approach them," she said.
Caring For Older People In An Ageing Society can be accessed at www.bioethicscasebook.sg.