Parental Rights, Best Interests and Significant Harms in Medical Decision-Making on Behalf of Children

Abstract

A number of high profile cases in the United Kingdom (UK) concerning the withholding and/or withdrawal of medical (and in one case, experimental) interventions for infants occurred in close succession. These legal tussles have not escaped public attention in Singapore or Hong Kong. In the main English language newspaper in Singapore for instance, a journalist observed that Singapore has yet to have a test case of desperate parents fighting healthcare professionals in court to prolong treatment for their children, even though legal requirements are broadly similar in both countries. When parents (or guardians) and healthcare professionals disagree, English law is clear that doctors cannot be forced to treat nor can paediatric patients (through their parents or guardians) compel treatments. Although there is no explicit legal or judicial pronouncement in Singapore or Hong Kong, the position that is generally endorsed in professional regulations is effectively similar to that in English law. If an agreement cannot ultimately be reached between parents (or guardians) and healthcare professionals, the dispute may be taken to court, as in the UK. The absence of case law in Singapore or Hong Kong creates an opportunity to examine possible differences in the legal construction and application of best interests and other principles or requirements. In this presentation, I consider the following questions in the context of Singapore (and, to a more limited extent, Hong Kong): (1) What is the appropriate threshold for judicial intervention and its values? (2) What values and considerations do and should inform judicial decisions? Additionally, I broadly consider the extent that judicial responses to these questions are likely to be influenced by social forces and public perception.