Sterilisation law to be updated

Planned changes include better protection for mentally disabled
By Poon Chian Hui, The Straits Times, 5 Jun 2012

THE law on sterilisation is to be updated after nearly 40 years, in a move that will give better protection to the mentally disabled.

It will aim to refine the process and the definition of who can give consent for a mentally-ill person to be sterilised.

This is one of three areas of the Voluntary Sterilisation Act that the Health Ministry is looking at changing.

The other two are:

Raising the fines for breaching patient confidentiality and forcing a person to get sterilised, to a maximum of $10,000. The current cap for the two offences is $2,000 and $5,000 respectively;

Removing the need for health- care institutions to seek approval from the Health Minister to perform the surgery.

But before any changes are made, the Health Ministry will seek feedback from the people to ensure the Act 'remains relevant and reflects the changing of the times', it said yesterday.

People can give their views to the Health Ministry from now till July 2. They can do so on an online form, via e-mail to moh_info@moh.gov.sg or a letter mailed to its office at 16 College Road, addressed to the marketing communications branch.

The Act, last revised in 1974, was introduced in 1970 to protect the rights of people seeking sterilisation for the purposes of family planning.

But in 2010, with the Mental Capacity Act coming into force, it became necessary for the two laws to have the same definition of when one can give consent.

Under the sterilisation law, the parent, guardian or spouse of anyone defined to be 'afflicted with any hereditary form of illness that is recurrent, mental illness, mental deficiency or epilepsy' can give the go-ahead for the surgery to be performed on the person.

This is too broad a definition, said the ministry, as some of those afflicted are capable of giving consent as defined in the Mental Capacity Act.

The ministry also wants to introduce an additional safeguard: a doctor has to certify that sterilisation is necessary in the person's best interests.

The planned updates would also bring the law in line with the United Nations Convention on the Rights of Persons with Disabilities.

Altogether, 103 nations have ratified it and Singapore will do so this year, said a ministry spokesman.

The ministry's move has been welcomed by doctors and others in the medical sector.

Urologist Lewis Liew said formalising the consent process into law helps protect doctors.

'It makes it more obvious what we can and cannot do, such that we don't run into any objections or legal problems.'

As for letting licensed hospitals, ambulatory surgical centres and specialist clinics carry out the sterilisation procedures without prior approval from the Health Minister, the spokesman explained that, since 1993, all health-care institutions have been licensed.

While it will open the door wider for more specialists to do the procedures, it is unlikely that standards will suffer, said Dr Fong Yoke Fai, who heads the Obstetrical and Gynaecological Society of Singapore.

'It's a necessary part of our specialist training, so all should be able to perform the procedure, which is not complicated,' he added.

Mr Wee Lin, chairman of Sunlove Abode for Intellectually Infirmed, a shelter for the mentally ill, said the changes will give these people more say as many of their parents - fearing their child will get pregnant or father a child inadvertently - prefer to have them sterilised.

'But what if the person gets better? Sometimes, there can be miracles and it will be quite horrible for the person because the surgery is usually irreversible,' he said.


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