When Giants Meet—a Discourse on Contemporary
and Alternative Therapy Use from an Ethical Perspective
Cindy Shiqi Zhu
Wee Lee Chan
Received: 29 November 2017 /Accepted: 7 May 2018 /Published online: 29 May 2018
National University of Singapore and Springer Nature Singapore Pte Ltd. 2018
Abstract In Singapore’s multicultural society, a sizable proportion of the population subscribes
to complementary and alternative medicine (CAM). In this article, we discuss the impact this has
on medical practice in the context of the four principles of medical ethics. To uphold the principle
of autonomy, we propose a non-judgmental approach towards patients who use CAM. Never-
theless, in order to promote health (beneficence) and prevent harm (non-maleficence), the safety
profiles of CAM must be studied through systematic research. In addition, the principle of justice
is one concerned with the fair distribution of scarce healthcare resources, while granting equal
access to healthcare regardless of beliefs. Understanding CAM from an ethical perspective
allows for the provision of safe, holistic, and culturally relevant care.
Keywords Complementary and alternative medicine
Chinese medicine (TCM)
Singaporeans enjoy a number of excellent health indicators, including the world’sfourth
longest life expectancy of 83.3 years (UN 2017b) and the sixth lowest infant-mortality
rate of 1.843 per 1000 live births (UN 2017a). Many of Singapore’s healthcare initiatives
have been applauded as success stories, including the Tuberculosis Elimination Program
(Chee and James 2003) and the National Child Immunization Program (Liew et al.
2010). While Singapore is at the forefront of modern medicine, many forms of comple-
mentary and alternative medicine are being practiced in this city-state.
Asian Bioethics Review (2018) 10:157–163
Cindy Shiqi Zhu and Wee Lee Chan contributed equally to this work.
* Cindy Shiqi Zhu
* Wee Lee Chan
Duke-NUS Medical School, 8 College Road, Singapore, Singapore