Codes of Practice for Healthcare Institutions Offering Novel Therapies

Mr Yip Hon Weng asked the Minister for Health in view of the recent case of a patient undergoing liver transplant shortly after cancer surgery (a) whether there are codes of practice for healthcare institutions presenting novel therapies; and (b) how long does a patient have to proceed with treatment after a novel therapy before being pronounced cancer-free.

Public healthcare institutions abide by MOH regulatory and services planning frameworks for the provision of clinical services. Medical practitioners are also bound by the Singapore Medical Council Ethical Code and Ethical Guidelines which stipulated that patients should be treated according to generally accepted methods, based on a balance of available evidence and accepted best practices.

Hence, any proposed novel innovative therapies will have to be assessed, balancing the available evidence for safety, efficacy and ethics, against accepted best practices. There must be professional consensus on the use of such novel therapies for the particular clinical situation should be sought from independent external experts and Clinical Ethics Committee, where appropriate.

Untested treatments that are not accepted as standard of care should only be offered under the strict context of research or clinical trial. These are subjected to MOH and HSA regulations and approval by institution’s ethics review committee and with informed consent from patients.

The term “remission” and “no evidence of disease” are commonly used to describe a clinical state where no evidence of cancer is currently detected in the body. Regardless of treatment type, patients will need to continue regular follow-up to screen for possible relapse, the frequency of which is based on clinical assessment and guidelines for specific cancers.