Singapore's Adult Guardianship Law and the Role of the Family in Medical Decision-Making

Singapore's adult guardianship law was derived from the Mental Capacity Act in England and Wales. This article explores the process of how Singapore's Mental Capacity Act was adapted and fine-tuned to operate in a jurisdiction with different cultural conditions, religions, familial norms, and social institutions. The first part of the article demonstrates that despite its apparent similarities, the policymakers in Singapore have omitted crucial portions of the Mental Capacity Act which deal with the human rights of persons lacking capacity. This omission is unsurprising considering Singapore's history of advancing an Asian values approach to human rights. In the second part, it will be demonstrated that Singapore's Mental Capacity Act has been interpreted by some healthcare professionals through the lens of relational autonomy in certain circumstances to accommodate a family-centric mode of decision-making. The appeal to relational autonomy may be explained on the centrality of the family in the lived reality of most persons in Singapore. In this regard, this article argues that a formal protocol should be drafted to guide healthcare professionals in navigating the tricky minefield of furthering a person's autonomy while recognizing the centrality of the family in certain contexts.